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Foes, backers of assisted suicide clash over initial report in Oregon

WASHINGTON (BP)–Opponents and proponents of physician-assisted suicide disagreed sharply over the meaning of a report on Oregon’s first full year of the legalized practice that showed 15 people took their lives with medication.
The report showed 13 of the 15 people who took their lives during 1998 had cancer, according to The New York Times. The average age of the 15 people was 69, and eight were men, The Times reported. The Oregon law, which went into effect in the fall of 1997, permits a person who has less than six months to live, in the opinion of two doctors, to seek approval for a fatal dose of drugs. Doctors may prescribe, but not administer, the drugs.
The report by the Oregon Health Division showed eight other people received prescriptions for lethal drugs, according to The Times. Six died from their terminal illnesses before taking the drugs, while two others were still alive at the end of the year, The Times reported.
Backers of the law said the report refuted critics’ charges it would lead to abuses and to attempts by many terminally ill people to move to Oregon to end their lives.
“This law has been seldom and carefully used with no failures, no complications, no misdeeds, no mistakes,” said George Eighmey, executive director of Compassion in Dying of Oregon, according to The Times. The organization supported passage of the law.
A Southern Baptist bioethicist and others took issue with such an assessment.
Ben Mitchell, an ethics professor at Southern Baptist Theological Seminary, said Eighmey’s comments were “just wrong.”
“There were failures — the failure of physicians to competently treat their patients; the failure of some Oregon health-care professionals to act responsibly; the failure, in some cases, of physicians to administer appropriate pain treatment,” said Mitchell, of Louisville, Ky., also a consultant for the SBC’s Ethics & Religious Liberty Commission. “There were misdeeds — healers turned to killers; a health-care system which was supposed to protect patients assisted in their demise. There were mistakes — the legalization of assisted suicide is itself a horrific mistake, and time will tell.”
Opponents of assisted suicide also pointed out the state has little power to require the reporting of such deaths and the process is shrouded in secrecy, meaning it is likely some, if not most, cases will not be reported.
“Under the law, the only information the [Health Division] is required to collect comes from the physician assisting the suicide, and even then there is no enforcement mechanism should the physician not comply with reporting rules or simply not report the suicide at all,” said Herbert Hendin, a professor at New York Medical College and coauthor of a study critical of the Oregon law, in a written release.
Staff members at the state and county levels were threatened with being fired if they released any unauthorized information about a death under the Death With Dignity Act, according to a memo from Oregon’s Center for Health Statistics.
The Oregon report was released only one day after a news service reported a study found widespread abuse of euthanasia and assisted suicide in The Netherlands. Though the practices are technically illegal in the European country, they are permitted to go on, although such deaths are required to be reported.
The study of recent surveys suggests “59 percent [of euthanasia cases] are illegally certified as deaths by natural causes, so none of those cases [has] the opportunity to be scrutinized by the authorities,” said John Keown of the University of Cambridge in England in an interview with Reuters Health. In 17 percent of cases, no alternatives to euthanasia were pursued, Keown said.
The study suggests “that, contrary to the claims of the Dutch medical establishment, euthanasia is not under effective control,” Keown said. It shows a “significant incidence of euthanasia without request and also the significant incidence of nonreporting of euthanasia by Dutch doctors,” he said.
“The Dutch have gotten themselves into a difficult situation,” Keown told Reuters Health, “because they decriminalized euthanasia, thinking that it could be effectively controlled, and the evidence shows that they failed to effectively control it.” Rescinding euthanasia’s legalization is “unlikely to happen, given the widespread support of it in Holland,” he said.
Physicians for Compassionate Care, an anti-assisted suicide organization in Portland, Ore., listed some actions taken in Oregon during 1998 that are threats for the future. Among them are:
— While the Oregon Health Plan fully funds assisted suicide for poor patients, it began restricting pain medicine for them.
— About 38 percent of patients found problems in receiving treatment for physical and mental disabilities under the same plan.
— Some private HMO insurance plans placed caps on home hospice care while fully covering assisted suicide.
“Sadly, many people just don’t get it,” Mitchell said. “One day our children or our children’s children will look back and rue the indignity of so-called ‘death with dignity.'”
At its 1996 meeting, the Southern Baptist Convention adopted a resolution condemning assisted suicide.
Oregon voters first approved a law legalizing assisted suicide in a 1994 initiative, but legal challenges blocked its enforcement for three years. The voters reaffirmed the law by a wider margin in 1997.
In a ruling the same year, the U.S. Supreme Court ruled unanimously states could prohibit assisted suicide, but its action did not prevent states from legalizing the practice.