Introduction
Death with dignity is certainly the first death act in the decade involving Oregon’s physician-assisted Act which was passed on November 4 by voters in Washington. This act is symbolic as it is the second act that permits physicians to assist ill patients in terminating their lives through prescribing poisonous doses of medication. ‘Death with dignity’ is modeled following Oregon’s law that includes certain safeguards designed to protect both patients and physicians. Enacted on October 27, 1997, Death with Dignity Act allows ailing Oregonians to terminate their lives using unpaid self-administration of lethal medications, specifically prescribed by a medical doctor or physician for that purpose (Corr, 2013, p. 135). The law requires (ODHS) the Oregon Department of Human Services to publish annual statistical reports and collect information about physicians and patients participating in physician-assisted death process (PAD) (Leeb, 2008, p. 64). Since this law was passed, close to 340 people have opted to terminate their lives. In addition to that, it has also offered state practitioners useful lessons on various ways to deal with this apparent issue. For instance, since the passage of this law, access to palliative and hospice care is seen to have gradually improved. There has also been a call to advance the assessment of depressed patients by physicians.
Prescriptions and Decisions
Katrina Hedberg, MPH, MD who is a medical epidemiologist based in Portland at the Oregon Public Health Division suspects that the number of people who ask for the prescription is likely to surpass that of those who literally fill the prescriptions and take the medication. Dr. (Matrise, 2008, p. 87). Gideonse an advisor to the board of directors of Choices and Compassion group which is based in Denver and Portland advocates and educates for care and choices at the termination of life. He posits that he has written quite a number of prescriptions in his practice for long-term patients. Collectively, he states that he always gets the opportunity to know patients seeking for the prescription in a very personal way to provide some level of relief especially for situations that are terrible.
Screening for Depression
Among the biggest concerns over the years is if the law made it very easy for depressed patients to terminate their lives. One of the organizations that opposes the law: Physicians for Compassionate Choices (PCC) suggests that it is under rare conditions for persons seeking lethal medications to actually be evaluated for depression. In 2007, 49 people ended their lives and none of those deaths had psychiatric referral yet depression is long known to be the leading causes of people to commit suicide (Srinivasan, 2011, p. 111). The current system in Oregon may not fully protect the few who are depressed from obtaining a lethal medication easily. Another study consisting of 58 terminally ill participants had 18 patients requesting for the legal prescription. Of the 18 that had requested for the lethal prescription, only 3 were found to meet the accepted depression criteria. Consequently, the three patients that were depressed died from lethal ingestion precisely within 2 months of the research interview.
As stated, the law eliminates persons that are unable to communicate or make decisions pertaining to health care. Physicians working in Oregon who are actively participating ought to ensure patients’ health is considered. Also, they ought to cautiously screen these patients while ensuring mental issues are addressed as well. Dr. Gideonse posits that majority of these people could be only depressed about their illness (Foley, 2011, p. 287). He also states that he has often faced dying patients who really have the urge to end their lives. These patients seeking his assistance in the prescription of the lethal drugs but his stand has always been that he is always there for anyone of them for the purpose of controlling their pain through certain prescriptions. Nonetheless, patients have the right to explicitly raise the subject of death without doubt or fear.
In order to curb this lethal activity, Oregon physicians have opted to use side on PAD ads since negligence of any minute level places it under microscopes making them answerable. On the other side of the debate, hospitals, Catholic physicians and the group Physicians for Compassionate Care oppose all aspects pertaining Death with Dignity act. Physicians are requested to take an affirmation pledge of the stand that the role of physicians is to alleviate suffering, heal illness and provide comfort for the dying and the sick (Maglin, 2010, p. 212).
A slippery Slope
Dr. Gideonse states that the Oregon law has over the years stabilized but no individual has tried to apply it to reduce euthanasia or to vulnerable populations. From a legal point of view, requirements of self-ingestion have put physicians from controversial causes. As with other things, what someone sees depends on where they sit. One lesson learnt in Oregon is that persons who end-up using the law seem to have control in their deaths just like they have had in their lives. The Oregon Act clearly outlines every protection for susceptible populations, a good example being those with dementia. Likewise, diseases that lack clear prognosis make quite arduous to apply the 6 month rule (Ball, 2012, p. 98). As the law stands today, physicians are left with no option but to choose sides.
References
Leeb, D. (2008). Oregon's Death With Dignity Act.
Matrise, L. M. (2008). Policy analysis of the Oregon Death with Dignity Act.
Srinivasan, E. G. (2011). Bereavement experiences following a death under oregon's death with dignity. S.l.: Proquest, Umi Dissertatio.
Foley, E. P. (2011). The law of life and death. Cambridge, Mass: Harvard University Press.
Maglin, N. B., & Perry, D. M. (2010). Final acts: Death, dying, and the choices we make. New Brunswick, N.J: Rutgers University Press.
Ball, H. (2012). At liberty to die: The battle for death with dignity in America. New York: New York University Press.
Corr, C. A., Corr, D. M., & Bordere, T. C. (2013). Death & dying, life & living. Belmont, CA: Wadsworth, Cengage Learning.
