ASSISTED SUICIDE: Studies Offer ‘Picture’ of Process
Two studies looking at Oregon's 1997 Death With Dignity Act paint "the clearest picture yet" of how the law is working. It has been used by 43 people in the last two years, the Washington Post reports. The first study, led by Portland psychiatrist Linda Ganzini and published in today's New England Journal of Medicine, surveyed 4,000 Oregon doctors who were "eligible to consider suicide requests from patients." Of the 65% who responded, 5% said they had at least one patient ask for a lethal prescription, and of the 165 requests described, 17 led to assisted suicides. Half of the patients were men and were married, only 2% were uninsured and 5% did not have a high school degree; two-thirds suffered from terminal cancer. Many suicide- seekers cited pain, breathlessness and fatigue as symptoms that influenced their decisions for assisted suicide. More than half mentioned "loss of independence, poor quality of life, a desire to control the circumstances of death, or a readiness to die" as reasons. But once doctors altered their care, either by directing patients to hospice care, improving their pain control, changing their medications or referring them to mental health counseling, almost half "changed their minds about wanting suicide."
Demographics of Dying
The second study, by the Oregon Health Department, interviewed relatives of 27 patients who died from euthanasia. Of that group, half were college graduates and none lacked health insurance (Brown, 2/24). On average, most were unconscious in 10 minutes and dead within three hours. A majority suffered from cancer, but others had chronic lung disease, AIDS or Lou Gehrig's disease (Cain, AP/Philadelphia Inquirer, 2/24). Family members said the patients "worried about future pain and misery" and had "lack of trust" in the long term support of the medical establishment (Washington Post, 2/24).
"Although concern about possible abuses persist, our data indicate that poverty, lack of education or health insurance, and poor care at the end of life were not important factors in patients' requests for assistance with suicide," Oregon health officials said (AP/Philadelphia Inquirer, 2/24). Ganzini noted, "It appears that physicians are proceeding in a very careful and prudent manner. That should be reassuring regardless of where you stand in this debate." Barbara Combs Lee, head of the Compassion in Dying Federation, added that Ganzini's study is "just more news of very careful and responsible use of the law in Oregon" (Washington Post, 2/24). George Eighmey, executive director of Compassion in Dying of Oregon, agreed, saying, "This report disproves everything the opponents are saying and dispels all the myths" about abuse of the law. But critics counter that the report uses "bogus statistics 'to minimize the importance of a human tragedy'" (McMahon/Koch, USA Today, 2/24). Dr. William Breitbart of New York's Memorial Sloan-Kettering Cancer Center expressed his concerns that the euthanasia "debate will now hinge on 'how best to kill people, rather than stepping back and debating how best can we prevent the suffering and despondency that leads to patients to ask physicians to kill them as the only way to stop the suffering'" (Foreman, Boston Globe, 2/24).
Meanwhile, the controversial "Final Exit" video that demonstrates how to commit suicide without the aid of a physician is drawing fire, even from Dr. Jack Kevorkian, the "lightening rod for the assisted suicide movement." Kevorkian lawyer Mayer Morganroth said the doctor, who helped over 100 people die, "thinks [the video is] outrageous and it's very dangerous." Howard Brody of the Michigan State University Center for Ethics and Humanities in Life Sciences, added, "There's every likelihood the people who will use this video might be medically unbalanced or severely depressed. This is not the person you want to encourage" (Kozlowski, Detroit News, 2/24).