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How Physician-Assisted Suicide (PAS) Activists May Attempt to Expand the Practice in Your State
Jessica Stanton, J.D. | 22 August 2019
In debate on the chamber floors, legislators have often uttered these words to support their position on certain legislation: “Oregon is known for its pioneering spirit.” Unfortunately, being a pioneer is not always a virtuous position.
Since 1970, Oregon Right to Life, the state’s largest and oldest pro-life organization, has frequently countered extreme, anti-life legislation. If such legislation passes here, activists inevitably attempt it in other states soon after. Thus, being aware of what we have encountered should be an early warning of what may be attempted in your state.
During the 2019 Oregon legislative session, four bills were introduced to expand assisted suicide, Senate Bill 579 and House Bills 2232, 2903[i] and 2217. Individually, each pushed Oregon closer to becoming the first state in the nation to legalize euthanasia. After a herculean effort by pro-life advocates spearheaded by ORTL, only one of the four became law. The 2019 session revealed a straightforward effort to expand PAS by removing waiting periods and changing definitions in the law.
Oregon was the first government in the world to legalize physician-assisted suicide (PAS) in 1994. Due to legal and electoral challenges, it did not take effect until 1997.[ii] During the campaign, pro-life advocates warned that legalizing assisted suicide would lead the way for other states. They were right. Since 1994, seven more states and the District of Columbia have legalized physician-assisted suicide.[iii] Unfortunately, Oregon’s law and twenty-years of experience are often pointed to as a “success.”
Removing Waiting Periods
PAS activists have long argued that Oregon’s law has sufficient safeguards to prevent abuse. The so-called safeguards referred to are a terminal diagnosis of six months or less to live from two doctors, a 15-day waiting period between the two requests for a lethal prescription, a 48-hour waiting period before the prescribing physician can write a lethal prescription, and being physically capable of swallowing. In 2019, they began an effort to walk back these limits, endangering our citizens even more.
Under SB 579,[iv] if a person is likely to die within 15 days, they can make both requests simultaneously. This is a dramatic change to the original law which required a minimum of 15 days to pass between the first and second requests. The bill also removed the 48-hour waiting period before the physician can write the prescription. Under the new law, the prescription can be written at the same time the two requests are made for those patients considered to be within 15 days of death. SB 579 was passed and signed into law by the governor.
Both waiting periods were included in the original law with the stated intent to ensure the person making the request had a time of reflection before receiving the prescription. The waiting periods were also acknowledged as a way to ensure the decision was independent and free from coercion.[v] Even though there have been troubling examples of the failure of these safeguards, the proponents have been undeterred in their push to expand the law. [vi]
Removing these safeguards, though for a limited group, is extremely dangerous. Now, when a person is close to death, someone with ill intent will have even more ability to influence the decision-making process. With the waiting periods gone, it will be nearly impossible to determine whether coercion or undue influence is present.
In HB 2232, which did not pass during the 2019 legislative session, PAS activists attempted to remove another so-called safeguard by further broadening a crucial definition in the law: the terminal disease definition.[vii]
Under current law, “terminal disease” is defined as: “an incurable and irreversible disease that has been medically confirmed and will, within reasonable medical judgment, produce death within six months.”[viii]
The legislation would have changed the definition to read: “Terminal disease means a disease that will, within reasonable medical judgment, produce or substantially contribute to a patient’s death.”[ix]
This change would have allowed virtually anyone with a terminal disease to qualify for the lethal drugs at any point.
PAS activists also attempted to change the law by re-defining “self-administer” under House Bill 2217.[x] The proposed definition was broad enough that medical devices such as a gas mask, IV, or feeding tube would have been a permissible means for the lethal drugs to enter into a person’s body.
Legislators and PAS activists justified changing the definition by stating that a small subset of the population seeking to use the law was excluded because of their inability to swallow the pills and have been harmed in their attempt to use the law.[xi] According to Oregon’s annual report on PAS in the state, from 1998-2018, only 28 patients have had difficulty ingesting the medication. Further, it is unknown exactly what caused the patient to have difficulty ingesting the lethal drugs.[xii] At the thousand-foot view of this legislation, PAS activists and legislators were willing to leverage the unknown complications 28 people encountered when using the law to push Oregon into legalizing euthanasia.
During the second public hearing on HB 2217, the Oregon Death with Dignity National Center detailed a lethal injection machine that could be used under the law.[xiii] The described machine bore a remarkable resemblance to the machine Jack Kevorkian was known to use from the back of his van during the 1980s.[xiv] Fortunately, the bill died in committee.
After 20 years of legal physician-assisted suicide, some of the strategies for legalizing euthanasia have been exposed. Oregon’s pioneering spirit has been misdirected and it can be expected that a similar strategy will be applied to other states. As more states legalize assisted suicide, PAS activists will then seek to remove safeguards and change definitions with the ultimate goal of legalizing euthanasia in the U.S.
[i] HB 2903 included changes to definitions that had the same effect of HB 2217 and HB 2232 combined. No action was taken on the bill during the 2019 legislative session which is why the analysis of the bill is not included. See https://olis.leg.state.or.us/liz/2019R1/Downloads/MeasureDocument/HB2903
[v] See pages 3 and 4: https://olis.leg.state.or.us/liz/2019R1/Downloads/CommitteeMeetingDocument/203698
[vii] Section 3 (13) “Terminal disease” https://olis.leg.state.or.us/liz/2019R1/Downloads/MeasureDocument/HB2232
[viii] ORS 127.800 s. 1.01 Definitions (12) https://www.oregon.gov/oha/PH/PROVIDERPARTNERRESOURCES/EVALUATIONRESEARCH/DEATHWITHDIGNITYACT/Pages/ors.aspx
[ix] Section 3 (13) https://olis.leg.state.or.us/liz/2019R1/Downloads/MeasureDocument/HB2232
[x] Section 3 (12) https://olis.leg.state.or.us/liz/2019R1/Downloads/MeasureDocument/HB2217
[xi] HB 2217 Oregon House Committee on Health Care March 19, 2019. http://oregon.granicus.com/MediaPlayer.php?clip_id=26244
[xiii] Death with Dignity National Center public testimony submitted on May, 9 2019. https://olis.leg.state.or.us/liz/2019R1/Downloads/CommitteeMeetingDocument/198274
Jessica Stanton, J.D., Oregon Right to Life Public Affairs Specialist