X-Message-Number: 8768 Date: Wed, 12 Nov 1997 13:31:27 -0700 From: David Brandt-Erichsen <> Subject: Oregon update The Oregonian newspaper (Nov 12) reports:- Doctors get advice on suicide questions Two physicians' groups offer guidelines on reconciling personal beliefs and patients' rights Dave Hogan of The Oregonian staff Doctors grappling with physician-assisted suicide are beginning to get written guidance. The Oregon Medical Association on Tuesday started offering doctors a "Compliance Checklist" outlining their rights and responsibilities under the law. And Physicians for Compassionate Care, which opposes assisted suicide, will send a letter Thursday to its 1,000 Oregon members giving recommendations on how to refuse to participate in the state's Death With Dignity Act. "Our members need to feel they have some guidelines from a larger group that they belong to, to help validate what they're doing, so that they don't feel all alone," said Dr. Greg Hamilton, a board member of Physicians for Compassionate Care. Hamilton signed the letter along with Drs. William Toffler and William Petty, other leaders of the organization. Both the letter and the checklist demonstrate doctors' efforts to collectively come to terms with how to proceed through the legal and ethical thicket of the new law. But whether asking doctors to state their position on assisted suicide -- as the Physicians for Compassionate Care letter urges -- will polarize them remains to be seen. "We all want to do the right thing for our patients at the end of life. We're all trying to help our patients," said Dr. Leigh Dolin, a Portland internist who voted for the law but worries about the intense scrutiny such a process brings. "It's scary for a physician to be in this position." The Oregon Medical Association checklist addresses all doctors, whatever their position on assisted suicide. Though the 5,700-member organization views the Death With Dignity Act as seriously flawed, it remains neutral on the issue of assisted suicide itself and has promised to strictly observe provisions of the law. The Compliance Checklist tells doctors they have a right to refuse a request to participate in an assisted suicide but warns them that they "may not abandon the patient." It advises such doctors to cooperate in referring patients to other physicians who will help them carry out the suicide. Physicians for Compassionate Care, on the other hand, advises its members that they can choose not to mention assisted suicide as an option for a patient and can decline to make a referral. Patients would be on their own to choose another doctor. Much of the OMA checklist reminds doctors who participate in the assisted suicide process to carefully document each step of the way and to make certain the suicide is voluntary. The OMA document contains a copy of the form that a patient requesting suicide is required to sign as part of the law. James Kronenberg, association spokesman, said the organization sees no reason why a physician cannot now start the assisted suicide process. The Physicians for Compassionate Care letter describes its recommendations to doctors who oppose assisted suicide as "intended to protect our patients and maintain our moral integrity." The letter recommends that doctors post in their waiting rooms a statement of their views on patient care, including their refusal to write a lethal prescription. The letter suggests treating the desire for suicide as a symptom requiring diagnosis and treatment. Physicians who support assisted suicide spoke favorably about the Physicians for Compassionate Care letter, provided the recommendations do not block patients' rights to receive aid in dying. "It is very appropriate and I think it's very necessary for physicians ... to let their patients know very early what their position is, so that if the patient feels very strongly, they can find a new primary care physician in a timely manner," said Dr. Peter Goodwin, a leader of Physicians for Death With Dignity. Goodwin said physicians willing to participate in assisted suicide are more likely to discuss the issue privately with their patients rather than posting their position. Rate This Message: http://www.cryonet.org/cgi-bin/rate.cgi?msg=8768