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A Chronicle of Euthanasia Trends in America

Oregon: "Botched" Suicides, Flawed Report

Oregon's second annual report on the state's experiment in physician-assisted suicide has raised more questions than it answers - about the Oregon law itself and the credibility of its proponents.

The report by the Oregon Health Division (OHD) was issued February 24 and published in the New England Journal of Medicine [see page 3]. It shows 27 reported cases of assisted suicide in 1999, up from 16 in 1998 (which in turn is a corrected figure, for the state reported only 15 cases last year but later found it had omitted a case that was reported late in the year). It also shows that Oregon physicians are entertaining a broader range of conditions as making a patient eligible for assisted suicide, as the practice moves beyond cancer to cover patients with AIDS, Lou Gehrig’s disease (ALS) and obstructive pulmonary disease.

Prompting the greatest controversy about the report, however, is what it does not show. While the OHD found no sign of any abuse of the law’s guidelines, news reports have documented several problematic cases. One example is the case of Patrick Matheny, who was given active "help" in taking lethal drugs by a relative when he found himself too physically disabled to take them; this prompted the state attorney general’s office to suggest that such "assistance" for persons with disabilities who want to die may be mandated by disability rights laws [see February/March 1999 Life at Risk]. In October, the case of Kate Cheney dramatized the forum-shopping that has allowed patients and families to bypass mental competency requirements: Cheney’s adult daughter, described as "somewhat coercive" even by the psychiatrist who approved the suicide request, simply went from one physician to another until she found one willing to find her mother competent to undergo assisted suicide despite her signs of dementia [see September/October 1999 Life at Risk].

The new OHD report shows that only 37% of the patients killing themselves in 1999 received a psychiatric evaluation. The report also comments on interviews with family members in some of the cases - but provides no check on physicians' account of events, since the family member to be interviewed in each case was generally selected by the physician himself.

A final case illustrating deficiencies in the OHD report came to light as the report was issued, with publication of the March 2000 issue of the Oregon newsweekly Brainstorm [see www.brainstormnw.com]. The magazine reported a case of "botched suicide" in which a man took the prescribed lethal dose, but lingered and suffered so terribly that his wife called 911 and had him hospitalized. The man later died, apparently of natural causes, in a nursing facility. "Right to die" advocates discussed the case at a local seminar in December, but had apparently concealed it from the public and from Oregon authorities.

The "botched suicide" problem is given further attention by a Dutch study printed in the same issue of the New England Journal of Medicine as OHD’s report [see page 4]. The study shows that 18% of physician-assisted suicides in the Netherlands go awry, leading doctors to dispatch their patients more directly by lethal injection (an option currently not allowed under Oregon law).

In 1997, when this study was available only in Dutch publications, opponents of assisted suicide cited it to support repeal of Oregon’s assisted suicide law. However, supporters of the law aired television ads declaring that "you could look forever and you won’t find that study – because it doesn’t exist" [The Oregonian, 10/15/97]. Oregon voters believed the latter claim and upheld the assisted suicide law – only to discover now, over two years later, that the study existed all along.

Life at Risk, Vol. 10, No. 2
February 2000 Issue