X-Message-Number: 8762 Date: Tue, 11 Nov 1997 10:58:18 -0700 From: David Brandt-Erichsen <> Subject: Oregon update from ASSOCIATED PRESS (Nov 10/97; 1:26 am EST) OREGON DOCTORS STRUGGLE TO PREPARE FOR ASSISTED SUICIDE 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 live.'' 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 judgment. 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 chairman. 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 said. 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 requirements. 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.'' Rate This Message: http://www.cryonet.org/cgi-bin/rate.cgi?msg=8762