The Oregon Experience

In the first publicly reported case of legal assisted suicide in Oregon, the woman who died had been turned down by two doctors, one of whom had diagnosed her as clinically depressed. However, she simply contacted suicide advocates who referred her to another doctor who saw no necessity of referring her to a psychiatrist or psychologist. (Indeed, suicide advocacy groups facilitated at least two-thirds of the reported suicides.)

According to official reports, 40% of those who died in the first year of legal assisted suicide were turned down by at least one doctor, and on average those who were assisted to commit suicide had been known by the doctors who assisted them only about one-tenth as long as a group of similarly situated patients who did not commit suicide.

These facts raise serious questions about whether depressed people requesting assisted suicide as a subconscious cry for help are being adequately identified and screened out.

In 14 of the 15 officially reported cases, pain was not the motivation for assisted suicide. In the remaining case the victim had expressed concern about future pain at the end of life. Instead, they were motivated predominately by concerns about "loss of autonomy" or of "control of bodily functions."

In comparison to the "control" group of similarly situated patients who did not commit suicide, they were in fact far less likely to have lost their functional capacity, suggesting that fear of future disability and dependence­without actually experiencing much of it-were the primary reasons they committed suicide.

People with a long-term experience of disability frequently point out that individuals who become disabled almost invariably go through a period of adjustment at the start of which they feel helpless and worthless but then grow to value their lives positively. Tragically, the available option of legalized assisted suicide seems to be

cutting this adjustment process short and leading to death while still in the first stages of experiencing disability. (Although the Oregon law applies only to the "terminally ill," one is considered terminally ill if expected to die without treatment even if one could live indefinitely if provided treatment. Thus, many people who could live indefinitely with a disability are eligible for assisted suicide.)

At the time of the original 1994 referendum adopting the Oregon law, much was made of the fact that it was limited to the prescription of lethal drugs the person would have to take himself or herself, and prohibited doctors from directly killing patients, such as by lethal injection. It was said that this provided a strong safeguard to ensure that death, if it occurred, was truly the person's own choice.

However, after Patrick Matheny, a person with Lou Gehrig's disease who was said to be incapable of taking a lethal prescription himself, was "helped" to die by his brother in an unspecified manner, the Oregon attorney general's office suggested that the Oregon law's limitation might discriminate against those incapable of self administration in violation of the state constitution and federal disability rights law. Thus, the much-touted "safeguard" of limiting the law to lethal prescriptions may be about to disappear.