Oregon Revisits Assisted-Suicide Debate Residents of the Only State with Right-to-Die Law Will Vote Again This Fall on Its Validity

Article excerpt

A clear majority of Americans surveyed agree that doctors should be allowed to hasten death under some circumstances.

But in the privacy of the polling booth (or in the stillness of prayer), it appears to be another matter. And especially when a loved one is involved, most people still are very hesitant to accept physician-assisted suicide as something that should be legally or morally acceptable.

Or to put it more simply, the head and the heart may be reaching different conclusions on this profound issue. In June, the United States Supreme Court ruled that there is no constitutional "right to die." But the justices left it up to the states to pass laws banning - or allowing - doctor-assisted suicide. The national debate is now shifting to Oregon, where a key test will come this fall. Voters here will be asked to reconsider support of a "death with dignity" ballot measure narrowly passed in 1994. Supporters say it would provide a strictly-regulated opportunity for patients diagnosed as terminally ill to ask for their physician's help in committing suicide. But opponents have held up the initiative in federal courts. State lawmakers in Oregon, as a group more Republican and more conservative than they were three years ago, put the issue back on the ballot in an apparent bid to repeal the measure. Supporters are frustrated - but not deterred - by having to face better-funded opponents again. "The more people consider it, the more people come to understand the complexities of end-of-life care, the more reasonable it appears that, yes, individuals should have some choice in the matter of how and when and under what circumstances they die when they're stuck in this prolonged dying process," says Barbara Coombs Lee, director of the Seattle-based group Compassion in Dying. But Ms. Lee, who is a medical nurse and a lawyer, allows that "this does not translate into political support in state legislatures." "There's ... a mismatch right now between the opinion of a majority of the people and the moralist agenda of many politicians in state legislatures," she says. For example, since Oregon's "Measure 16" passed three years ago, not a single bill allowing physician-assisted suicide has passed in the more than 20 states where such bills have been introduced. In only one state - Michigan - is there a signature-gathering effort to follow Oregon's lead. Thirty-five states now have laws outlawing physician-assisted suicide or euthanasia. And earlier this year, the United States Senate unanimously voted to forbid the use of federal funds to pay for or promote such procedures. But while lawmakers at the state and federal levels may be more conservative these days, it also is clear that those professions dealing most directly with the issue are wrestling over it as well. The issue is a struggle for medical doctors. A key tenet of the Hippocratic oath is that "I will neither give a deadly drug to anybody if asked for it, nor will I make a suggestion to this effect." Some doctors publicly advocate helping certain patients end their own lives. Seven percent of Oregon physicians surveyed by the New England Journal of Medicine had written prescriptions for a lethal dose of medication. Marcia Angell, executive editor of the New England Journal of Medicine, asserts "the highest ethical imperative of doctors should be to provide care in whatever way best serves patients' interests, in accord with each patient's wishes, not with a theoretical commitment to preserve life no matter what the cost in suffering." But the American Medical Association balks at that view. "Physician-assisted suicide is against the code of medical ethics and incompatible with the physician's role as healer and caregiver," says Thomas Reardon, chair of the AMA Task Force on Quality Care at the End of Life. "It is not a constitutional right." Here in Oregon, the state medical association has moved from a neutral position on the "death with dignity" measure to opposition. …