Debate over change to 'Death with Dignity' act
Physician-assisted suicide now physician-assisted death
What's in a word? Lots, when the issue is physician-assisted suicide, or — as it's now known in Oregon, physician-assisted death.
The state with the landmark statute allowing dying patients to ask their physicians for medication they can choose to take to end their lives has changed the term for the act from "suicide" to "death" in its official references to people using the act, which state health and human services officials say makes it more consistent with the law.
Denver-based Compassion & Choices, an advocacy group supportive of the act and the terminology change, further reported on its web site that the references to physician involvement will be removed wherever possible, with the Oregon Department of Public Health retiring the term entirely and instead referring to "persons who use the Oregon Death with Dignity Act."
Advocates of the law argued that terminally ill patients who choose to end their lives are not the same as people who choose suicide under other conditions. The term "physician-assisted death" will now be used in reports and on the state's web sites.
The Death with Dignity Act (DWDA), passed in 1994 and signed into law four years later, specifically states that its provisions do not "constitute suicide, assisted suicide, mercy killing or homicide," but deaths that took place under the provisions of the act have been both commonly and officially referred to as physician-assisted suicide, or PAS.
New term: Accurate or deceptive?
Compassion & Choices hailed the terminology change, even as Oregon Right to Life's director described the change as a "euphemism" to make the idea easier to accept.
"Eliminating the emotionally laden and inaccurate word 'suicide' from state references to the DWDA is a major leap forward in clarifying the public's perception of the distinction between suicide and a terminally ill patient's choice for a peaceful and dignified death," Compassion & Choices stated in prepared comments released in October.
Then again, says Euthanasia Prevention Coalition spokesman Alex Schadenberg, "In other words, assisted suicide ceases to be assisted suicide if you stop calling it assisted suicide? What's next?"
There is no state Death with Dignity "program" in Oregon. Patients and physicians do not register or otherwise notify the state prior to implementing the act. The decision to request a prescription for lethal doses of medication is left up to patients (provided they are competent) and physicians. The state Department of Human Services collects information about patients who participate each year, and issues those data in an annual report.
In 2005, 39 physicians wrote a total of 64 prescriptions for lethal doses of medication, the department reports. Thirty-two of the 2005 prescription recipients died after ingesting the medication; of the 32 recipients who did not ingest the prescribed medication in 2005, 15 died from their illnesses, and 17 were still alive as of the end of that data year.
Charles J. Bentz, MD, FACP, president of the Portland, OR-based Physicians for Compassionate Care Education Foundation (PCCEF), suggests the Oregon Department of Public Health was "bullied" by proponents of the Death with Dignity Act into changing references to "suicide" to "death."
"Rather than using the phrase 'physician-assisted suicide' to describe this practice, the state agency will now use the vague and misleading language favored by one side in our statewide debate on assisted suicide," Bentz states.
PCCEF states that it opposes PAS on the grounds that it undermines trust between physicians and patients, changes the physician's role "from the traditional role of healer to that of the executioner," and devalues the lives of vulnerable and dying patients.
Kenneth Stevens, MD, vice president of PCCEF, says using the term "physician-assisted suicide" accurately describes this choice of death.
"Physician-assisted suicide is the standard phrase for describing the act of writing a prescription for a patient with the intent that the patient will take that medicine for the sole purpose of causing their death," he says. "It is the standard phrase in the medical, legal, and scientific literature."
A 2005 survey of 1,000 physicians revealed that a clear majority (57%) believe it is ethical to assist an individual who has made a rational choice to die due to unbearable suffering, while 39% believe it is unethical, according to New Jersey pollster HCD Research and the Louis Finkelstein Institute for Social and Religious Research. The survey report is available at www.jtsa.edu/research/finkelstein/surveys/pas.shtml.
To read Oregon's Death with Dignity Act in full, go to www.oregon.gov/DHS/ph/pas/index.shtml.
Source
For more information, contact:
- Compassion & Choices, P.O. Box 101810, Denver, CO 80250. Phone: (800) 247-7421. Web site: www.compassionandchoices.org.
- Euthanasia Prevention Coalition, Box 25033, London ON N6C 6A8, Canada. Phone: (877) 439-3348. Web site: www.epcc.ca.
- Physicians for Compassionate Care Educational Foundation, P.O. Box 6042, Portland, OR 97228. Phone: (503) 533-8154. Web site: www.pccef.org.
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