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Ethicists alarmed at Oregon law: growth of assisted-suicide efforts feared.

Catholic church officials and ethicists reacted with alarm to Oregon's new physician-assisted suicide law, the Ballot Measure 16 that passed in the November general election.

The law permits a patient, within six months of his or her expected death, to administer a lethal drug prescribed by a physician.

This is "a very ominous public policy development not just for Oregon" but for the entire world, because it makes Oregon "the first jurisdiction in the world to decriminalize physician-assisted suicide," said Robert Castagna, the Oregon Catholic Conference's executive director. The conference vigorously opposed the measure before it passed by an apparent 52 to 48 percent margin.

In the Netherlands, he explained, prosecutors choose not to confront physicians who assist in suicides, but euthanasia remains a violation of the Dutch penal code.

Castagna said the narrow win indicates "a rather severely divided public." When a simple majority enacts such a major policy change, the decision lacks consensus, he said. "We are violating fundamental positions, beliefs and policies of the minority."

Hilda Nelson, a research associate at the Hastings Center, a New York research institution that examines medical ethics issues, believes the issue of physicianassisted suicide will not go away, given previously defeated initiatives in California and Washington and Dr. Jack Kevorkian's assistance to many individuals who committed suicide in Michigan.

"You have to fight it out in public debates," she said. "We are a people who like to have control."

Dominican Fr. Kevin O'Rourke, who founded and directs the Center for Health Care Ethics at St. Louis University, said Oregon has the highest percentage of unchurched people of any state. As physician-assisted suicide proposals surface elsewhere, they can be challenged even among those who do not believe in life after death by showing "it is harmful for the common good to establish a mentality where you solve human problems by killing yourself."

He asked whether "society is going to stand for courage or for acquiescence to suffering by suicide." As an illustration, he said, "Have you ever heard anyone say, 'Oh, mom's committing suicide, isn't that wonderful?' We don't celebrate suicide," but try to explain why a person did it. In contrast, "if you go to a good wake of a person who died after suffering, you do celebrate the person's life and death" and perhaps their courage in facing suffering. For the health care community, he said, legalized physicianassisted suicide "changes the nature of the practice of medicine" from association with prolonging life to association with intentional dying.

With religious people, physician-assisted suicide can be challenged as a moral evil, fundamentally wrong "because it assumes the creature has a power that he or she does not have." Freedom is always limited, he said.

"The most important thing people can do" to avert physician-assisted suicide, Nelson said, "is to get universal access to health care. Once you have that in place on a federal level, I think you will find fewer people wanting this kind of an option because they will feel safer about their health care."

People who distrust their physicians fear "that when they are really ill and facing the end of life, things will come out of their control," she said. "It's odd that at the same time, people can distrust their physicians and give them this kind of new power."

Because patients must administer the lethal dose themselves, Nelson said, the Oregon law discriminates against people physically unable to do so. Also, it appears to leave poor people vulnerable, for they might be willing and able to pay a doctor once, to prescribe a lethal dose, even though they could not afford longer term care.

The American Medical Association opposes physician-assisted suicide and campaigned against the Oregon measure. The Oregon Catholic Conference, in a statement after passage, reminded "individual doctors, nurses and pharmacists of their rights in conscience to refuse to participate in requests for assisted suicide," and called upon terminally ill patients and their families "to seek the best means of pain control" and community support through hospice and pastoral care.

Nelson said doctors tend to fight death as the enemy and need to respond better, "to take responsibility for standing by their patients as they die, in ways they are not good at doing now." They need "to know when to work with the dying process instead of torturing a patient in the attempt to keep it at bay," she said.

Opponents of physician-assisted suicide, said O'Rourke, "have a responsibility to offer the type of help that allows people to overcome their suffering." For instance, families and parishes need to reach out to make sure people do not die of despondency or despair.
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Title Annotation:1994 Oregon Ballot Measure 16
Author:Gibeau, Dawn
Publication:National Catholic Reporter
Date:Dec 2, 1994
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