frequently asked questions

There is a great deal of information, and disinformation, available about Oregon's Death with Dignity Act and physician-assisted dying. This section provides clear answers to questions people typically ask about these sometimes confusing issues. Click here to read the Oregon Department of Human Services' FAQ about the Oregon law.

People Want to Know

What is the greatest impact of the Oregon law?

The greatest impact of the Oregon Death with Dignity Law may lie in the peace of mind it provides those who will never use it but who know it is an available choice available. Many more lethal prescriptions are requested under the law than are used.

Can the federal government overturn Oregon's law?

The Bush Administration is attempting to use the federal Controlled Substances Act (CSA) to overturn the Oregon law. Congress passed the CSA specifically to (1) ban the use and trafficking of illegal drugs and (2) regulate the use of legal narcotics for approved medical purposes. The CSA does not apply to the Death with Dignity Act because the Oregon law specifies only the use of legal narcotics for physician-assited dying. In the United States, it is the states, not the federal government, that licenses physicians and determines what is and is not legitimate medical practice. The Supreme Court case Gonzales v. Oregon represents a unprecedented federal intrusion into state authority to regulate medical practice.

What is the legal history of Oregon's law?

Oregon voters twice affirmed physician-assisted dying as a legitimate medical practice under very specific conditions and with very strict guidelines -- designed to protect both patient and doctor. The resulting law was upheld in the U.S. District Court and Court of Appeals and now awaits a ruling in the Supreme Court, which previously found no constitutional right to physician-assisted dying and determined that the states can more appropriately decide the issue. Oregon decided the issue, and the Oregon Death with Dignity Law went into effect on October 27, 1997.

Would a Supreme Court defeat end physician-assisted dying in America?

Every day in every state, when a dying patient suffering intolerable pain asks for and receives a doctor's help in hastening death through legal medication, this is physician-assisted dying. Only Oregon strictly regulates and monitors this common practice. If the Supreme Court rules against Oregon, the practice will be forced underground, as in all other states, exposing dying patients to possible abuse or coersion and doctors to possible prosecution and imprisonment.

Is the Oregon law a "slippery slope" toward euthanasia?

This is a common and completely false claim. The simple fact is that Oregonians would not have voted for a loosely written, open-ended law. The law's multiple safeguards specifically require and guarantee direct patient involvement. In direct contrast, euthanasia is a loose, ambiguous concept that often implies a person's involuntary death. Euthanasia is illegal in the United States and has no relation to Oregon's carefully written and regulated Death with Dignity Law, and there have been no efforts to expand it beyond its strict guidelines.

Why are some states trying to replicate Oregon's law?

The strength of the Oregon law lies in its very strict and specific guidelines, which leave nothing to guesswork or interpretation. The three main reasons other states hope to replicate Oregon's law are because:

1. The Oregon law respects and upholds the integrity of the doctor-patient relationship.
2. The Oregon law requires that the patient self-administers the prescribed medication to hasten death.
3. The Oregon law ensures that the patient – and no one else – is the driving force, the ultimate and conscious decision maker in the process.

Does the Oregon law encourage patients to act too soon?

No. Only terminally-ill patients who are diagnosed with six months or less to live may request to use the law to hasten their deaths -- and typically only as a last resort as each day becomes increasingly unbearable. The primary physician's diagnosis must also be certified by a consulting physician, which ensures an accurate prognosis and helps prevent mis-diagnoses.

Can patients be coerced to request the law by unethical or over-burdened care givers or family members?

No. The law specifically requires that if there is any evidence of coercion, the process is immediately stopped. Moreover, physicians who work regularly and closely with terminally ill patients ensure that the law's second physician's opinion requirement alone ensures against coercion. Further, the State of Oregon reports of no evidence of coercion since the law's enactment.

With today's medical advances, doesn't proper pain management negate the need for laws like Oregon's?

No. In fact, many of the law's opponents admit that even the most aggressive pain management measures fail to alleviate the suffering of 5% of terminally-ill patients. In addition, many Drug Enforcement Administration activities today prevent physicians from providing adequate pain management for suffering patients out of fear of investigation and possible prosecution. Moreover, pain is only one of many complex problems, including loss of dignity and autonomy and immeasurable mental and emotional anxiety and fear.

Can't people simply hasten death through overdoses or by refusing medication, nutrition or hydration?

Ironically, such measures can take several weeks before resulting in death and may include unanticipated and agonizing effects -- effects that often can only be palliated through days or weeks of deep sedation. In contrast, the purpose of the Oregon law is to provide dying patients with the control, predictability and peace of mind that comes with knowing the how and when of death.

Has Oregon's law resulted in decreased use of hospice?

No. In fact, Oregon has more than 50% hospice usage -- among the highest hospice utilization rates in the country and largely due to more than ten years of frank discussion and greater awareness of end-of-life options for the terminally ill in Oregon.

With the Oregon law, how can patients trust their doctor will do everything possible to treat the terminal illness?

The fact is that many healthy Oregonians today discuss end-of-life issues with their doctors and increasingly demand active participation and decision making in their own end-of-life care. Oregon doctors, as a result, today work harder to prolong patients' lives and enhance quality of life, while respecting patients' final wishes when their suffering becomes intolerable. Because of the law's protections, most Oregonians know they will not face abandonment by their doctors when the suffering becomes unbearable and use of the law is requested. This is the root of the patient-doctor relationship.

Does Oregon's law contribute to a "culture of death"?

Quite the opposite. Most people understand death as a natural part of life. Providing dignity, control and peace of mind during a patient's final days with family and loved ones places much greater focus on the Gift of Life than on the often painful and aganozing process of dying.

Are people with disabilities encouraged to use the law?

To equate a disability with death is insulting, and no one can be encouraged to use the law. The Oregon Death with Dignity Law exists only for dying patients whose mental, physical and emotional suffering has become intolerable and who wish a peaceful and dignified passing. There are many in the disabled community who support the Oregon law – not because they are disabled, but because they are people.

Are racial minorities and the poor, undereducated, uninsured and other marginalized persons encouraged to use the law?

No one is encouraged to use the law. To date, persons who have chosen to use the law have been well educated, have had excellent health care, have had good insurance, have had access to hospice and have been well supported financially, emotionally and physically. Absolutely no HMO or insurance company participates in this process.

Do people move to Oregon in order to use the law?

The Oregon Department of Human Services has no reports of individuals moving to the state in order to avail themselves of the law, which requires persons who are terminally ill to be legal residents of the State of Oregon.

What about under-reporting regarding use of the Oregon law?

Physicians who do not comply with reporting requirements under the Death with Dignity Law forfeit protection under the law's safe harbor provision and are subject to prosecution. Ongoing studies by the Oregon Department of Human Services and the Oregon Health Sciences University indicate that far more lethal medications are prescribed under the Oregon law than are ultimately used -- futher proving that the law is much scrutinized and seldom used.

Is Oregon's law the equivalent of "playing God?"

Those whose spiritual beliefs include opposition to physician-assisted dying are free to not use the Oregon law. However, many others with strong religious and spiritual beliefs also support a dying patient's right to make one's own end-of-life choices. Limiting one's end-of-life choices to suffering terrible physical and emotional agony and the loss of personal dignity is neither humane nor divine. Those who are trapped in prolonged suffering prior to an inevitable death, and who choose to hasten that death, make that choice not as God, but as a conscious, self-determined individual. This is no more "playing God" than to suggest that one more procedure, one more pill or one more feeding tube may preserve a life that is all but ended.

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