Unless you live in the Pacific Northwest, you may not know that the voters in the state of Washington passed a “death with dignity” initiative on November 4 by a 16-percentage-point margin. In 1997, a ferocious battle preceded the narrow approval of an Oregon law allowing doctors to write lethal prescriptions for dying patients. In 2006, the law survived a Supreme Court challenge brought by two attorneys general. Now, in contrast to the earlier drama, the extension of the so-called right to die to a second state in November was almost ho-hum news.
Part of the reason is that in 10 years of experience with Oregon’s law, only 541 patients in a state of 3.7 million acquired prescriptions for lethal drugs. Of those, only 341 used them. None of the fears surrounding the new law have proved justified. No public outcry has arisen over pressuring dad to die so junior can sell the business. No flood of lawsuits has been filed over the legislation.
A decade-old Washington state law allowing doctors to write lethal prescriptions for dying patients has led to improved care at the end of life.
What has happened, writes Courtney S. Campbell, a religion and philosophy professor at Oregon State University, is that doctors have almost certainly changed the way they practice medicine. One of the law’s major selling points was that it would lead to the alleviation of unbearable pain among the dying. The public response to the issue caused doctors, hospitals, and hospices to pay more attention to pain. Laws and licensure requirements were altered so that doctors no longer faced investigation if they boosted dosages of medication to potentially dangerous levels for terminally ill people. Today, the issue of pain has become secondary. More than 80 percent of the patients requesting lethal drugs cite a “loss of autonomy” as justification. Pain is sixth on the list.
The expressed purpose of the Oregon law, like that of the Washington initiative, is to allow residents to choose death with dignity. Drugs are not a precondition for such a death, Campbell says, nor does the “possession of a right [entail] its subsequent use.”
It may be, writes Campbell, who considers the law a “moral mistake,” that the mere possibility of legalizing physician-assisted death serves as sufficient impetus to find alternatives for improving care at the end of life.
THE SOURCE: “Ten Years of ‘Death with Dignity’” by Courtney S. Campbell, in The New Atlantis, Fall 2008.
Photo courtesy of Flickr/Alex