There is a certain bureaucratic crispness to the report issued Feb. 17 by Oregon’s Health Division.
In 15 of the 29,000 deaths reported in the state last year, the cause of death was “drug overdose, legally prescribed.” Each of the 15 had filled out a simple, one-page form titled “Request for medication to end my life in a humane and dignified manner.”
The average age of the eight men and seven women was 69. Thirteen of them had cancer; the other two had heart or lung disease. There were mostly white, well-educated, and had good health insurance. Most of the 15 died within one hour of taking the lethal medication, although it took four of them more than three hours to die. In one case, the person lingered more than 11 hours before succumbing.
For all its air of administrative objectivity, this new report on the first year of legalized assisted suicide in Oregon is a highly political document. Its unstated but unmistakable aim is to refute the arguments of assisted-suicide opponents.
In the report summary issued to the press and quoted widely and unquestioningly in subsequent media reports, the state argues: “Physician-assisted suicide was not disproportionately chosen by terminally ill patients who were poor, uneducated, uninsured, fearful of the financial consequences of their illnesses or who lacked end-of-life care.”
Those who chose to kill themselves are portrayed as strong and heroic. Or, in the dispassionate, purportedly nonbiased prose of the report, people who had been “decisive and independent throughout their lives.”
The state downplayed the fact that its report was culled from interviews with a handful of doctors and from death certificates. Nor did the report mention that there is no penalty under the law for doctors who do not document cases where they help patients to die.
What that means is that nobody really knows how many patients killed themselves last year.
Moreover, the 15 cases reported could be presumed to be a highly skewed sample, reported by doctors who are advocates of the law and who see their patients as “good examples.” That explains why the 15 who opted for death were all well-off and with good insurance plans. It strains credibility to suppose that any doctor would voluntarily admit to prescribing lethal drugs for a terminally ill patient who felt pressured by poverty or mental illness.
Of course, the report contains no mention of the mental health or well-being of the 15 who sought to kill themselves. The new report also fails to note that from 1999 on, Oregon will be paying for the assisted suicides of poor people as a “benefit” under its welfare program.
These are the kind of questions to which Oregonians, and indeed all Americans, should be demanding answers. None of what this report talks about sounds like medical care. Instead, it sounds a lot more like a bureaucratic prelude to mandatory death for the aged and terminally ill.
While Oregon is the first state in the world to legalize this barbaric practice, the Netherlands has been permitting it for years, although it remains technically illegal there. Ironically, the Oregon report was released on the same day that the Journal of Medical Ethics reported that cases of terminally ill and severely handicapped people being forced to commit suicide often go “unreported and unchecked” in the Netherlands.
There is nothing in this report from Oregon that provides assurance that such abuses will not happen here as well.
First published in Our Sunday Visitor (March 7, 1999)
© David Scott, 2009. All rights reserved.
