Death With Dignity Act: Shocking Drop in Euthanasia Requests

The Evolution of Oregon’s Death With Dignity Act

The Birth of a Movement

Twenty years ago this month, the entire nation was watching Oregon decide how to die. On Nov. 4, 1997, Oregon voters upheld America’s first doctor-assisted suicide law, the Death With Dignity Act. The wildly controversial law allowed terminally ill patients with less than six months to live to ingest a lethal dose of drugs. The bill sparked death threats, legal battles and a massive freak-out in the Roman Catholic Church, which spent millions of dollars campaigning against it.

In the past two decades, the law has rocked the medical profession, served as a political pawn and comforted the hopelessly sick. At least 1,127 people have used the law to die in Oregon. One of them, Brittany Maynard—a beautiful 29-year-old with brain cancer—tugged the heartstrings of the nation when she ended her life three years ago. But many of them made the choice without public notice—and, as proponents note, painlessly. Death With Dignity is widely considered a success in Oregon.

It’s part of how the state defines itself: as pioneering, stubbornly independent and deeply compassionate. Since then, five states and Washington, D.C. have followed Oregon’s lead and adopted physician-assisted suicide. At the time, the outcome wasn’t such a no-brainer. The fight was politically risky and emotionally wrenching. And the people leading the way had to be brave. How did they find the courage?

A Personal Crusade: The Story of Frank and Barbara Roberts

Oregon state Sen. Frank Roberts repeatedly introduced bills to legalize Death With Dignity. Roberts’ wife, then-Oregon Gov. Barbara Roberts, carried on the cause after his death in 1993. In September 1992, Frank Roberts was in for a routine check. The doctor told him he had lung cancer and it was terminal. They made the decision not to tell anyone. He didn’t want people to look at him with pity.

Ann Jackson, former director of Oregon Hospice and Death With Dignity advocate, met her fiancé, John, at the Bohemian Club in San Francisco in 1991. She planned to move in with him. But when she arrived on his doorstep, just before the 4th of July in 1996, his eyes and skin were yellow. He was diagnosed with pancreatic cancer and given a life expectancy of three months.

Frank Roberts eventually lost track of reality. In the last weeks he was alive, he was asleep more and more and was in a great deal of pain. He stopped eating and lost control of his bodily functions. The last thing he ate were his sister’s home-canned peaches. Ann Jackson got John into hospice before he could take the pills he’d collected to kill himself. But they had to sedate him to the point of unconsciousness. He was 59 when he died.

Barbara Roberts believes that, if the Death With Dignity law had been in place, her husband would have done it before there was no end to the pain, before all of the pleasure in his life was gone.

Advocates and Activists: The People Behind the Movement

Ann Jackson has no doubt that John—as much as Frank Roberts—would have chosen to die with dignity if the law had been available. The ideal death, according to Michael Hayward, a former nurse and firefighter who has volunteered for two years with Compassion and Choices Oregon, is planned, painless and relatively inexpensive—thanks to lethal drugs that should be readily available to anyone who needs them.

But Hayward is going public with a closely kept secret about pentobarbital, the optimal drug for his clients: It’s no longer available in Oregon. The next-best drug, secobarbital, costs $1,500 to $2,300—more than five times what pentobarbital costs. Even at that price, it’s hard to get.

Oregon state officials say terminally ill Oregonians currently cannot obtain pentobarbital, the drug commonly used in death-with-dignity cases. Michael Hayward just watched somebody die. And he’s angry, because the next death he witnesses may be more difficult—and a lot more expensive.

The shortage of drugs played a role in the botched execution of Clayton Lockett in Oklahoma last month. According to media reports, the death-row doctor used a new cocktail of drugs that left Lockett writhing in pain before he died 43 minutes later of a heart attack. With publicity like that, it’s hardly surprising that nobody involved in the pentobarbital supply chain wants to talk about Oregon’s problem.

Gary Miner, compliance director for the Oregon Board of Pharmacy, says that the shortage affects a limited number of people, but for those it does affect, it’s a significant problem.

The Law in Practice

How the Death With Dignity Act Works: A Step-by-Step Guide

The Death With Dignity Act allows terminally ill patients with less than six months to live to ingest a lethal dose of drugs. The law requires patients to be mentally competent and to request the medication twice, 15 days apart, from their physician. The patient or their representative must also sign a written request for the medication, and the patient’s physician must confirm that the patient is terminally ill and competent.

