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20 Years of the Oregon Death with Dignity Act

September 7, 2017

This year we commemorate the 20th anniversary of implementation of the Oregon Death with Dignity Act. We are featuring stories of those who in 1997 campaigned against the repeal of the law adopted by Oregon voters 3 years before. Today we launch the series with an overview of the year as summarized in the 1997 Annual Report of our predecessor organization, Oregon Death with Dignity Legal Defense and Education Center.

Other installments in the series:

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In 1994, Oregon voters approved the nation’s first physician assisted dying statute, the Oregon Death with Dignity Act. Immediately, the law became embroiled in legal challenges and legislative attempts to repeal it. These efforts culminated in 1997, with courts allowing the Act to go into effect and Oregon voters rejecting Measure 51, a repeal ballot initiative.

Twenty years ago, in November, the effort to repeal the Oregon Death with Dignity Act failed and implementation of the law began. In the two decades since the law started providing peace of mind to dying Oregonians, the Death with Dignity National Center defended the policy in state and federal courts. The law’s passage established a template for other statutes and campaigns for end-of-life choice across the country, and our organization has worked to expand the policy nationwide, with four more states and Washington, D.C. adopting similar statutes between 2008 and 2016. Perhaps most important, the Act brought to the fore a conversation about death and dying in America that was long overdue, and gave terminally ill Oregonians the chance to determine the time and manner of their death.

Today the Death with Dignity movement advances with greater speed than ever; this year alone, policy reform around physician assisted dying was considered in an unprecedented 30 states.

Commemorating 20 Years of Death with Dignity

As part of our celebration of the 20th anniversary of the Oregon Death with Dignity Act, over the next few weeks we’ll look back at the historic events that provided the foundation for our work. Through the recollections of key individuals and through archival materials, we’ll review the pivotal year and its impact on the years that followed and our accomplishments.

ODLDEC 97 Report - Cover

The cover of the 1997 Annual Report of the Oregon Death with Dignity Legal Defense and Education Center.

We begin with a look at 1997 through the eyes of the Executive Director of the Oregon Death with Dignity Legal Defense and Education Center, John Duncan, who summarized the year’s accomplishments of our predecessor organization in a comprehensive annual report.

1997: A Pivotal Year for Death with Dignity

For historians of the death with dignity movement in America, 1997 will be seen as the pivotal year when mainstream legitimacy was established.

—John Duncan, Oregon Death with Dignity Legal Defense and Education Center

Thus begins the Executive Director’s Report opening the 1997 Annual Report of the Oregon Death with Dignity Legal Defense and Education Center (ODLDEC/Center).

The Annual Report offers a thorough summary of the momentous year, for our organization and for the assisted dying movement overall.

John Duncan lists three events that marked the irrevocable change of the landscape:

  • The Supreme Court of the United States ruled, in Lee v. Oregon, that, while there was no constitutional right to assisted dying, each state must decide the issue.
  • The Oregon Death with Dignity Act survived the onslaught of litigation attempting to annul it.
  • Oregon residents voted against repealing the Act. The 60 to 40 vote reaffirming the nation’s first assisted dying law capped four months of one of the most expensive campaigns in state history.
Death with Dignity advocate John Duncan

John Duncan in an archival photograph from the 1990s.

Oregonians will clearly never again accept the idea that people must suffer against their will at the end of life.

—John Duncan, Oregon Death with Dignity Legal Defense and Education Center

Twenty years later, his words still stand.

What did 1997 look like in the assisted dying movement and the organization leading it?

1997 in the Death with Dignity Movement

Litigation in Courts

The Center’s Litigation Project experienced a “climactic year” in 1997. The lawsuit filed by National Right to Life in 1994 was dismissed when the US Supreme Court denied NRL’s appeal against the Ninth Circuit Court’s dismissal, in Lee v. Oregon.

The Act officially took effect on October 27, 1997, just a few days before the repeal measure was defeated at the ballot. The Measure 51 campaign occupied so much public bandwidth that “the media did not even realize that the Act was in effect until November 4, the day of the election” in which Oregon voters rejected Measure 51.

Though the Center ultimately prevailed in federal courts, it also had to fight opponents in the Oregon legislature.

Hearings in the Oregon Legislature

Having voted for the law three years prior, there was no vocal public support for the repeal; only religious institutions and some media argued for it.

