A smiling Barbara Coombs Lee, executive director
of the pro-euthanasia organization Compassion in Dying, held a press conference
to announce that on March 25 the first publicly known legally assisted suicide
occurred under the Oregon "Death with Dignity" law. The (Portland)
Oregonian subsequently reported that earlier another individual had killed
himself or herself with the assistance of a Hemlock Society leader. Other
unannounced suicides may have occurred, since no accounting will be given
by the state authorities to whom such deaths must be reported until at least
10 reports have been filed.
"Hooray for the people of Oregon," said Faye Girsh, executive
director of the Hemlock Society. "I'm in awe. This is an historic moment.
. . . There will be many others now."
The woman whose assisted suicide was announced by Coombs Lee was first
turned down by her own physician as well as a second physician, who concluded
that she was depressed and that her depression was affecting her desire
to end her life. She then contacted Dr. Peter Goodwin, medical director
of Compassion in Dying.
Goodwin told the American Medical News that the woman was able to look
after her own house, was able to walk up and down stairs, and was not in
great pain. However, she had had breast cancer for 22 years, could no longer
garden, and for two weeks had been unable to do aerobic water exercises.
Goodwin said that in his view "the quality of her life was just disappearing."
He acted quickly to put her in touch with another doctor willing to prescribe
lethal medication for her because, Goodwin said, "She could have had
a stroke tomorrow and lost her opportunity to die in the way she wanted."
In an anonymous interview with the Associated Press, the doctor to whom
Goodwin referred the woman said he first met her two and a half weeks before
she killed herself. She was "certainly in pain," the unidentified
doctor said, but he did not claim the pain was untreatable. Instead, he
reported, "She didn't like to use pain medicine and used very little
of it. ... [I]f you talk to old physicians about her, there was never any
ambivalence about the level of care that she wanted which was always low
to minimal."
He stated that the cancer had spread into her lungs and "this was
causing a gradual decline in her ability to breathe," although he gave
no indication that treatments had been considered to assist her breathing.
The anonymous doctor said the woman's suicide "was an extremely moving
experience for me. ... This is impressive. You meet a person, you meet her
two weeks before she is going to die. You realize that you are going to
help her go through with this and it is extremely painful because it's something
that you don't want to do. It is a person that you want to keep knowing
and you can't, if you believe in her right and you respect her motivation.
It's impossible to say no but at the same time it['s] a big personal loss
and there['s] a lot of reluctance involved."
American Medical Association Board Chair Dr. Thomas Reardon, himself from
Portland, questioned the adequacy of the woman's psychiatric evaluation
and criticized the brevity of involvement of the physician who prescribed
her death-inducing drugs. "This does not sound like the picture the
Oregon Right to Die people painted when they were campaigning for the law,
which involved a caring physician with a long-standing relationship with
the patient," Dr. Reardon said.
Less information was available about the other person known to have killed
himself or herself. Nothing was published about the person's condition or
diagnosis. According to an Oregonian story based on an interview with an
unidentified family member, the individual contacted the Hemlock Society
after last November's referendum, and was referred to Myriam Coppens, a
marriage therapist active in Hemlock who met with the family and referred
them to a doctor willing to prescribe lethal drugs. The person "waited
quite a while before using the medication," according to the Oregonian,
then committed suicide in the presence of his or her family. Unlike in the
case of the woman who killed herself March 25, no doctor was present when
he or she ingested the lethal drugs.
The fact that the only sources for information were proponents of legalized
assisted suicide led some to point out the ease with which abuses and grounds
for caution about the execution of the new law could be kept from public
scrutiny. Oregon State University ethicist Courtney Campbell, Ph.D., said
the media accounts "do not provide adequate public monitoring and oversight,
and may in fact distort the picture. It's no coincidence that the 'first
reported' death was a 'media-genic' death. If it had turned out otherwise,
who would have known?"
Gayle Atteberry, executive director of Oregon Right to Life, said, "We're
at the mercy of those who want to tell us what they want to tell us."
Rules issued by the Health Division of the Oregon Department of Human Resources
to govern reporting assisted suicides require little information from which
conclusions will be able to be drawn about implementation of the law. It
will be impossible to tell, for example, whether suicides are disproportionately
assisted for members of low-income or minority groups.
Testifying at a hearing on the reporting rules, Dr. Kenneth R. Stevens
Jr., chairman of the department of radiation oncology at Oregon Health Sciences
University, said that the rules "are analogous to doctors performing
an experiment of giving instructions and instruments to patients for them
to remove their own gallbladders at home, with the only monitoring being
the number of gallbladders received by the Oregon Health Division."
In contrast, Compassion in Dying's Coombs Lee praised the regulations as
protecting the privacy of those who take their own lives, their doctors,
and their families.
Regardless of the amount of information available, euthanasia advocates
were not shy about using the occasion of the first publicly reported suicides
to
proclaim the Oregon law only, in the words of the Netherlands' Dr. Pieter
Admiraal, "an important first step." Michael Schwartz, a Michigan
attorney who has represented Jack Kevorkian, said the debate over assisted
suicide will shift from whether to allow the practice to when.
"At some point, people will say this is a reasonable medical procedure.
Then they will begin to question why we limit the law to those who have
six months to live. What is the magic in six months?" Schwartz asked.
"If someone has pain and suffering and nothing can be done, why does
a person with months to live get the choice and someone who has 15 years
of agony and misery does not? That's the biggest drawback I see in Oregon's
law."