Act helps protect Oregonians, My View

By Peg Sandeen, Portland Tribune, July 27, 2007

Let's be clear: One reason that Oregonians passed the Death With Dignity Act in 1994 and reaffirmed it in 1997 is that health care professionals have been helping patients die for decades, with no safeguards or procedures to protect the patient.

In fact, a 1998 study published in The New England Journal of Medicine of 1,902 physicians who care for dying patients across the U.S. said: "We found that requests for assisted suicide or euthanasia are frequently made to physicians who practice in specialties in which they are likely to care for dying patients and that the decision to honor such a request is not rare in the United States."

Since the law was passed in 1997, 292 patients have died under the terms of the law, according to the state's Public Health Division (www.oregon.gov/DHS/ph/pas/docs/year9.pdf).

The majority of Death With Dignity participants suffered from terminal end-stage cancer. They are well-educated, elderly and follow to the letter of the law the safeguards and procedures outlined in the law.

If Korn's description of what happened with Wendy Melcher is accurate, it falls outside Oregon's Death With Dignity Act for several reasons:

1. The patient must self-administer the medication. There are no provisions in the law for a doctor or any other health care professional to help the patient ingest or inject the medication. For patients like Wendy Melcher who had difficulty in swallowing, the Oregon Death With Dignity Act simply was not an option.

2. Additional safeguards, such as family notification and psychological counseling, are clearly spelled out in the law to ensure the patient is of sound mind when making the request. Incidentally, the request must be done both orally twice, and in writing once, and witnessed by someone other than the attending physician and the patient's family.

3. There is a 15-day waiting period between the patient's first oral request and a 48-hour waiting period from the patient's second oral request before the prescription can be written.

4. There is a requirement that all the written and oral requests, the second opinion and any additional counseling from the physician be documented in the patient's medical records and reported to the Oregon Department of Human Services. The department also releases an annual report on the law.

The legalization of "death with dignity" in Oregon has resulted in a careful evaluation of end-of-life options. Rather than undermining end-of-life care, the Death With Dignity Act has been associated with increased hospice referral rates and improvements in the training of physicians in palliative (comfort) care.

In Oregon, we do a better job of managing pain than other states because of the act. We also do a better job of protecting patients.

Oregon's law is working as intended by voters – to give dying Oregonians a choice when they are in the final stages of a terminal disease.

Peg Sandeen is executive director of the Death With Dignity National Center.

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