Twenty-five years after Oregon voters passed the Oregon Death with Dignity Act—the first statute of its kind in the world—we are launching a series chronicling the campaign that led to its passage and its enduring legacy as a catalyst for expanding end-of-life options across the country. This is the first installment.
Geoff Sugerman had been awake for 55 hours straight.
It was July 8, 1994. Sugerman, the campaign manager of the political action committee Oregon Right to Die, and his staff had been racing against the clock to count, organize, and sort signatures gathered to place a death with dignity measure on the Oregon state ballot for the November 1994 election.
Ten weeks prior, Sugerman had gathered the first signature on the steps of the Oregon State Capitol. Today, the committee would submit 95,777 signatures to the Secretary of State’s office—30 percent more than needed to quality for the November ballot.
“What an exciting day that was for all of us across America, who have been working on right-to-die issues for so long,” wrote the late Peter Goodwin, MD, a co-founder of Oregon Right to Die and one of the first physicians to speak out publicly in support of assisted dying.
“A New Idea”
Years before the PAC was formed, the ballot measure drafted, and the campaign for the passage of the Oregon Death with Dignity Act launched, a small group of individuals began gathering – first in a public library, then in a church, and later in their own office space – to have conversations about how to improve end-of-life choices for dying patients, many of whom endured unbearable suffering at the end of life.
Geoff Sugerman (left) with Eli Stutsman, JD, leader of the Oregon Right to Die PAC and lead author of the Oregon Death with Dignity Act.Eli Stutsman, the lead author of the Oregon Death with Dignity Act and a member of Death with Dignity’s Board of Directors, was a founding member of this group. By early 1993, Stutsman recalled,
We would soon go public with a new idea. We believed that a competent, terminally ill adult, with a prognosis of six months or less to live, should be allowed to hasten a difficult death within narrow and well-defined circumstances, if he or she so desired.
Groups in other states had tried and failed to pass ballot measures. In 1991, voters in Washington state rejected a ballot initiative that would have legalized voluntary euthanasia; Californians defeated a similar measure the following year.
Despite the groups’ laudable work, Stutsman and others knew euthanasia was a non-starter. The group’s members realized that in order to combat the fears and rhetoric about “mercy killings,” the law must call for the patient to self-administer the medication.
From the Legislature to the Ballot Box
Frank Roberts understood this. Before his death in 1993, the longtime Oregon legislator introduced three death with dignity bills. None made it out of committee. The issue was too controversial, and many lawmakers who were supportive feared speaking out for fear it would hurt their prospects for reelection.
The Legislature’s refusal to move a bill convinced advocates that their best chance of success was at the ballot box, where Oregon voters could “enhanc[e] their reputation as Western mavericks,” as the Oregonian wrote in a November 1994 piece about Oregon Right to Die’s campaign.
The successful signature-gathering effort earned Oregon Right to Die’s death with dignity measure a place on the November 1994 ballot, as Measure 16. The next four months were critical.
Could the campaign, which in Sugerman’s words started “from less than Square One,” convince the people of Oregon that medical aid in dying was a humane and much-needed option for individuals in the final stages of a terminal illness? Or would voters side with the opposition, led by the well-funded Catholic Church, whose Portland archbishop wrote an op-ed denouncing Measure 16 as “murder without mercy”?
Oregon Right to Die was outspent $5 million to $1 million in what was at that time the most expensive battle over a ballot initiative in state history. But in the end, Oregonians voted to pass Measure 16, making their state the first place in the world with an assisted dying statute.
“Oregon Moves Into the Forefront”
“With its passage,” the Associated Press reported on November 11, 1994, “Oregon moves into the forefront of the movement to give the dying the freedom to choose when, and how, their lives end.”
This is, of course, not the end of the story. Legal and legislative battles ensued; religious opposition to the law remains strong; and opponents continue to bring challenges against aid-in-dying laws in other states.
But the fact remains that, a quarter century after Oregonians approved the first-of-its kind law, the Oregon Death with Dignity Act has withstood all attempts to nullify it. It has become a part of the medical standard of care in Oregon and the model for laws in eight additional jurisdictions across the country.
Moreover, Oregon’s law has had a profound impact on end-of-life care nationwide.
After the passage of the law 25 years ago, patients began speaking more openly with their doctors about their preferences for treatment at the end of life, whether or not they were interested in utilizing the Death with Dignity Act.
The mere existence of the law diminished the longstanding taboo of talking about death and dying publicly. In the process, the public began to explore the full range of end-of-life options to a greater degree and policymakers, clinicians, and health systems created policies and procedures to ensure patients’ preferences for care were documented and honored.