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PHYSICIAN ASSISTED SUICIDE:

ACTIVITY IN OREGON: 1994 to 1997

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1994 - The initial ballot measure was approved:

Citizens in the state of Oregon approved Ballot Measure 16 during the 1994-NOV elections. It would have legalized euthanasia under limited conditions. 1

Under the Death With Dignity law, a person who sought physician-assisted suicide would have to meet certain criteria. The person:

bulletmust be terminally ill.
bulletmust have 6 months or less to live.
bulletmust make two oral requests for assistance in dying.
bulletmust make one written request for assistance.
bulletmust convince two physicians that she/he is sincere, is not acting on a whim, and that the decision is voluntary.
bulletmust not have been influenced by depression.
bulletmust be informed of "the feasible alternatives, including, but not limited to, comfort care, hospice care and pain control."
bulletmust wait for 15 days.

If the individual met all of these requirements, then they would have been able to obtain a prescription of a barbiturate that would be sufficient to cause death. The ultimate decision to take the medication would be left up to the individual. Mercy killings by a family member or friend would not be allowed. Assisted suicides of the type performed by Dr. Jack Kevorkian would not be permitted. Physicians would be prohibited from inducing death by any other method, including injection or carbon monoxide.

Various informal polls in Oregon had consistently shown that most people are in favor of such a law. Most physicians were as well.2

The National Right to Life Committee, supported by the Roman Catholic church, obtained a court injunction to delay implementation of the measure. The law became stalled in the appeals process. In the meantime, the measure was not enacted. The Oregon Medical Association originally took no stand on the matter but later came out against it because of what it considers legal flaws.

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1997 - The second referendum was approved:

Conservatives within the Oregon government forced approval in early 1997-JUN of a second public referendum. It was a mail-in ballot procedure, held from 1997-OCT-15 to NOV-4. A poll indicated that this second referendum was supported by about 61% of adults in Oregon.

Both sides in the debate had planned to invest 10 million dollars in advertising prior to the referendum. The Roman Catholic church and other conservative religious groups financed the campaign against access to assisted suicide. They have remained in the background, preferring to funnel their funds through Physicians for Compassionate Care (a group of over 1000 doctors). By early October, they had received 3.8 million dollars in contributions. They were able to finance paid co-coordinators, lawn signs, billboards, frequent media ads and pamphlets. Other groups opposed to assisted suicide were: Yes on 51 Committee, Oregon State Council of Senior Citizens, Oregon Catholic Conference, Oregon Citizens Alliance - Families for 51PAC, and Oregon Right to Life Issues PAC. Some groups promoting access to assisted suicide were: Oregon Right to Die, and Oregon Death With Dignity Legal Defense and Education Center. Most doctors and most psychiatrists in Oregon favored the law.

One concern in Oregon relates to the sole suicide method that the measure would allow. Death by injection would not be permitted. Medication intended to cause death can only be given orally. This is considered by many to be a fatal flaw in the bill. Oral medication is sometimes not effective because some patients vomit up the pills before they can take full effect. Others are unable to swallow pills because of their physical condition. The result may be a coma or a lingering death in intractable pain. At the same time, many physicians find it difficult to abandon the use of pills and directly inject a poisonous substance. Derek Humphry, co-founder of the Hemlock Society wrote that the Oregon law "could be disastrous" because it did not permit lethal injections. He referred to a study in the Netherlands that showed that pills often failed. "The only two 100% ways of accelerated dying are the lethal injection of barbiturates and curare or donning a plastic bag." 3

An unidentified lawyer said: "It's becoming the abortion issue of the next century and just as nasty...Yet it is even more important because how we die concerns absolutely everyone." There is a strong element of truth in this statement. Even though a minuscule percentage of people would ever request assistance in dying, many (perhaps most) people will be comforted by knowing that assistance is available if one asks for it. Meanwhile, many others are concerned that people would be given the choice to end their life -- a matter that they believe should be determined only by God.

The groups promoting access to assisted suicide had received contributions of only $800,000 and were about $300,000 in debt by the time of the referendum. Their campaign was run by volunteers. Both sides accused each other of "lying, distorting research, misrepresenting information and running campaigns based on fear and deception...Some advertisements have been so outlandish that media outlets have refused to run them." 2

The vote was about 60% in favor of access to physician assisted suicide.

