Policy implications of the Oregon Death with Dignity Act

¶ … death with dignity is a contentious issue with opposition in courts and in the public. The California Compassionate Choices Act would allow those diagnosed with a terminal illness to choose to end their life with dignity, including choosing physician-assisted suicide. The bill recently failed, but it will certainly return to the ballot in a different form. However, similar measures in many other states have failed, including Michigan, and the only state to currently allow death with dignity is Oregon. Congress has passed laws allowing patients to choose to refuse certain medical care.

End of life issues are complicated. Indeed modern medical practices have improved care and further complicate the issues of when and where a person ends their life. Many prominent medical cases indicate the difficulty of making these decisions, including Karen Quinlan, Elizabeth Bouvia, Robert Wendland, and most recently, Terri Schiavo.

Social workers must be cognizant of the ethical and moral considerations of these difficult choices, and cultural practices and beliefs are a major factor in death with dignity choices.

The Oregon Death with Dignity Act as added to the controversy, but was recently upheld by the Supreme Court. The law has brought death with dignity into the public view, and writings by David Gil continue to inform the public and inflame the issue in some people's minds. The act attempts to give terminally ill or incapacitated patients the choice to die with dignity, when they choose to die. Many European countries have laws defining "terminal" and other conditions, and have condoned euthanasia for many years. A majority of Americans believe a person has the right to end their life in certain situations, and the Oregon law confirms this, as there are more elderly suicides in Oregon than other states.

Two of the most well-known advocates of physician-assisted suicide are Dr. Jack Kevorkian and Dr. Timothy Quill. Moral conservatives oppose euthanasia because they believe it is morally wrong, and is the same as ending life-sustaining treatment. Both doctors feel physician-assisted suicide is a compassionate alternative to living the remainder of life filled with pain and suffering. Many others agree, and there are even published documents instructing loved ones and physicians how to go about assisting in a death with dignity suicide. In fact, many physicians feel that physician-assisted suicide could help keep health care costs in check as the baby-boomer generation ages. Unfortunately, statistics are lacking in the area of terminally ill patients and how many would end their lives if given the choice. Statistics do show, however, that many physicians receive requests for medications that will hasten death, or requests for lethal injections, and that a small number to comply in some cases.

Many physicians oppose the practice because they feel it goes against the oath they took to always save lives, while some do sympathize with terminally ill patients. There are also similar considerations for nurses and pharmacists who might be involved in the assisted suicide. The most famous proponent of physician-assisted suicide is Dr. Jack Kevorkian, now serving a prison sentence for the practice in Michigan.