The New Atlantis has a long article reviewing the state of Oregon's ten-year old experiment known as the Death with Dignity Act. Written before Washington's overwhelming approval of a similar measure, the piece carefully examines the history of the legislation, the arguments in favor of physician-assisted suicide, and the experience that Oregon has had with it. Written by Courtney Campbell, Hundere Professor in Religion and Culture at Oregon State University, it is clearly tilted against the act, and he makes his position clear at the end of the piece.
One of the observations that I found particularly interesting can be found under the fold.
Death with dignity is the death of choice for relatively few persons.
Before the act was implemented, opponents anticipated a demographic migration of near-terminal patients to Oregon, such that Oregon would become a “suicide center” for the terminally ill, with all sorts of ensuing social catastrophes. The empirical evidence does not bear out these projections. In ten years, 541 Oregon residents have received lethal prescriptions to end their lives; of this number, 341 patients actually ingested the drugs. These figures are not only lower than the substantial numbers predicted by opponents, they are even smaller than the more conservative estimates anticipated by advocates. While those figures have generally risen each year, the deaths under the ODDA still comprise a very low proportion of Oregon’s total deaths."
Before the act was implemented, opponents anticipated a demographic migration of near-terminal patients to Oregon, such that Oregon would become a “suicide center” for the terminally ill, with all sorts of ensuing social catastrophes. The empirical evidence does not bear out these projections. In ten years, 541 Oregon residents have received lethal prescriptions to end their lives; of this number, 341 patients actually ingested the drugs. These figures are not only lower than the substantial numbers predicted by opponents, they are even smaller than the more conservative estimates anticipated by advocates. While those figures have generally risen each year, the deaths under the ODDA still comprise a very low proportion of Oregon’s total deaths."
Given the predictions of both the ODDA’s original supporters and opponents, one might be inclined to ask not why are some terminally ill patients seeking recourse to physician-assisted suicide, but rather why aren’t more of them doing so? In some years, and in some cases, the prospect of federal intervention may have had a kind of “chilling” effect—if not necessarily among patients requesting such assistance, then on willing physician participants. There may also be a general demographic factor at work: younger persons may be more willing to support physician-assisted suicide than elderly persons who may be staring their own mortality, or that of loved ones, in the face.
However, a likelier explanation may be that the ODDA served as a catalyst to improved end-of-life care among Oregon practitioners—including the increased use of hospice and palliative care, and the easing of restrictions on the drugs practitioners could provide to relieve pain. This is a very significant possibility, because it implies that ensuring a dignified death may not be a matter of changing the laws so much as a matter of changing medical practices and professional education. Moreover, it suggests that, for most people, a pharmacologically-induced death is not a precondition of a dignified death, nor that the possession of a right entails its subsequent use.
However, a likelier explanation may be that the ODDA served as a catalyst to improved end-of-life care among Oregon practitioners—including the increased use of hospice and palliative care, and the easing of restrictions on the drugs practitioners could provide to relieve pain. This is a very significant possibility, because it implies that ensuring a dignified death may not be a matter of changing the laws so much as a matter of changing medical practices and professional education. Moreover, it suggests that, for most people, a pharmacologically-induced death is not a precondition of a dignified death, nor that the possession of a right entails its subsequent use.
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