In 1997, United States Supreme Court Justice William Rehnquist ended his opinion in the landmark case of Washington v. Glucksberg with the words, "Throughout the Nation, Americans are engaged in an earnest and profound debate about the morality, legality, and practicality of physician assisted suicide. Our holding permits this debate to continue, as it should in a democratic society." In the same year, Oregon voters continued the debate and by a 60% to 40% margin upheld Oregon's one of a kind Death with Dignity Act.

The personal freedom to choose the time and manner of one's own death for those who are facing a terminal illness, is the most profound freedom one possesses. We all will someday have to consider our end-of-life options. We should have the right to consider the full range, including proper pain management, continuation of medical treatment, and hastening one's death.

In 1994 and again in 1997 the voters of Oregon provided all terminally ill citizens of this state with a legal, humane and dignified way to end their lives. Oregon's law permits a person who has been diagnosed with a terminal disease and given less than six months to live by two physicians the right to ask for medication to hasten his or her death. It took eleven years before the states of Washington and Montana followed Oregon's experiment.

Why did it take so long for others to follow Oregon's lead? Mainly, they waited until the judicial system addressed the issue of whether Oregon's law was constitutional. This concern was resolved by the US Supreme Court in Gonzales v. Oregon, 546 U.S. 243 when the court ruled that the US Attorney General did not have the legal power to impose a federal standard on using lethal drugs in Oregon for purposes of implementing the Death with Dignity Act.

Others waited because they wanted to see how the experiment worked in Oregon. By the time Washington voters approved their law and the courts ruled Montanans have the right to die with dignity in 2008, Oregon was able to produce eleven years of data showing the law was implemented with an unblemished record.

The data proved that none of the risks or abuses predicted by opponents of the law occurred. Instead, the law brought significant benefits to Oregonians and to all Americans. The law benefits Oregonians in a number of ways:

• Dying Oregonians who want to control the timing and manner of death can do so in a humane and dignified manner.
• Dying Oregonians have a much greater chance of receiving good pain and palliative care than do those in most other states because Oregon physicians have made efforts to improve their knowledge and skill in pain care. (L.Ganzini et al "Oregon Physicians' Attitudes About & Experiences with End-Of-Life Care since Passage of The Oregon Death with Dignity Act." The Journal of the American Medical Association 5/9/01)
• The utilization of hospice care has increased from 22% in 1994 to 37% in 2000 and rose to 53% in 2009. The national average is 41.6% in 2009.
• More Medicare patients die at home, and fewer die in acute care hospitals in Oregon than any other state. (SusanTolle et al. "Oregon's Low In-Hospital Death Rates: What determines where people die and satisfactions with Decisions or Place of Death." Annals of Internal Medicine 4/20/99)

The entire nation benefits from the experience in Oregon. The Oregon Department of Human Services is required to provide actual data each year and that data is informative to the debate about legalization of assisted dying. We now have 12 years of data that refutes the unfounded predictions of the opponents to Oregon's law. For example:

• Myth: Hundreds of people would use the law each year and hundreds would move to Oregon to use the law. Reality: In the first year of the law's existence only 16 Oregonians died after completing the process. In 12 years, a total of 460 died using the law; an average of 38 per year. This corresponds to an estimated 19.3 Death with Dignity Act deaths per 10,000 total deaths each year. The law is seldom used, but it provides comfort to thousands who know it is available if worse becomes worse in their final days.
• Myth: Dying people would be coerced into using the law because family members would not want their inheritance depleted. Their slogan was one would have the "Duty to Die." Reality: In my 12 years facilitating dying Oregonians with the law, not one claimed they were being urged to use the law by their family. In fact, in most cases it was the dying person who had to persuade their loved ones to support them in their decision to use the law. Finally, coercion or exerting undue influence over a patient is a Class A felony under the law, punishable by life in prison and a $50,000 fine.
• Myth: 25% of the people who consumed the lethal dose of medication would stay alive for more than 3 hours and most of them would awaken to later die an agonizing death. Reality: The average length of time from consumption of the medication to death is 2 hours with fewer than 4% of those who died taking longer than 3 hours. One person out of 460 (1/5 of 1%) awakened after taking the medication and the patient later died peacefully.
• Myth: Depressed people would abuse the law out of desperation. Reality: The safeguards in the law require the patient be mentally competent, and if either of two doctors has any concerns about the patient's mental competence, then the patient must be referred for a mental health evaluation.

It's time for all states to unite with Oregon, Washington and Montana to allow their citizens the right to die with dignity and grace.