An eligible patient can end his or her life under the Death with Dignity Act only if the requirements set down by the DWDA can be satisfied. Before a physician could write the prescription for the lethal medication that would end the patient’s life, DWDA requires that two oral requests should be made by the patient fifteen days apart. After making his or her oral requests, the patient is also required to provide the prescribing physician with a signed written request which has been attested to by two reliable witnesses.
After satisfying the request requirements, a confirmation of the diagnosis and the prognosis of the patient’s illness should be made by the prescribing physician with the help of a consulting physician. Then the patient’s capability to make a sound decision is determined. In case one or both the prescribing and consulting physicians decide that the patient is suffering from a psychological or psychiatric impairment, therefore incapable of making a sound decision, the patient would be subjected to a psychological examination.
When the findings of said psychological examination disqualify the patient from the DWDA, he or she will instead be offered with the alternative choices such as “comfort care, hospice care, and pain control” (Oregon Department of Human Services). However, concerned citizens and physicians in Oregon have questioned the implementation of the Death with Dignity Act. The International Task Force on Euthanasia and Assisted Suicide, in an article entitled “Seven Years of Assisted Suicide in Oregon” claimed that the DWDA was not being implemented correctly.
For instance, while the law was supposed to be applicable only to terminally-ill patients who are expected to die within six months, one patient was found to be still alive17 months after being given the prescription for lethal medication. They also cited figures from the 2003 annual report which showed that three patients who actually died in 2003 were given their lethal drug prescriptions as early as 2001 and 2002. In other words, the report showed that the provision concerning the granting of prescription for the lethal medication to patients who were expected to die in six months was not being followed properly.
If such would be the case, the task force argued that the law is prone to abuse. Moreover, the task force observed that the provision regarding the psychological or psychiatric impairment of the patient who is requesting lethal drug prescription had likewise been ignored in several instances. Specifically, they referred to the case of 64-year-old Michael Freeland who, in spite of “a 43-year history of acute depression and suicide attempts,” was given a lethal drug prescription without being subjected to the required psychiatric consultation (International Task Force on Euthanasia and Assisted Suicide).
The two-week requirement between the two requests for lethal prescription made by a patient was also found to have been violated in some of the cases. The task force claimed that the professional relationship between the prescribing physician and the patient in some of the cases were only about one week – implying that either the prescribing physician did not comply with the law or some other prescribing physician wrote the prescription after the first physician refused the request for reason of ineligibility.
Meanwhile, the task force suspected that financial consideration was involved in some DWDA decisions when they found out that 36% of reported deaths authorized by the law involved older people who were under the Medicare program and poor patients covered by Medicaid. It was led to this conclusion by the fact that the Medicaid program of Oregon covers expenses associated with a physician-assisted suicide but does not pay for other interventions needed by patients (International Task Force on Euthanasia and Assisted Suicide).
Meanwhile, in spite of the claims made by advocates of the law that the DWDA would result to better pain management for terminally-ill patients, a study had proven otherwise. The study which was conducted by researchers belonging to health and science universities in Oregon showed that before 1977, around 33% of families who had dying patients said that the pain suffered by their relatives “was moderate or severe in the week before they died. ” However, when DWDA took effect, the number rose to 50% between the years 2000 and 2002, despite the fact that Oregon was known to use strong pain relievers in hospice care. This observation led Dr.
Robert Orr, the Vermont Alliance for Ethical Healthcare president, to remark that “hospice care [in Oregon] has deteriorated since 1997” after the Oregon Death with Dignity Act took effect. What the survey appeared to have proven was the allegation by opponents of the law that physicians would no longer take the trouble of improving pain management after the patient has already been given a lethal drug prescription (Nowak). In 2003, Attorney General John Ashcroft issued a ruling that controlled drugs could no longer be used in physician-assisted suicides in Oregon, a decision which could have dealt a severe blow to the DWDA.
Unfortunately, he was overruled by a panel of three judges from the 9th U. S. Circuit Court of Appeals. The following year, the government lawyers appealed the ruling to the 25-judge appeals court, arguing that physician-assisted suicide is not a legal medical purpose which turns doctors into killers, declaring that they are willing to go as far as the Supreme Court to oppose the DWDA. (Ertelt. 2004) However, the Supreme Court rebuked the Bush government with a 6-3 decision favoring the Oregon law in 2006, ruling that physicians who engage in assisted suicides could not be prosecuted by the federal government (Medrano. 2006).
The state of Oregon is the first state to have legalized assisted suicide. Although the proponents of the Oregon law refuses to consider it a euthanasia law, the rest of the country still believes that assisted suicide and euthanasia are essentially the same. In spite of the supposed stringent requirements provided by the Oregon law, the annual reports themselves show instances of violations which, in the eyes of its opponents, constitute abuse. If such instances of violations or abuse could not be prevented, perhaps the best choice that America could make is to prevent further euthanasia or assisted suicide laws from being enacted.
The United States Supreme Court should be made to understand that both euthanasia and assisted suicide should not be legalized simply because either or both practices violate man’s basic right to life guaranteed under the constitution of the land.
Docker, Chris. “Euthanasia in Holland. ” The Scottish Voluntary Euthanasia Society. 1996. 5 June 2008. <http://www. euthanasia. cc/dutch. html> Emanuel, Ezekiel J. “The History of Euthanasia Debates in the United States and Britain. ” Annals of Internal Medicine Volume 121, Issue 10. 15 November 1994. 5 June 2008. <http://www. annals. org/cgi/content/full/121/10/793>