Death with dignity

November 28, 1994

Voters in Oregon put the medical profession on notice earlier this month when they approved a "Death with Dignity" ballot measure setting out conditions under which physicians can prescribe a fatal dose of drugs for terminally ill patients. Plenty of doctors don't want that power, and the American Medical Association joined religious groups in campaigning fervently against the measure. But Oregon is not the first state to contemplate such a measure -- and it won't be the last.

The new Oregon law, which takes effect next month, specifically forbids the kind of active euthanasia practiced in the Netherlands. While it is technically illegal for Dutch physicians to give terminally ill patients lethal injections or otherwise hasten their deaths, when specified conditions are met doctors are not prosecuted for these acts.

Oregon's law has a number of strict safeguards. It applies only to patients with terminal illnesses who are not expected to live more than six months. The patient must make three requests, one in writing, over a 15-day period. The written request must be witnessed by two other people, one of whom cannot be a relative or beneficiary of the dying patient's estate. If these and other conditions are met, the physician who prescribes the lethal medication cannot be subject to prosecution.

Even so, patients who want to take advantage of the new law may not find it as easy as they expect. Physicians do not have to comply with requests, and surveys show that many doctors would refuse. What they will have to do, however, is face more squarely the agonizing way so many Americans die. The "death with dignity" movement is fueled in large part by anger at a medical system that too often goes to heroic lengths to keep the machinery of life moving, while paying little attention to the suffering that such efforts can cause.

The Oregon law should become a catalyst for better communication between patients and physicians. As things stand now, some requests to die could mask other problems -- a need for better pain relief or simple loneliness. Better counseling about the availability and benefits of hospice programs could turn patients' thoughts from death toward making the most of the life they have left.

Physician-assisted suicide prompts fears of abuse, and Oregonians will now begin to learn whether those fears are grounded. Whatever happens there, the demand for death with dignity -- with or without physician-assisted suicide -- will continue to grow.

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