A gift from Oregon.

Byline: The Register-Guard

Passions run high on both sides of the debate over physician-assisted suicide, but even those who bitterly oppose Oregon's pioneering Death with Dignity law stand to benefit from its enactment.

In fact, it's fair to say the nation as a whole owes Oregonians a debt of gratitude for bringing badly needed attention to the issue of pain management and end-of-life care for patients with terminal illnesses.

As the fate of Oregon's one-of-a-kind law is being considered by the U.S. Supreme Court, Americans are being exposed to the arguments Oregonians weighed before passing the Death with Dignity Act in 1994 and rejecting an attempt to repeal it in 1997. Only a tiny fraction of eligible state residents - less than one-tenth of 1 percent - have opted to hasten their deaths under the strict provisions of the law in the seven years since it was implemented. But recent surveys confirm that the option is at least discussed by nearly one in five terminally ill Oregonians.

The ramifications of that discussion have reverberated beyond individual families and into physicians' offices, hospitals and medical schools. Regardless of their position on physician-assisted suicide, health care professionals quickly realized they had a lot to learn if they were going to counsel and care for dying patients in Oregon.

In truth, they've only just begun, but already the Death with Dignity law has prompted changes in health care practices and pain management that have made Oregon the nation's acknowledged leader in high-quality end-of-life care. Oregon is in the forefront of providing state residents with access to hospice care and is a leader in the use of advance directives, in which a dying person can express how he or she wishes to be treated at the end of life.

Oregon doctors also prescribe morphine at a higher rate than in other states, signaling that physicians here are more willing to treat pain aggressively. In addition, only about 20 percent of Oregonians die in a hospital; nationwide, the hospital death rate is well over 50 percent. Nine of 10 people, when asked, respond that they'd rather die at home than in a hospital.

All of this contributes to the paradox of physician-assisted suicide: Legalizing the practice has led to improvements in end-of-life care that reduce the actual use of assisted suicide. And those improvements are expanding beyond Oregon's borders and enhancing the end-of-life care for patients throughout the United States.

The religious, ethical and legal issues associated with physician-assisted suicide don't lend themselves to easy resolution. But the willingness of Oregonians to be the first in the United States to enact a death with dignity law has forced health care professionals everywhere to improve their approach to and emphasis on caring for dying patients.

Sooner or later, every American will be grateful for that.