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Physician Assisted Suicide (PAS)

Timeline of U.S. and international
developments from the year 2000 to now
:

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The listing below are brief overviews of Physician Assisted Suicide
developments federally, in various states, and other countries.

Detailed activity in California, Oregon and Washington state are described in separate essays

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law books and gavel Year 2000: Status in the U.S.

Within North America (Canada, the United States, and Mexico), only the state of Oregon had a law passed by the Legislature that legalised Physician Assisted Suicide (PAS). That law became effective in 1997.

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Subsequent developments, year 2000 to now:

  • 2000-JAN-11: California: The California legislature was scheduled to consider a "Death with Dignity Act." The law in California currently allows adults of sound mind to "execute a declaration governing the withholding or withdrawal of life sustaining treatment." The proposed law would go further by allowing a person under severely restricted circumstances to obtain "medication for the purpose of ending his or her life in a humane and dignified manner." Doctors would have immunity from civil or criminal actions as long as they participated "in good faith compliance with the act." The act was rejected by the Legislature on FEB-3.

  • 2001-NOV-5: USA: Attorney General attempted to override Oregon's law: The federal Attorney General John Ashcroft wrote a letter to Asa Hutchinson, chief of the Drug Enforcement Administration. He declared that assisting a terminally ill patient to commit suicide is not a "legitimate medical purpose" for federally controlled drugs. He said that any physicians who use drugs to help patients die face suspension or revocation of their licenses to prescribe federally controlled drugs. A court injunction was obtained to block Ashcroft's initiative. More details.

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  • 2002-MAY: HawaiI: Physician assisted suicide bill rejected: The "Death with Dignity Act," HB 2487, was passed by a House committee in late 2002-FEB. It would have allowed "a terminally ill, competent adult to obtain a prescription for medication to end his or her life in a humane and dignified manner through a self-administered oral lethal dose. [The bill] Prohibits mercy killings, lethal injections, and active euthanasia." Senator David Matsuura the chairperson of the Senate Health Committee, personally disagreed with the bill, and refused to allow it to be voted upon by his committee. In a surprise move, the Senate overruled Matsuura by voting to pull the bill out of the Health Committee. HB 2487 was debated on 2002-MAY-2, but was defeated by a margin of one vote on the next day. More details.

  • 2002-JUN-30: USA: NRLC expands mandate: The National Right to Life Committee was organized in 1972 to restrict or eliminate abortion access.  They decided at their Pittsburgh PA convention, (held JUN-27 to 29), to expand their mandate to include seeking bans on human embryo stem-cell research, physician-assisted suicide, and human cloning. 1

  • star 2002-SEP-22: Belgium: A PAS law, "Termination of Life on Request and Assisted Suicide Act" that legalized PAS became effective.

  • 2004-MAY: Oregon: Federal Attorney General Ashcroft loses court case: U.S. Attorney General John Ashcroft had challenged Oregon's assisted suicide law in the Ninth Circuit Court of Appeals. He argued that physicians who prescribed lethal medications were in contravention of the federal Controlled Substances Act. By a vote of 2 to 1, a three judge panel disagreed, ruling that the regulation of medical practice is a state matter and is outside the jurisdiction of the federal government.

  • 2004-JUL-20: Ashcroft asks for review: John Ashcroft asked that the May decision of its three-judge panel be reviewed by at least 11 judges. His request was denied in August after most of the 25 judges on the court voted against a review.

  • 2004-AUG: Oregon: Results of pain study: Researchers at the Oregon Health & Science University (OHSU) conducted a survey of the level of pain among 1,724 patients in Oregon, as subjectively perceived by family members of the patient, not the patients themselves. They found that since assisted suicide became available, pain has apparently increased. Conservative Christian and secular media disagree about the cause. More details.

  • 2004-NOV-09: Oregon: Ashcroft requested appeal of Oregon's assisted suicide law: U.S. Attorney General John Ashcroft asked the U.S. Supreme Court to review the decision by the 9th U.S. Circuit Court of Appeals which ruled that the federal government cannot regulate medical practice by preventing physicians from prescribing lethal medication to persons who want to commit suicide under Oregon's assisted suicide law.

