Seventeen years ago, the people of Oregon took a bold step in end-of-life care and comfort. By citizen initiative, they adopted eligibility criteria and practice guidelines for terminally ill, mentally competent adults to obtain medication that would ensure peaceful dying.
I was one of the drafters of that law, and I have stood by every word ever since. For years, when reporters asked what I would change in the law, I replied "one comma," to clarify that impaired judgment from any type of mental dysfunction disqualifies a patient from making a request. Subsequently, we did change that comma.
Fourteen years of experience integrating aid in dying into Oregon medical practice, three years replicating that experience in Washington and two years with a different regulatory model in Montana now inform policy-makers. Our work to craft subsequent Death with Dignity Acts and aid-in-dying policies reflects the wisdom gained from practice.
Opponents believed catastrophe would befall Oregon and medical practice would suffer, but the opposite occurred: End-of-life care is robust, thriving and increasingly patient-centered in Oregon. Thousands of patients find comfort every year knowing they do not have to suffer unbearably. No evidence exists of anyone harmed. Opponents' assertions to the contrary rely on vast conspiracy theories, fraud and cover-up by Oregon hospices and the hospice association, officials at the Department of Health, the medical disciplinary board and police departments in communities across the state. These scary stories hold no credibility, and polling reveals a full 77 percent of Oregonians support their Death with Dignity Act.
Proponents believed terminally-ill patients want and need assurance they can control the time and manner of their dying and will apply profound thought and care before ever exercising this control. We believed nothing could override doctors' drive to cure disease and prolong life, but that as death inevitably approaches, most doctors would allow qualifying patients this measure of comfort. Those beliefs have been validated.
Oregon's data and experience has revealed other truths. We could not have predicted all of them, but they carry important lessons for our future advocacy:
As the U.S. Supreme Court intended, Oregon has served as a laboratory to test the impact of a new end-of-life option on patients, physicians and end-of-life care. Washington's data and experience reproduced the findings from Oregon. The "laboratory experiment" is complete, and the results will inform our advocacy from now on.
We will work for policy that reflects community standards, establishes clear guidelines and guides physicians in safe and responsible aid-in-dying practice, without burdensome government reporting on every patient encounter. Bureaucratic paperwork has provided important data demonstrating the safety of aid in dying, but it is not responsible for making the practice safe. As is clear in Montana, physicians meticulously adhere to a standard of practice defined by the bounds of the Court decision, without the needless and intrusive burden of government reporting.
We will affirm the true purpose of aid-in-dying medication is to provide comfort and improve the quality of life for dying patients. Physicians intend to comfort, and patients intend to acquire the ability to escape unbearable suffering.
As advocates, we have defended the law from multiple attacks. As stewards, we have guided patients, families and medical professionals through the eligibility requirements, procedural guidelines and reporting duties of aid in dying. As investigators, we have observed the law's provisions play out at countless bedsides, living rooms and kitchen tables across the state. Medical studies, state reports and our own experience inform our "post-Oregon" advocacy. We must not ignore the lessons of Oregon's data and experience.
Follow Barbara Coombs Lee on Twitter: www.twitter.com/@bcoombslee
Scott Swenson: When the Politics of Death Lacks Dignity
Hillary St. Pierre: Why I Considered Assisted Suicide
Rev. Dr. Martha R. Jacobs: Thanks to Dr. Jack Kevorkian
Janice Van Dyck: Dying with Dignity In Oregon
Role Reversal: The Supreme Court on Physician Aid-in-Dying
Death with Dignity Act - Oregon.gov
Assisted Suicide | "Death with dignity" act passes | Seattle Times ...
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Thank you,
-Susan Fried Perl
Robert Orfali, Author "Death with Dignity: The Case for Legalizing Physcian-Assisted Dying and Euthanasia." (www.DeathwithDignityBook.com).
Oregon has ANOTHER law, called the "Oregon Pain Management" (OPM) where it is plainly stated- "As long as the intention for prescribing analgesics is the relief of pain, the possibility that they may hasten death is not a reason to withhold these medications from a dying patient."
http://www.oregon.gov/OHA/OHPR/PMC/module/15.shtml
In Oregon, they are so gung-ho on this doping, they DO IT AUTOMATICALLY. Sure cuts down on patient resistance to what they are going to do to you. They do ask you for "permission" after being stupified with the dope.
Oh yes, I have a problem with that. And I have a problem with how CROOKED the system is about charging Social Security UNGODLY amounts of money for all this. I believe I saw a bill for a Quarter Million for my "care". But I don't really know for sure because I was doped out of my gourd at the time.
Full story with lots of detail at- http://familyrights.us/vpap/
Leonard Henderson, co-founder
American Family Rights
http://familyrights.us
"Until Every Child Comes Home"©
"The Voice of America's Families"©
And of course, as others have noted, there is a cultural tendency toward fearing the simple fact of one's own mortality. Those who live with this fear may well believe it to be a positive trait that all should harbor. Then there are those like me, who believe the finite nature of a human lifespan serves to make the time we have precious and valuable.
Since death is inevitable, making the end of life worthwhile is as important as making the bulk of life worthwhile. Oregon led the way, and I for one, thank them.
Unfortunately, during her last month she was either weeping because of the pain she was suffering if she limited her pain medication enough to be aware of her surroundings, or she was incoherent from the amount of medication needed to control her pain. No sane society should make someone endure that indignity.
We are so terrified of death we force others to endure misery. I have the ability to ensure that my pets do not suffer in agony but we cannot seem to afford the same courtesy to our fellow humans. It is a crime.
Although my mom was a strong advocate, when her cancer was diagnosed, it had already metastasized throughout her body and she was given 2 to 6 months, she felt she did not want to ever go back to hospital care and also decided not to request the Dignity forms.
She chose no further treatment and with her Medicare, was able to get free hospice care. With my husband's agreement, I moved in with her so she could have family and friends come to visit more easily and be surrounded by her own things in a one story apartment instead of our house with stairs, eta. and where it would be more isolating.
The entire hospice care..people..training for me..options for therapies for relaxing/pain relief..the nurses/social workers/ paperwork done for us..A Wonderful Service..wonderful!! When pain did start in the last few weeks, I was taught how to give it and monitor for her. She never suffered...wasn't allowed to suffer..and passed peacefully, surrounded by love of family and the hospice people who cried with us when she passed.
Tea