The latest report has appeared on how Oregon's so-called Death with Dignity Act is working. Under this Act, which came into force in 1997, a doctor may prescribe lethal drugs for a terminally ill patient to take if, and as and when, he or she decides.
The number of deaths from such lethal prescriptions is now between three and four times what it was at the outset 13 years ago. Moreover, as most physicians in Oregon won't touch the practice, applicants are shopping around to find a small number of doctors who are comfortable with it. The latest report (for 2009) shows that some individual physicians wrote up to six prescriptions. The question must be asked: how objective can we regard an assessment that is carried out by a doctor who is not the patient's regular practitioner and who sees no problems with physician assisted suicide?
Advocates of a similar law here in Britain are fond of pointing to 'research' that purports to show that vulnerable groups are not being put at risk by Oregon's assisted suicide law. But the research in question is deeply flawed. It compared assisted suicide rates among whites as against ethnic minorities, among poor as against rich people, among college graduates as against the less well educated, among men as against women. But vulnerability to assisted suicide cannot be measured via such standard socio-economic groups: it applies across the board of society. Interestingly, though, the 'research' found that college graduates were seven times more likely to seek assisted suicide than less well-educated people. This finding was not allowed, however, to disturb the conclusion that vulnerable people were not being put at risk: it seems that college graduates aren't regarded as potentially vulnerable!
What about the elderly? Aren't they a vulnerable category? Of course they are, and the 'research' told us that they weren't at risk. This was a remarkable conclusion given that every report since 1998 has shown that the main demand for physician assisted suicide in Oregon comes from those aged between 65 and 84, and especially 65 and 74. So how did the 'researchers' reach their conclusion? The compared assisted suicide rates among those aged 85 or over with those from people aged between 18 and 64!
Campaigners for changing British law are usually silent about other research, which shows that, out of a sample of deaths from physician assisted suicide in Oregon, one in six had been suffering from treatable depression that had not been picked up by the prescribing physicians. This is, perhaps, hardly surprising when we consider how the assessment process is being conducted (see above). But the research report, which comes from genuinely independent researchers and was published a couple of years ago in the British Medical Journal, concludes frankly that "the current practice of the Death with Dignity Act in Oregon may adequately protect all mentally ill patients". It is interesting to note that the number of patients referred by physicians for psychiatric examination has fallen from 37% in 1998 to zero.
Under the Oregon law, once a patient has received lethal drugs from a compliant physician, it is up to the patient to take or not take them. That's fine, you might say. But think about it this way. What happens, if the prescribed drugs are force-fed to the patient or mixed in with a normal drink without the patient's knowledge. There is no way of detecting whether that happens. There is no requirement for anyone to be present when the drugs are taken - in 2009 the prescribing physician was present in only one in 20 cases.
The House of Lords 2005 Report on Lord Joffe's assisted Dying for the Terminally Ill Bill concluded that an Oregon type law in Britain would lead to around 800 deaths per year. Research in Britain by Professor Clive Seale based on confidential doctors' questionnaires concluded that there were no cases of assisted suicide in Britain currently (see http://www.carenotkilling.org.uk/?show=709 ) and we know that only 130 or so British people have travelled to Dignitas over the last ten years to end their lives - on average less than 20 per year - so with an Oregon type law we would be looking at a 4,000% increase in British cases. Having said that Britain is very different form Oregon - and we are only very slowly emerging from economic recession with cuts in health spending imminent and many families facing financial hardship. In such an environment the subtle pressure on vulnerable people to end their lives so as not to be a burden on families, carers and the state could prove overwhelming for many.
We should heed these warnings when we listen to the strident demands of our own euthanasia lobby to follow Oregon's example.
Read more:
Records and reports data on the Act
Washington State Department of Health 2009 Death with Dignity Act Report
Washington: First Year Under Legalized Assisted Suicide
Washington State "Death with Dignity" Statistics are Consistent with Elder Abuse
First 10 months of 'Death with Dignity' law sees 36 assisted suicides
The chilling truth about the city where they pay people to die
Don't follow Oregon's lead