  • 2005-MAR-30: Vermont: Physician assisted suicide bill proposed: A bill was introduced into the Vermont legislature during 2004 to legalize physician assisted suicide. It was patterned after the Oregon law which had been in place for six years. The bill was not acted upon. It was reintroduced in 2005-FEB and has a possibility of being examined by legislative committees during 2005-APR. A Xogby poll conducted in 2004-DEC showed that 78% of 500 randomly selected adults said that they would support a bill to allow terminally ill patients to get medication from their physicians to hasten death. The bill is opposed by an group of physicians and religious organizations called the Vermont Alliance for Ethical Healthcare. They have put forward the slippery slope argument: they are concerned that the bill could lead to abuses, and eventually to mandatory euthanasia. The Alliance's president, Dr. Robert Orr, said: "The biggest concern is the expansion of the criteria and the abuses that have been increasingly evident" in the Netherlands, where euthanasia is legal. The bill is being promoted by Death With Dignity Vermont. One of its founders is Dick Walters, 79, a retired merchandise manager for retail department store chains, who was troubled during the death of his father. He said: "He asked me to help him, and there was nothing I could do. It frustrated me." He was jointed by Dr. Richard Austin, 82 who said: "I've seen some of my friends here die rotten deaths." He doesn't want to die a similar death. They were joined by another doctor, Carmer Van Buren, 77 who was initially troubled by the concept of helping a patient die. But he concluded that hastening death for the terminally ill "is not suicide."

    Nancy Dubler, a professor of bioethics at the Montefiore Medical Center in New York said that without a law: "people of a certain education and class and profession will have access to it when others will not. [Oregon] "has demonstrated that it's socially and morally responsible, socially and morally possible to have a physician-assisted suicide program." However, she has reservations. She added: "I fear if you take a program like Oregon's to a place like California or New York you may get less admirable results." 2

  • 2005-MAR-31: Florida: Terri Schiavo died: During 1990, when she ws 26 years-of-age, the supply of oxygen to her brain was stopped temporarily. She was left in a vegetative state. Her husband advocated removal of her feeding tube in 1998. After seven years of battles in the Florida Legislature and Courts, the tube was removed. She died 13 days later. An autopsy later revealed that, contrary to her parents' beliefs, she "was in a persistent vegetative state. ... she had massive and irreversible brain damage and was blind." 7

  • 2005-OCT-05: Oregon: U.S. Supreme Court hears arguments on Oregon's law: Oral arguments will be heard by the U.S. Supreme Court in its first assisted suicide case since 1997 -- Gonzales v. Oregon. In 2001, U.S. Attorney General John Ashcroft issued a directive stating that: "Assisting suicide is not a 'legitimate medical purpose'....and that prescribing, dispensing, or administering federally controlled substances to assist suicide violates the federal Controlled Substances Act." So far, courts have decided that the federal act does not restrict the behavior of physicians. 3

    The Family Research Council, a fundamentalist Christian advocacy group, filed an Amicus Curia brief in favor of preventing Oregon doctors from engaging in physician assisted suicide. 4

  • 2006-JAN-17: U.S.: Supreme Court upholds Oregon's law: In the case Gonzales v. Oregon, the U.S. Supreme Court ruled by a 6 to 3 vote that in 2001 John Ashcroft had incorrectly interpreted the Controlled Substances Act of 1970 -- a law originally intended to fight illegal drugs. Justice Anthony Kennedy issued the ruling for the majority. He wrote, in part:

    "It is difficult to defend the attorney general's declaration that the statue impliedly criminalizes physicians-assisted suicide."

    As expected, the strict constructionist judges on the Court -- Justice Antonin Scalia, Justice Clarence Thomas, and Chief Justice John Roberts -- dissented.

