Monday, January 8, 2018

Hidden problems with the Oregon assisted suicide law uncovered.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Link to the article by Fabian Stahle: Oregon Health Authority Reveals Hidden Problems with the Oregon Assisted Suicide Model.

Euthanasia and assisted suicide are being promoted world-wide. Recently the Swedish National Council on Medical Ethics published the report, "Assisted death: A Knowledge Compilation."


Fabian Stahle, a Swede who opposes euthanasia, sent EPC an article revealing the hidden problems with the Oregon Assisted Suicide model. 

Stahle read the Swedish report and noticed a quote from Professor Linda Ganzini, from Oregon, who stated that the six-month expected survival time applies, 
“if no treatment is given to slow down the course of the disease”
Stahle responded to this statement by asking the Oregon Health Authority by email if Ganzini’s comment was correct. Stahle asked:
In the law, “terminal disease” is defined as an incurable and irreversible disease that has been medically confirmed and will, within reasonable medical judgment (in the opinion of the patient's attending physician and consulting physician), produce death within six months. 
Is this rule interpreted as ‘without administration of life-sustaining treatment’?”
Craig New analyst for the Oregon Health Authority responded
“. . . your interpretation is correct. The question is: Should the disease be allowed to take its course, absent further treatment, is the patient likely to die within six months?”
This means that the definition of terminal illness, in Oregon, includes people who will become terminally ill if they refuse effective medical treatment or care.

To clarify the response, Stahle followed up by asking the next two questions:

If the doctor suggests, to an eligible patient, a treatment that possibly could a) prolong life, or b) transform a terminal illness to a chronic illness, or c) even cure the disease—and if the patient doesn't give his/her consent to the proposed treatment is he/she still eligible to take use of the Act? 
If a patient with a chronic disease (for instance, diabetes) by some reason decides to opt out from the life-sustaining medication/treatment and by doing so is likely to die within 6 months, thereby transforming the chronic disease to a terminal disease—does he/she then become eligible to take use of the act?
New responded with the following answer:
“Interesting questions. While this is not addressed specifically in the law, the answer in both cases is yes – those patients would qualify.
Craig New confirms that the language in the Oregon assisted suicide law may have deceived people into thinking that the Oregon law is limited to people who are terminally ill.

Fabian Stahle included more detail in his article. Stahle concluded by stating: 
We need to consider the significantly expanded dimensions as to who qualifies for assisted suicide under the Oregon model. It is definitely not the scenario that is being presented in the polls or propaganda by advocates. Proponents want to sell the Oregon model with the assurance that the offer for medically assisted suicide only applies to dying patients where all hope is lost. But it is completely misleading. Sick people in Sweden and elsewhere deserve something better than laws with such inherent dangers beneath the surface.
Link to the article by Fabian Stahle: Oregon Health Authority Reveals Hidden Problems with the Oregon Assisted Suicide Model.

1 comment:

Dr Jos Welie said...

The same problem already surfaced in the discussions leading up to the new Dutch law from 2011.

The Dutch law does not require patients to be "terminally ill", and no specific time limit is provided. Instead, it requires a patient's suffering to be unbearable and beyond reasonable medical relief -- or as the text of the law states (in translation): "no prospect of improvement". (Termination of Life on Request and Assisted Suicide (Review Procedures) Act. CHAPTER II. DUE CARE CRITERIA. Section 2).

The latter was supposed to be the objective counterbalance to the highly subjective unbearability . But in fact, it is up to the patient to decide whether any particular medical mode of relieving the suffering is reasonable. So if a patient deems the treatment unreasonable, the suffering then is beyond reasonable relief and the legal conditions fior euthanasia or PAS are met (see Explanatory Note to the new law; Handelingen Tweede Kamer, 1998-1999, 26691, nr. 3, p. 8-9).

For more info, see the book Henk ten Have and I published back in 2005: Death and Medical Power. An Ethical Analysis of the Dutch Euthanasia Practice. London: Open University Press, 2005.


Jos Welie, Omaha, NE, USA

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