X-Message-Number: 8762
Date: Tue, 11 Nov 1997 10:58:18 -0700
From: David Brandt-Erichsen <>
Subject: Oregon update

(Nov 10/97; 1:26 am EST)


   SALEM, Ore. (AP) - Now that Oregon voters have upheld the state's
   assisted-suicide law, doctors face some vexing questions: How can they
   determine that someone has less than six months to live, as the law
   requires? Can they say with certainty that a patient is free of
   depression and able to make a rational decision to ask for suicide
   pills? Will the terminally ill feel pressure to end their lives
   because they lack adequate care?

   ``This is new for everybody,'' said James Kronenberg of the Oregon
   Medical Association. ``Would the typical physician be prepared to
   proceed with this today? I think the answer is probably no.''

   Ready or not, doctors face the dilemma of being asked not only to heal
   people but also to help the terminally ill kill themselves.

   Three years ago Oregon became the first state to approve a
   death-by-prescription law, but legal challenges had kept the law from
   being used. The U.S. Supreme Court threw out a challenge to Oregon's
   law, and last week voters defeated a measure to repeal it. The state
   claims the law is in effect.

   The law says terminally ill people can ask their doctors for
   prescriptions for lethal medicine. A 15-day waiting period is required
   between a patient's first request for the drugs and the time the pills
   can be obtained from a pharmacist.

   The law specifically forbids lethal injections, a provision that
   sponsors included to make sure voters didn't see assisted suicide as a
   form of euthanasia, or so-called mercy killings in which one person
   takes another's life.

[NOTE from DBE:  This is a commonly repeated misconception.  The law does
not specifically forbid lethal injections, and in fact does not say
anything at all about lethal injections.  It says that any lethal
prescription must be self-administered and cannot be administered by anyone
else.  If a lethal injection were self-administered it would therefore be
legal under this law.]

   Before a prescription could be written, two doctors would have to
   determine that the patient has less than six months to live.

   ``That's the area that seems to be causing the most discomfort,''
   Kronenberg said. ``Many physicians have serious concerns about their
   ability to make an accurate prognosis about how long someone has to

   Some doctors also have expressed doubts about being able to recognize
   clinical depression in terminally ill patients. The law says doctors
   must order counseling for patients who appear to have impaired

   Representatives of 25 hospitals and medical groups have formed a task
   force in hopes of giving guidance about medical and ethical issues.

   ``It's fair to say that we have a number of concerns about this, and
   we don't have the answers,'' said Dr. Patrick Dunn, the task force

   Opponents of assisted suicide have warned that health maintenance
   organizations might pressure patients to commit suicide as a way to
   avoid the high cost of end-of-life care.

   The state's largest insurer, Regence BlueCross BlueShield of Oregon,
   rejects that notion, saying the decision whether to commit suicide
   will be made solely by patients and their doctors.

   ``People who would take this would only have days to live,'' company
   spokesman Ken Strobeck said. ``When they choose to go this route,
   there would be virtually no change in the cost of their treatment.''

   Dunn said he's more worried about whether some terminally ill people
   will lack access to hospice care and pain treatment programs.

   In the Netherlands, where euthanasia is practiced, universal health
   care exists, meaning that the terminally ill are not forced to choose
   suicide if they can't afford hospice care or pain treatment, Dunn

   Other questions have been raised, including whether Oregon will become
   a suicide ``resort'' for terminally ill people from other places.

   The law refers to ``Oregon residents'' but doesn't set residency

   Barbara Coombs Lee, the law's chief sponsor, said she doubts doctors
   would be willing to prescribe lethal drugs to someone who shows up out
   of the blue.

   The law will work fine once people get used to it, she said, adding:
   ``There has never been a medical treatment that has been so carefully
   detailed as this one.''
