A patient can rescind a request at any time and in any manner. The attending physician will also offer the patient an opportunity to rescind his/her request at the end of the 15-day waiting period following the initial request to participate. (Oregon "Death With Dignity" FAQ)
Additionally, there are reporting requirements, on the part of the physician. The state has consciously set about to track the utilization of the law and make adjustments accordingly. "Physicians must report all prescriptions for lethal medications to the Department of Human Services, Vital Records. As of 1999, pharmacists must be informed of the prescribed medication's ultimate use." (Oregon "Death With Dignity" FAQ)
The individual, physician and witnesses must contest that the patient must not appear to be suffering from any psychological disorder that would impair his or her judgment or decision making processes. The criteria that an individual must meet to participate in the act are as follows:
The law states that, in order to participate, a patient must be: 1) 18 years of age or older, 2) a resident of Oregon, 3) capable of making and communicating health care decisions for him/herself, and 4) diagnosed with a terminal illness that will lead to death within six (6) months. It is up to the attending physician to determine whether these criteria have been met. (Oregon "Death With Dignity" FAQ)
Functionally, though some would argue not ideologically the theory behind the signing of "Death With Dignity" documentation is similar to signing advanced directives, in the form of what most institutions and professionals would call a "no code," where the individual, or his or her signatory signs a document that asks that no advanced measures be taken to extend the life of the individual. In a sense the legalese is much the same and guised along the same lines as a last will and testament that requires complete lucidity or a signatory who is aware of the individual's wishes. This is not in the least an unknown concept, that attempts to circumvent traditional legal documentation, the difference is that the precedence of the act of signing one's life away, not in a passive but instead in an active sense is at stake. This is to some theorists very similar to Roe v Wade (1973) (Hillyard & Dombrink, 2001, p. 125) with the exception that the individual is choosing to end his or her own life, and the "victim" is not nameless, faceless and voiceless, as many argue in the case of abortion rights. The individual has for all intents and purposes lived the whole scope of ones life, as they must be above the age of 18 to participate in the act. Though argument could also enter that the age of consent for most other legal responsibilities, 18 is far to young for participation in such a decision, legal precedence allows such. Finally, the state of Oregon also tried to limit their place as a destination for death by limiting availability of services to Oregon residents, (Hillyard & Dombrink, 2001, p. 69) though many are quick to point out that there is no formal residency requirement (such as in the case of other residency issues that hold time limits from 3 months to 1 year depending on the issue and state) one must simply prove that they currently reside in Oregon. (Oregon "Death With Dignity" FAQ) No doubt if abuses are noted through tracking (done yearly by the Department of Human Services of Oregon, as reported by physicians) there will be further stipulations placed upon those qualified to participate.
The clear purpose or focus of the law, to allow the individual dying patients the right to choose an early termination of their life, with the assistance of medication and a physician to prescribe it can also be muddied by situations where court appointed and statutory guardians have had potential conflicts of interest, and another party with authority, such as a doctor who is qualified by the law to determine whether the patient is terminally ill is needed to assist in settling the dispute. This is clearly an aspect of the benchmark act passed by Oregon, as many individuals and physicians choose not to participate for reasons that have little if anything to do with the actual desire to spare themselves or their loved one the agony of their dying days. Though in Oregon the stipulation was made that the physician, and/or health care provider was not the administering agent of the lethal medication, (a variance from California and Washington State legislative attempts) and that the patient must do so him or herself, legal implications are still present as the physician and by virtue of necessity the pharmacist becomes the avenue for the lethal medication. There are still many issues at work her that will likely be played out in the courts and legislatures for some time to come.
Objectives, Values, Ideological Orientation of the Policy: Underlying Theories, Target Population and the Manner it is effected, Financial Costs and Benefits, Quality of life, Historical background of the Policy
The values and the ideological orientation of the statute appear to be based on non-discrimination, civil rights and self-determination. Studies of patient attitudes toward assisted suicide and euthanasia indicate a patient's interest in physician-assisted suicide appears to be a function of psychological stress and social factors. Worldwide, about a million people commit suicide annually and the Surgeon General of the United States is currently campaigning to reduce this rate. "An estimated 765,000 Americans attempt suicide each year, according to the AAS [American Association of Suicidology]." (Wetzstein, 2000, p. 2) Though of these individuals only part are successful, more women than men attempt suicide but more men are successful and certain demographics of individuals are at higher risk, including but not limited to the elderly. There are few statistics that detail the reason for suicide, but it is to be assumed that many are cases of perceived terminal illness. The national and international attempts to prevent suicide are longstanding, though they have evolved over the years, ideologically altering the idea of suicide as an unforgivable act to one that needs to be treated with preventative measures. (Wetzstein, 2000, p. 2) it would seem that the acceptance of the right to die would be incongruent with the overall standard of attempting to reduce suicide rates. The results of a 2006 Gallup poll gives an indication of the overall ethical moral opinions on the issue of suicide:
Gallop Poll Question 1: "Next, I'm going to read you a list of issues. Regardless of whether or not you think it should be legal, please tell me whether you personally believe that in general it is morally acceptable or morally wrong? How about... suicide?"
Gallop Poll Question 2: Next, I'm going to read you a list of issues. Regardless of whether or not you think it should be legal, please tell me whether you personally believe that in general it is morally acceptable or morally wrong? How about... doctor-assisted suicide? (Public Agenda 2006)
The moral dilemma is of coarse vast and ethically sensational, but it holds true that civil rights and individual rights are an equally pressing part of the ethical/moral equation as are personal feelings regarding the fear many people feel when they attempt to empathize with individuals who are terminally ill or suffering and without the personal control to contain such suffering or even watching someone they love suffer, without the personal control to contain such suffering. Most individuals over the age of 30 have had at least some impact from the death of loved ones, and have watched as others struggled with decisions regarding the lives of others. In fact in a Time Magazine Poll (2005) there is a clear indication that at least one third of American's have had to make life or death health care decisions for loved ones.
Time magazine poll Question: Have you personally been in a situation with a parent or other loved one in which you had to make a choice about using extraordinary measures to keep them alive?
In a 2005 Pew Research Poll many people also intoned that they desired…