Euthanasia, Physician-Assisted Suicide, and Oregon's Death with Dignity Act

Introduction: What Euthanasia Really Means

Euthanasia means "good death." Many people view euthanasia as a "mercy killing" — an act carried out out of concern or compassion for a dying person who is suffering. However, when euthanasia is coerced or made the only available option, it no longer signifies a "good death." In reality, it signifies death — and possibly forced death. As scholar Maggie Little has observed, medicine sometimes gets in the way of a truly good death, and practices like euthanasia, when misapplied, can strip away the very quality the term promises.

Concerns About Physician-Assisted Death

Physicians should not be given the option to hasten death, even when a patient is terminally ill. The most significant concern is the potential harm to patients who are poor and cannot afford adequate care. If physicians are permitted to assist in suicide or to euthanize their patients, they may come to view euthanasia not as a compassionate means of ending suffering, but as a practical cost-saving measure. This economic incentive could corrupt the foundational principles of medical care and put vulnerable populations at disproportionate risk.

Oregon's Ballot Measure 16 and the Death with Dignity Act

Oregon's Ballot Measure 16 established Oregon as the first U.S. state to permit physician-assisted suicide under specific legal restrictions. It was the first such law in the world. The measure was approved on November 8, 1994, receiving 627,980 votes. By the end of 2015, a reported 991 patients had died using prescriptions obtained under the act to end their own lives. While the median age was 71, some younger individuals were also represented. These figures raise important questions about the nature of euthanasia, palliative care, and physician-assisted suicide — and where Oregon's law fits among them.

Defining Key End-of-Life Terms

Active euthanasia is a form of euthanasia in which a person — typically a physician — commits a deliberate act intended to end a patient's life. This may occur through a lethal injection or another direct physical means.

Passive euthanasia occurs when someone ends a patient's life by omitting an act that would otherwise have extended it. Examples include withdrawing food or discontinuing treatment for an illness.

Physician-assisted suicide is often confused with euthanasia. Euthanasia involves a physician both omitting and performing actions that end a patient's life. Physician-assisted suicide, by contrast, is when a doctor provides the patient with the means to end his or her own life without being directly involved in the act. For example, a doctor may write a prescription for a lethal dose of medication or provide information on techniques for ending life — but the patient performs the final act alone.

Palliative care, also called end-of-life care, is a strategy designed to improve the quality of life for patients and their families facing a life-threatening illness. It does so through the prevention and relief of suffering by means of early identification, thorough assessment, and treatment of pain and other problems, whether physical, psychosocial, or spiritual. Palliative care emphasizes comfort rather than curative treatment.

Involuntary euthanasia occurs when a patient is unable to make a decision about ending his or her own life — for example, when in a coma or when the patient is a minor — and the decision must therefore be made by another party.

References

Claiborne, W. (1997). 'Death with Dignity' measure may make Oregon national battleground. The Washington Post. Retrieved April 7, 2016, from http://www.washingtonpost.com/wp-srv/national/longterm/supcourt/stories/062797d.htm

Oregon Revised Statute. (2016). Oregon Death with Dignity Act. Oregon.gov. Retrieved April 7, 2016, from https://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Pages/ors.aspx