Our current Board President, George Eighmey, was vice chairman of the Oregon State House Judiciary Committee at the time. An outspoken champion for the Death with Dignity Act, he convened these hearings to give supporters of the law an opportunity to make the case for the Act and against its repeal. The hearings in the Oregon House and Senate committees took place between January and June 1997.

“I was able as vice-chair to give hearings” on the law, George says. “I got to pick people from both sides” of the issue. “There were overflow crowds of people. We had to have extra rooms with cameras so people could watch the testimony.”

The Center provided expert witnesses, including experts (law professors, doctors), patients, and family members to testify before the Committees in favor of the Act and against the repeal. Opponents in the legislature recruited legal and medical experts to justify a legislative repeal.

The Center also fought attacks from the Oregon state legislators who accused it of a lack of integrity and callous disregard for human life, and The Oregonian newspaper, the publication of record in the state, which ran a number of editorials against the organization and the law.

The main line of attack on the Act was the allegation that life-ending medications often failed and patients would not die. Despite a number of testimonies to the contrary, the legislative opponents became “addicted to the rhetoric of failure,” writes Duncan.

George recalls, “There were people that said, ‘you have to swallow these pills and you’re going to wake up and you’re going to regurgitate and you’re going to be forced to do it.’ They believed there was coercion going on. Then there was the religious opposition. ‘I don’t want to see my loved one go to hell.'”

“’I would just ask them questions: how do you know this will happen?'” George says. “‘Where’s your evidence?’ Our purpose was to build up a record of showing how these people were in effect lying so that we could have them on record giving this false testimony.”

In the end, opponents of Death with Dignity in the Oregon State Legislature managed to refer a repeal measure to the November ballot. Shortly thereafter, another line of attack opened when legislators tried to draft the explanatory statement for the repeal in the Voters Pamphlet. The battle played out in the state courts, with ODLDEC ultimately prevailing.

Campaign Against Measure 51

As an educational organization, ODLDEC could not conduct any lobbying or political actions; rather, the campaign against the repeal of Measure 51 was led by Oregon Right to Die, the Political Action Committee which had passed Measure 16 in 1994.

No on 51 campaign materials. Clockwise from top left: Flyer asking Oregon voters to stop state legislators from referring a repeal measure to the ballot; Voters’ Pamphlet with the first page of Measure 51 information; an ODLDEC ad in The Oregonian newspaper reporting on the results of a poll; a No on 51 yard sign; the “Three Reasons” handout outlining why Oregonians should vote No on Measure 51.

The Center assisted the “NO on Measure 51” campaign* by providing speakers for a wide variety of public forums, with experts speaking on an almost daily basis at churches, schools, civic and medical groups, and the media.

The tired argument that Measure 16 was passed by too slim a margin in 1994 became irrelevant.

—Eli Stutsman, JD, Oregon Right to Die & lead author of the Oregon Death with Dignity Act

Federal Challenges

After the repeal failed in November 1997, a new opponent emerged: the federal government. US Senator Orrin Hatch (R-Utah) and Representative Henry Hyde (R-Illinois) asked the Drug Enforcement Administration to determine whether controlled substances could be prescribed under the Oregon Death with Dignity Act.

That battle, too, ultimately ended in the Supreme Court, and it wasn’t resolved until 2006 with the Gonzales v. Oregon ruling state law has priority in regulating the practice of medicine.

1997 at ODLDEC

The political turmoil hampered ODLDEC’s core educational activities, but, John Duncan noted, “ironically, the tumultuous year has left the Center much stronger.”

Beginning in July, under the leadership of Professional Education Director, Peter Goodwin, MD, ODLDEC assisted the Oregon Right to Die PAC’s campaign against Measure 51 with education programs aimed at doctors.

Physicians for Death with Dignity

First, the Center organized the medical community around the implementation of the law, forming Physicians for Death with Dignity, “by far the largest physician group in the country to support aid in dying.”

As a result of an outreach campaign, in which the Center mailed a letter and a brochure to every practicing physician in the state, some 400 doctors responded with a pledge to “support a patient’s right to the option of physician assistance in dying.”

The Center kept Oregon doctors informed about the fast-moving developments and invited them to take a public stand for death with dignity, with more than 30 education events featuring supportive doctors.

After the election, with the law in place, the Center set up network of physicians to serve as referral resources for doctors opting out of the law.

