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May 9, 2017

Death with Dignity?

Patricia Price

Doctor Prescribed Suicide is a complex issue with lots of history, and so this procedure will unfold over time, giving us all pause and somethings about which to think.


Since 1990, when Jack Kevorkian made headlines, the media has pitched assisted suicide for the dying and severely disabled in positive and – sometimes – even glowing terms. It is not easy to watch a loved one suffer.


In 2013 Pew Research Center found that 62% of adults said that a person suffering severe pain with no hope of improvement has a moral right to end their life. Only 47% approve of laws to allow doctor-assisted suicide, while 49% oppose such laws.


Is suicide a criminal act? No, it never has been. A dead person cannot be charged, tried and convicted. Attempted suicide is no longer criminalized so that a person may get the psychological help that they need.


In November 1994, Oregon voters passed the Death with Dignity Act (DWDA) with 51% in favor. This policy gives “an authorized agent” the power to prescribe a lethal dose of drugs to a terminally ill or disabled patient (terminally-ill in the DWDA is defined as having six months or less to live). Oregon was the first state to impose this law – in 1997 – after legal injunctions were lifted.


So, what is wrong with this act of mercy? Policies affect people, and we are dealing with a healthcare system. Things do not always go as planned. Assisted suicide is now legal in five States (OR, WA, VT, CA, CO) and the District of Columbia. These laws contain no protections for the frail, disabled, and the mentally ill. They also provide no protection against coercion. The DWDA fundamentally gives power to one group to prescribe a lethal dose of drugs for another group, while deeming it as “medical treatment!”


The latest report shows that in Oregon, 204 lethal drug prescriptions were written, and there were 114 “reported” assisted-suicide deaths in 2016. The total number of deaths is 1,127 since the Oregon law was enacted. Of the 114 who died, 19 people had received lethal drug prescriptions years before.


This statistic is staggering! It means that 13.4% of the patients who died that year were not terminally ill, as defined by the DWDA, when the doctor wrote them a prescription for lethal drugs.


Doctors’ prognoses are not fail-safe. Only five of the 144 patients who died in 2016 were referred for a psychological evaluation, and the Oregon Public Health Department (OPHD) doesn’t know whether 54 of the patients who received prescriptions actually took the lethal drugs or not. [OPHD, “Oregon’s Death with Dignity Act – 2016,” Data Summary 2/10/17]


Let’s not forget insurance companies’ role in assisted suicide. Will they continue to provide palliative care and treatments like insulin for diabetes – the more costly option – to a person with a “deemed” short time to live even if it improves the quality of their life at that time? How will this affect insurance coverage in the future? Do we trust insurance companies?


There is a lot more to social policies than one might think: lots more to talk about.


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