Reuters News Agency stated:

"White House spokesman Scott McClellan said the Justice Department was reviewing the ruling. Both sides predicted the decision likely will lead to more states adopting assisted suicide laws." 5

  • 2008: Oregon: The Oregon Department of Human Services collected data associated with the state's PAS law between 1998 and 2007. The New England Journal of Medicine reported that Oregon:

    "... physicians wrote a total of 541 prescriptions for lethal doses of medication (almost always secobarbital or pentobarbital), and 341 people died as a result of taking the medications. Thirteen patients who had received prescriptions were alive at the end of 2007, and the rest of those who received prescriptions ultimately died of their underlying disease. The group of patients who died after ingesting a lethal dose of medication had a median age of 69 years, almost all were white and relatively well-educated, and the group consisted of slightly more men than women, according to data collected by the About 86% were enrolled in hospice programs, and 81.5% had terminal cancers." 9

  • star 2008-FEB-19: Luxembourg: The Parliament of Luxembourg passed a law that covered living wills and legalized physician-assisted suicide and euthanasia. It became effective on 2009-MAR-16. The law became effective on 2009-MAR-04. This made PAS avaialble in four locations around the world:
    • Belgium, the Netherlands, and Switzerland in Europe, and
    • The state of Oregon in the U.S. 9

The practice is technically illegal elsewhere in the world, but is frequently performed as an underground practice in secret, both by medical professionals, and relatives of the person seeking an end to their life.

  • star 2008-NOV: Washington State: Voters passed a plebiscite that legalized PAS. The vote was 58% to 42%. The Washington Death with Dignity Act was patterned after Oregon's law that was made effective in 1997-OCT. The law in Washington became effective in 2009-MAR-04. PAS is illegal elsewhere in North America (the rest of the U.S., Canada, and Mexico).

  • star 2013 Vermont: VT Statutes 5281 to 5293 in Chapter 113 "Patient Choice at End of Life" cover the PAS law in Vermont, which was passed by the state Legislature and became effective on 2013-MAY-20. Minor amendments were made in 2015-MAY.

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2015-DEC: Status of PAS in the United States:

  • Physician Assisted Suicide (PAS) is available -- or will be avaailable in the future when laws become effective -- in five states:
    • Governors in four states -- California, Oregon, Vermont, and Washington state -- have signed physician assisted suicide bills into law.

    • It was legalized by a court decision in Montana.

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Information sources on Physician Assisted Suicide:

The U.S. public, faith groups, and advocacy groups are severely divided on matters related to physician assisted suicide. Some of the web sites dealing with this topic are:

We recommend that you access multiple sites, in order to to understand all sides to the issue.

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References used:

  1. Jim Rudd, "National Right to Life's Deception," at: http://covenantnews.com/rudd020701.htm
  2. Joh Schwartz & James Estrin, "In Vermont, a Bid to Legalize Physician-Assisted Suicide," Gadsden Times, (Alabama), 2005-MAR-30, at: http://www.gadsdentimes.com/
  3. "U.S. Supreme Court begins hearings in assisted suicide case tomorrow," Life Site News mailing, 2005-OCT-04. See http://www.LifeSiteNews.com
  4. "Amicus Brief Filed in Oregon Assisted Suicide Case: Gonzales v. Oregon," Family Research Council, at: http://www.frc.org/
  5. James Vicini, "Court rules govt. can't stop Oregon suicide law," Reuters News Agency, 2005-JAN-17, at: http://today.reuters.com/
  6. "A Careful Reading of State Reports Indicates Oregon and Washington Laws are Safe and Rarely Used," Death with Dignity National Center, 2010-Spring, at: http://www.deathwithdignity.org/
  7. "Schiavo autopsy shows irreverible brain damage," NBC News, 2005-JUN-15, at: http://www.nbcnews.com/
  8. "Countries with End-of-life help laws and/or regulations," Dignitas, 2016-FEB-22, at: http://www.dignitas.ch/
  9. Robert Steinbrook, "Physician-Assisted Death — From Oregon to Washington State," The New England Journal of Medicine, 2008-DEC-11, at: http://www.nejm.org/
  10. "Chapter 113: Patient Choice At End Of Life," Vermont General Assembly, 2013 & 2015, at: http://legislature.vermont.gov/

Site navigation: Home page > "Hot" topics  > Assisted suicide > U.S. > here

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Copyright 2000 to 2016 by Ontario Consultants on Religious Tolerance
Last updated 2016-FEB-23

Author: Bruce A Robinson
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