Response was predictable:

bulletThe Associated Press reported, incorrectly, on 1997-NOV-4 that if the law were upheld, then the debate over assisted suicide in Oregon would be settled.
bulletBarbara Coombs Lee, the main sponsor of the 1994 law said: "The people of Oregon have spoken twice now at the ballot box."
bulletBob Castagna, spokesperson of the Oregon Catholic Conference commented "This is a tragic day for Oregon, the nation and the world."
bulletGayle Atteberry, executive director of Oregon Right to Life said that the law is a "blot" on the state: "Oregon will become known as the death capital of the United States....We'll never give up protection of innocent life."
bulletPenny Schleuter, a 56-year-old Oregon woman with ovarian cancer commented: "It's important to have the option. Terminally ill people will find comfort from the fact knowing that it's there."
bulletJanice Elsner, another terminally ill woman called assisted suicide a "Pandora's box" that eventually could lead to mercy killings. "If we're willing to kill terminally ill people, we won't just stick to that one corner of society that we want to put it in."

In a surprising development, an employee of the state attorney general's office said on 1997-NOV-4 that the law had cleared all of the court appeals on October 27, and was actually in force.

Within 24 hours of the announcement of the results, state officials started to prepare forms for physicians to record instances of assisted suicide. These were later distributed to all physicians in the state. The "Request for Medication to End my Life in a Humane and Dignified Manner" form requires two doctors to record:

bulletThe patient's medical diagnosis.
bulletTheir prognosis.
bulletThe date of the first request for suicide assistance.
bulletAn assessment that the patient is capable, fully informed, and acting voluntarily.
bulletThat the patient is aware of risks associated with the medication.
bulletThat the patient has been informed of alternatives, such as hospice and pain management.
bulletThat the patient is informed that they can withdraw their request at any time.

Rules and regulations were already available; they had been drafted a few years ago, when the law was originally approved. Professional organizations of physicians, pharmacists and psychiatrists also prepared procedures to govern their members' involvement.

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1997 - The first opposition from the Federal Government:

Immediately after the law was affirmed, Thomas Constantine (R), the administrator of the federal Drug Enforcement Administration (DEA) issued a policy statement. 4 He stated that prescribing drugs to help their terminally ill patients kill themselves would be in violation of the Controlled Substances Act. It "was not a legitimate medical use under the federal drug laws... [He] warned that the government would impose severe sanctions on any doctor who writes a prescription for lethal doses of medicine for a patient." Their prescription-writing authority could be canceled.

This statement was written at the request of Republican Senator Orrin Hatch (R) and Representative Henry Hyde (R). It is ironic that conservative Republicans such as Hatch and Hyde are normally in favor of states' rights and against federal interference in local affairs. But their moral concerns at allowing people to ask for help in committing suicide outweighed their political philosophy.

Dr. Charles Hofmann, president of the Oregon Medical Association stated: "The only official word we have is that physicians who prescribe barbiturates for assisted suicide could face sanctions. Our recommendation would be to not become involved until this is settled."

Oregon Senator Ron Wyden, himself an opponent of assisted suicide, and Oregon Governor John Kitzhaber attempted to convince the Justice Department that any such sanctions against physicians would be a misreading of the control substances law. Robert Applegate, a spokesperson for the governor said: "We think that what happened is that the DEA was pushed out on a limb by a couple of powerful conservatives."

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References:

  1. The text of the Oregon Death With Dignity law is at: http://www.rights.org/
  2. Robert Matas, "Oregon Reconsiders Death-With-Dignity Law," The Globe and Mail newspaper, Toronto ON, 1997-NOV-3, Page A1.
  3. Derek Humphry, "Oregon's Assisted Suicide Law Gives No Sure Comfort in Dying," Letter to the Editor, New York Times, 1994-DEC-3.
  4. Timothy Egan, "Oregon's Assisted-Suicide Law Threatened by a Technicality", New York Times Service, 1997-NOV-19

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

or: Home > "Hot" topics  > Suicide menu > Assisted suicide > U.S. > Oregon > here

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Copyright 1997 to 2006 by Ontario Consultants on Religious Tolerance
Last updated 2006-JAN-18

Author: Bruce A Robinson

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