Problems With Oregon Assisted Suicides are Real

November 6, 2007

The myth about Oregon legal assisted suicide is that all is A-Okay because the Oregon Statistics don’t reveal abuses. Of course, that is because they were designed not to reveal abuses, and indeed, those in charge have admitted in testimony to a House of Lords investigative committee that they have neither the legal authority or budget to investigate potential illegal practices.

That makes this published study (“Physician-Assisted Suicide versus Palliative Care: A Tale of Two Cities”) of palliative care so important. It was reported by Dr. David Jeffrey, a palliative care specialist from Scotland who spent September and October of last year in Washing and Oregon as a Winston Churchill Memorial Trust Fellow, investigating end-of-life care in those two states. He wrote a 46 page report, published in April 2007, that is sobering about the actual practice in Oregon that the state’s bureaucrats don’t want to see and the media do not want to report. He does not seem morally opposed to assisted suicide but concludes it would not be a good idea to legalize it in the UK.

Here are some excerpts from the assisted suicide section in the report:

I had numerous descriptions of cases of PAS. I include one that a doctor claimed went well and another which illustrates just how badly it can go wrong: Case History A young man moved specifically here because Oregon had the law. He had a strong belief in an after life. He decided the day, took the medication and died peacefully. The hospice nurse knew the day but was not involved. She came to the house after his death and supported the family Case History

A patient with a cancer had a friend who was a doctor. This friend told him that it was going to be a painful way to die and advised him to take advantage of the PAS law. The hospice staff felt he was not ready to die and were concerned that he may have bypassed some of the legal hoops. The family were not happy and everybody involved was uneasy. After taking the lethal prescription the patient didn’t die quickly. The family were upset..why hasn’t he died?. The wife said she had to leave, she could not cope with the situation. The volunteers from a pro PAS organization found two men who knew nothing about nursing care to sit with the patient until he died the next morning. The wife became profoundly depressed and attempted to commit suicide herself.

This really caught my eye. Note that it supports the belief that most doctors won’t do killing, and it supports my belief that there are Kevorkian-style death doctors.

In one hospice program, they have had 28 cases of PAS since the legislation was in force. In 23 of the cases same doctor was involved. He is known as a strong advocate for patient choice and does offer all the alternatives. Only a few doctors participate perhaps because a significant proportion of Oregonians do not support PAS. There can be problems in leaving the lethal medication at home. In one case where there was doubt as to whether the patient was competent when he eventually took the medication and it may have been administered by the family. The question of administration was a delicate one, a patient even had a PEG feeding tube inserted solely to allow him to have PAS.

Inserting a feeding tube for use in suicide! That opens many ethical questions and would seem to be on the border of active euthanasia.

Despite PAS sold by advocates and the media through scare mongering as a means for ending pain for which nothing can be done, in Oregon, it isn’t about that at all.

I learned that the patients who choose and carry out PAS are not suffering, they are a tiny group who simply seek control as to when their life will end. They are independent and have no interest in receiving palliative or hospice care. The main benefit of the PAS legislation in Oregon appears to be that it offers patients a way out if things get too bad. The need for this safety net is fueled by the fundamental lack of trust that these patients have in the medical health care system. I found that there are still many physicians in Oregon who object to PAS.

It’s a shame the paper doesn’t name names, but perhaps it was the only way for Dr. Jeffrey to obtain the information. In any event, his study illustrates that while some certainly support PAS–all is not well with Oregon. It is a matter about which the media should be more curious. But I am not holding my breath.

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