OREGON: Panel Pens Assisted-Suicide Guide

      The Task Force to Improve the Care of Terminally-Ill Oregonians Tuesday released its "guidebook of professional standards for doctor-assisted suicide," the Portland Oregonian reports. Based on the input of 25 health care organizations with differing views on assisted suicide, the 91-page guidebook was created to help health care providers "grapple with end-of-life care." Dr. Susan Tolle, director of the Center for Ethics in Health Care at Oregon Health Sciences University (the organization that "convened the task force"), noted that many health care organizations "stepped to the forefront to set standards for the professions they represent." The Oregon Board of Medical Examiners "strongly and publicly stated that physicians are expected to provide adequate pain medication at the end of life and will be disciplined if they grossly and repeatedly undertreat the pain of dying patients." The National Hospice Organization, which opposes assisted suicide, set as its policy "that hospices will not hasten death but instead will help patients live fully until they die, supported by comfort care."

Crime Or Compassion?
      The Oregonian reports that the state of Oregon is still wrangling over certain subtleties in the Death With Dignity Act. A "key" question "is how much a caregiver can assist when a terminally ill patient takes lethal medication under the law." While the law says no one can be criminally prosecuted for "being present" when an assisted suicide takes place, some groups "have asked whether a care provider can mix the lethal drugs, hand them to a patient, or spoon- feed them, if requested." The Oregon Nurses Association is particularly concerned about how lethal medications are administered. "Assistance with medications is a very big gray area, and that has led many nurses to believe that ultimately ... we're going to be confronted with some kind of required assistance. ... We need to know where we stand," said ONA administrator for professional services Susan King. While David Schuman, deputy state attorney general, said the law "probably" allows a doctor or nurse to administer the lethal drugs, the Oregonian notes that Schuman's opinion "shocked some legislators." State Sen. Ken Baker (R) said, "If someone wants to use this mechanism to end their life, then they are not only making the decision themselves, they are following through with that decision themselves. When you involve another person, then you start to lose your self-determination, and that's the key behind the entire statute." But Barbara Coombs Lee, author of the assisted-suicide law, "said she does not think that a caregiver assisting a patient would compromise the spirit of the law." Baker said "he expects" state legislators "will consider clarifying the law on the matter of assistance from care providers"; however, he said lawmakers are "not planning any aggressive tinkering."

Subsidizing Suicide
      With the guidebook completed, the Oregonian reports that the task force will now "turn its attention to expanding insurance coverage for hospice care and other comfort care for all Oregonians." Tolle said, "If you have no health insurance ... then it is cheaper to pursue assisted suicide than pay the expenses of hospice and comfort care" (Hoover, 3/4). Syndicated columnist Cal Thomas criticizes "'right to die' advocates ... telling taxpayers they have an obligation to subsidize poor people who wish to end their lives." Thomas writes that "once a right is created, it isn't long before anyone who cannot afford to exercise that right is regarded as a victim of discrimination." He concludes, "When man places himself in the supreme position of deciding right from wrong, it is a very short step toward deciding such things for others and forcing even people who don't agree to subsidize these practices with their tax dollars" (Los Angeles Times, 3/4).