Once these requirements are met, the patient’s physician can write a prescription for the lethal medication, which is usually pentobarbital. The patient or their representative must then obtain the medication from a pharmacy and ingest it in a lethal dose.

The law also requires that patients be informed of the risks and benefits of the medication, as well as any alternative treatments that may be available. Patients must also be informed that they may change their mind at any time and that the law does not require them to use the medication.

The Death With Dignity Act has been in effect since 1997 and has been used by at least 1,127 people in Oregon. The law has been the subject of much debate and controversy, but it remains a popular option for many terminally ill patients in Oregon.

Real-Life Stories: The Impact of the Law on Terminally Ill Patients

Brittany Maynard, a 29-year-old with brain cancer, was one of the most high-profile cases of the Death With Dignity Act. In 2014, she chose to end her life using the law, citing her desire to avoid suffering and maintain her dignity. Maynard’s case sparked a national debate about the law and its implications.

Another notable case is that of Randy Stroup, a 75-year-old man with pancreatic cancer. In 2015, Stroup used the Death With Dignity Act to end his life, citing his desire to avoid further suffering and maintain his independence. Stroup’s case highlights the importance of the law in allowing terminally ill patients to maintain control over their own lives.

The Role of Healthcare Providers: Navigating the Complexities of Assisted Suicide

Healthcare providers play a crucial role in the Death With Dignity Act. They must ensure that patients are informed of the risks and benefits of the medication, as well as any alternative treatments that may be available. Providers must also confirm that patients are mentally competent and have made a voluntary decision to use the law.

However, healthcare providers may also face challenges and complexities when navigating the Death With Dignity Act. For example, providers may struggle with the emotional and psychological implications of assisting in a patient’s death. They may also face legal and ethical concerns, particularly if they are unsure about the patient’s mental competence or the patient’s ability to make a voluntary decision.

To address these challenges, healthcare providers must receive training and education on the law and its implications. They must also be prepared to navigate the complex emotional and psychological dynamics that can arise when assisting in a patient’s death.

Challenges and Controversies

The Pentobarbital Shortage: A Global Political Battle with Local Consequences

The shortage of pentobarbital, the drug commonly used in death-with-dignity cases, has had significant consequences for terminally ill patients in Oregon. The shortage has left patients without access to the optimal drug for their needs, and has forced them to seek alternative options that may be more expensive and less effective.

The shortage of pentobarbital has been attributed to the global political battle over capital punishment in the United States. U.S. prison officials use pentobarbital in lethal injections, and the federal Food and Drug Administration has restricted the use of the drug for this purpose. As a result, the manufacturer of pentobarbital has stopped shipping the drug to the U.S., leaving patients without access.

The shortage of pentobarbital has also highlighted the need for alternative options for terminally ill patients. Secobarbital, a similar drug, has been offered as an alternative, but it is much more expensive and harder to obtain.

Secobarbital: The Costly Alternative and Its Implications

Secobarbital, a similar drug to pentobarbital, has been offered as an alternative option for terminally ill patients. However, it is much more expensive and harder to obtain than pentobarbital.

The cost of secobarbital is estimated to be between $1,500 and $2,300, which is more than five times the cost of pentobarbital. This has significant implications for terminally ill patients, who may not be able to afford the alternative medication.

The shortage of pentobarbital and the high cost of secobarbital have highlighted the need for alternative options for terminally ill patients. One potential solution is the use of compounding pharmacies, which can create customized medications for individual patients. However, this option is also subject to regulations and restrictions, and its effectiveness is still unknown.

Ultimately, the shortage of pentobarbital and the high cost of secobarbital have raised important questions about the accessibility and affordability of assisted suicide for terminally ill patients. As the debate over the Death With Dignity Act continues, it is essential to address these challenges and ensure that patients have access to the medications they need to maintain their dignity and autonomy.

Balancing Compassion and Cost: The Practical Aspects of the Law

As the Death With Dignity Act continues to shape the medical profession and comfort the hopelessly sick, one of the significant challenges it faces is the practical aspect of balancing compassion and cost. The law has sparked a massive debate on the intersection of politics and compassion, and how ordinary people can make a difference.

One of the most critical aspects of the law is the availability of lethal medication. In recent years, terminally ill Oregonians have faced significant hurdles in obtaining pentobarbital, the optimal drug for physician-assisted suicide. The shortage of this drug has led to a global political battle over capital punishment in the U.S.

According to the federal Food and Drug Administration, the manufacturing of pentobarbital has moved overseas, and the company has made a policy decision not to ship it because it can be used in death-penalty cases. This has led to a significant increase in the cost of the next-best drug, secobarbital, which costs $1,500 to $2,300, more than five times what pentobarbital costs.

