Assessing Oregon's Assisted-Suicide Law
DEBBIE ELLIOTT, host:
Senator Trent Lott on the hurricane, FEMA and his fellow Republicans just ahead, but first, after the Supreme Court opens its new term tomorrow, one of the first cases it will consider is the Bush administration's challenge to Oregon's physician-assisted suicide law. The Oregon Death With Dignity Act has been in effect for nearly eight years. That's enough time to get an idea of how legalized physician-assisted suicide works. As Colin Fogarty of Oregon Public Broadcasting found, the state's experience has produced some surprises.
COLIN FOGARTY reporting:
Election night 1994 in Portland was a heady time for right-to-die activists. Political strategist Jeff Sugarman had just managed the first ballot initiative campaign in the world to successfully legalize physician-assisted suicide, and he believed it was just the start.
(Soundbite of 1994 statement)
Mr. JEFF SUGARMAN (Political Strategist): I think that the suit's historic in the sense that we have come up with a very moderate and a very sensible approach to a very complex problem. And I think other states and other countries will look at this as a workable solution to the needs of people who are dying.
FOGARTY: But the law was held up in court for three years. And rather than the beginning of a movement, Oregon's law proved to be a one-shot phenomenon. Willamette University law Professor Valerie Vollmar, who's been tracking the issue since 1990, says Oregon has a risk-taking tradition that assisted-suicide supporters haven't been able to replicate elsewhere.
Professor VALERIE VOLLMAR (Willamette University): I think one of the problems for the supporters is that the opponent's realizing that it can be passed. Get involved earlier and lobby harder. That's where the money and the organization and the lobbying ability are.
FOGARTY: But if right-to-die activists were overly optimist, dire predictions by opponents of the Oregon law have also proven to be off the mark. Take this 1997 ad in support of a measure to repeal the Death With Dignity Act, warning that suicide pathologist Jack Kevorkian was on his way.
(Soundbite of 1997 advertisement)
Unidentified Man: That's right, Dr. Death himself. Why? Because he says Oregon's law will lead to botched suicides. He'll bring his death machine and set up shop in our back yard.
FOGARTY: One prominent critic at the time, state Senator Eileen Qutub, even held up a bottle of pills in the Oregon Senate listing the nightmarish side effects of what she predicted would be commonly botched suicides.
(Soundbite of vintage speech)
State Senator EILEEN QUTUB (Republican, Oregon): Acute abdominal pain, nausea, vomiting, aspirations of vomit with subsequent pneumonia or lung disease.
FOGARTY: But those predictions did not come true. Jack Kevorkian never came to Oregon. The lethal injections he administered to patients in Michigan are not allowed by the Oregon law, which requires patients to take the drugs orally. And there have been few clinical problems. Seven annual reports by the state Department of Human Services say most of the 208 cases of physician-assisted suicide have ended peacefully in less than a half an hour.
But to opponents of assisted suicide, those official statistics are suspect. Dr. Ken Stevens with Physicians for Compassionate Care says the numbers depend on voluntary reporting by doctors, who may not be at the patient's bedside.
Dr. KEN STEVENS (Physicians for Compassionate Care): In the first few years, the doctors were present at the time that the patients took the medication about half the time. In this last year, 2004, the doctors were present in only six of the 37. There's significant holes in information that we have.
FOGARTY: Still, Stevens and other critics of the law have not proven prescient in their claims that patients at the margins of society would be pressured to end their lives. Dr. Susan Tolle has been closely monitoring end-of-life care in Oregon as head of the Center for Ethics at Oregon Health and Science University.
Dr. SUSAN TOLLE (Center for Ethics, Oregon Health and Science University): One of the projections had been it would be the poor and the uninsured and the vulnerable. And it has proved to be the highly educated, more often white, insured cancer patient.
FOGARTY: Even some doctors who have written lethal prescriptions have been surprised by how few people use the law and by the reasons those patients give for ending their lives. Salem oncologist Peter Rasmussen says his patients focus more on personal autonomy than on physical symptoms, like pain and shortness of breath.
Mr. PETER RASMUSSEN (Salem Oncologist): And what I've learned from this is that patients don't have such a narrow view of what's important. They're also very concerned about their own perceptions of their personal dignity and things like that. And these aren't things that doctors are necessarily trained or used to dealing with.
FOGARTY: Perhaps the least surprising thing about the law is that it is still the subject of intense debate, even within Oregon's medical community. The Oregon law gets its ultimate test before the US Supreme Court this week.
For NPR News, I'm Colin Fogarty in Portland.
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