Task Force on Life Ending Medications

After Measure 16 passed in 1994, claims emerged that a full quarter of “assisted suicides” failed. The claim became the opponents’ mantra in the repeal campaign.

To counter, ODLDEC partnered with Compassion in Dying Federation, a predecessor organization of Compassion & Choices, to form the Task Force on Life Ending Medication in order to clear up the confusion.

The Task Force, led by Peter Rasmussen, MD, and including Barbara Coombs Lee, executive director of Compassion in Dying and chief petitioner for the Oregon Death with Dignity Act, examined all available data and worked toward developing an effective protocol for aid in dying drugs.

The report was completed after the November 4, 1997 election and distributed to Oregon physicians in 1998.

Public Education and Polling

In response to legislative testimonies claiming that Oregonians wanted an opportunity to vote on the law again, the Center commissioned a poll to investigate.

Sixty-one percent of Oregonians supported the law and 66 percent opposed a repeal, a finding ultimately confirmed in the November election itself. The “failed assisted suicides” argument held little sway with respondents; rather, voters were irked by having to again vote on a law they had already passed three years before.

The Center placed full-page ads in papers around the state to present the poll.

In the months before the election, ODLDEC provided its own and Physicians for Death with Dignity representatives to give a number of public talks and media interviews around the state.

ODLDEC 97 Report - Appendices

Appendices of ODLDEC’s 1997 report: the Physicians for Death with Dignity brochure (left) and copy of a full-page ad in The Oregonian reporting poll findings.

The Center produced a newsletter publication, The Oregon Report (now Dignity Report), covering the developments, for thousands of subscribers.

“The Center continues to be the only source of reliable and timely information about the Oregon Death with Dignity Act,” wrote Duncan, referring to state and national media outlets, students, academic researchers, and others around the US—a role that continues to this day.

Dying Well Network Project

In early 1997, ODLDEC concluded it was better suited to the education, legal defense, and advocacy work, rather than providing direct services to patients.

As a result of this analysis, ODLDEC awarded, in August 1997, a $50,000 seed grant to Compassion in Dying Federation, a predecessor organization of Compassion & Choices, to start a local organization in Oregon. The Federation’s new affiliate, Compassion in Dying Oregon (CIDO) would “provide counseling and support for terminally ill patients and their families” in a similar way it had been doing in Washington since 1993.*

The Center referred terminally ill patients and their loved ones to CIDO, which provided information and “support in making end-of-life decisions including the choices available under Oregon’s Death with Dignity Act.”

Oregon Death with Dignity Act Since 1997

The Oregon assisted dying law has been providing comfort at the end of life to Oregonians for 20 years.

Despite being affirmed at every judicial level, assisted dying continues to face opposition. Legal challenges to similar laws have been ongoing, from Vermont to California. But the simple fact is that the Act works exactly as intended; has resulted in no negative outcomes; and has allowed Oregonians peace of mind and self determination over how and when they die.

Moreover, the law provides a blueprint for other states working to improve and expand end-of-life options for their residents.

“Today the Oregon Death with Dignity Act is the public policy yardstick against which all other death with dignity reforms are measured,” the law’s lead author and our board member Eli Stutsman says. “Oregon’s death with dignity policy has become the bedrock of the ‘right-to-die’ movement in this country, and the public policy platform that still drives this social movement.”

Our work to educate legislators and build partnerships with diverse stakeholders has helped pass assisted-dying laws in five states and the District of Columbia. We will continue our work to define and grow the Death with Dignity movement for the next 20 years and beyond.

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* We will be featuring more on the campaign in the coming weeks.

** In 2004 Compassion in Dying merged with End-of-Life Choices, the renamed Hemlock Society, to form Compassion & Choices; CIDO was renamed Compassion & Choices Oregon. In 2016, Compassion & Choices of Oregon was absorbed into the national organization, ceasing services to Oregonians. Subsequently, in 2017 Compassion & Choices of Oregon’s former volunteers formed End of Life Choices Oregon to fill the gap and continue providing direct services to Oregonians.

2 Comments.

Katie
October 2, 2017 at 2:32 pm

Great movement, great courage! I hope we Georgians can get it going in our state. How do I even start and where?

Peter Korchnak, Death with Dignity
October 9, 2017 at 4:22 pm

Thanks, Katie. The best place to start advocating for death with dignity in your state is our advocacy center:

https://www.deathwithdignity.org/learn/advocates/

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