This has sparked concerns among advocates and medical professionals, who argue that the law should be supported regardless of a citizen’s ability to pay. “When Oregon citizens are denied access to that law, then something needs to be done,” says Michael Hayward, a former nurse and firefighter who has volunteered with Compassion and Choices Oregon.

The Future of Death With Dignity

Expanding the Law: How Other States Are Following Oregon’s Lead

Since Oregon’s Death With Dignity Act was passed in 1997, five states and Washington, D.C. have followed suit and adopted physician-assisted suicide laws. This has sparked a national conversation on the role of activism and advocacy in shaping healthcare policy.

One of the most significant challenges facing the expansion of the law is the pushback from religious and political groups. The Roman Catholic Church, which spent millions of dollars campaigning against the law in Oregon, continues to be a vocal opponent of physician-assisted suicide.

Despite these challenges, advocates remain optimistic about the future of the law. “The Death With Dignity Act is widely considered a success in Oregon,” says Ann Jackson, a former director of Oregon Hospice and Death With Dignity advocate. “It’s part of how the state defines itself: as pioneering, stubbornly independent, and deeply compassionate.”

Overcoming Obstacles: The Fight for Access to Lethal Medication

The shortage of pentobarbital has led to a significant challenge for terminally ill patients seeking to end their lives under the Death With Dignity Act. Advocates are calling for greater access to lethal medication, citing the need for a more humane and compassionate approach to end-of-life care.

“It seems obvious that if there was an Oregon law, passed and supported by the majority of voters, that enabled physicians to relieve end-of-life pain and suffering, then the law should be supported regardless of a citizen’s ability to pay,” says Hayward.

The Next Frontier: Exploring the Boundaries of Physician-Assisted Suicide

As the Death With Dignity Act continues to shape the medical profession and comfort the hopelessly sick, one of the most significant questions facing advocates and medical professionals is where the boundaries of physician-assisted suicide should lie.

Should the law be expanded to include patients with non-terminal illnesses? Should it be available to patients who are not mentally competent to make their own decisions? These are just some of the questions that will continue to shape the national conversation on physician-assisted suicide.

Personal Stories and Reflections

Brittany Maynard: A Young Woman’s Choice and Its Impact on the World

Brittany Maynard’s decision to end her life under Oregon’s Death With Dignity Act sparked a global conversation on the role of physician-assisted suicide in end-of-life care. Her story has inspired countless people around the world to re-examine their own values and beliefs about death and dying.

Ann Jackson’s Story: Love, Loss, and the Power of the Death With Dignity Act

Ann Jackson’s story is one of love, loss, and the power of the Death With Dignity Act. Her fiancé, John, was diagnosed with pancreatic cancer and given a life expectancy of three months. Jackson’s story highlights the importance of access to lethal medication and the need for a more humane approach to end-of-life care.

The Human Side of Assisted Suicide: What We Can Learn from Personal Experiences

The stories of Brittany Maynard and Ann Jackson highlight the human side of assisted suicide. They demonstrate the need for compassion, empathy, and understanding in end-of-life care.

As the national conversation on physician-assisted suicide continues to evolve, it is essential to remember the human side of the issue. By sharing their stories, advocates and medical professionals can work towards a more humane and compassionate approach to end-of-life care.

The Bigger Picture

The Intersection of Politics and Compassion: How the Death With Dignity Act Fits into the National Conversation

The Death With Dignity Act has sparked a national conversation on the intersection of politics and compassion. The law has been hailed as a pioneering effort in end-of-life care, and its impact will be felt for generations to come.

The Role of Activism and Advocacy: How Ordinary People Can Make a Difference

The Death With Dignity Act would not have been possible without the tireless efforts of advocates and activists. From Barbara Roberts to Ann Jackson, ordinary people have made a significant impact on the national conversation on physician-assisted suicide.

The Legacy of Oregon’s Death With Dignity Act: A Model for the Nation

Oregon’s Death With Dignity Act has set a precedent for the nation. It has sparked a national conversation on the role of physician-assisted suicide in end-of-life care, and its impact will be felt for generations to come.

The law has demonstrated that it is possible to balance compassion and cost, and that ordinary people can make a difference in shaping healthcare policy. As the national conversation on physician-assisted suicide continues to evolve, Oregon’s Death With Dignity Act will remain a beacon of hope and compassion for generations to come.