Oregon reaffirms assisted suicideBMJ 1997; 315 doi: https://doi.org/10.1136/bmj.315.7118.1251f (Published 15 November 1997) Cite this as: BMJ 1997;315:1251
Voters in the western state of Oregon have upheld the United States's first law that allows assisted suicide for terminally ill patients.
In 1994 Oregon, known for attempts at various types of medical reform, narrowly passed a law that permitted doctor assisted suicide. The law was challenged in the courts, which declared that states have the right to pursue such approaches. Opponents of suicide, most notably the Roman Catholic church, spent over $4m (£2.5m) to bring the issue back.
In one of the biggest turnouts in Oregon's history there was 60% support for upholding the law. Twenty other state legislatures have banned doctor assisted suicide, and in two states the voters have refused to allow it.
Under Oregon's law a patient requesting suicide must have full decision making capacity. Two doctors must confirm the capacity. The patient must have a life expectancy of less than six months and must make the request for suicide in a written form. After 15 days a doctor may prescribe lethal doses of drugs.
Doctors will not have to inject lethal drugs themselves, nor will they be forced to participate in a suicide request if they object on moral grounds. The law will, however, protect doctors who do participate.
Opponents of doctor assisted suicide argued that voters were unaware of the care provided for people who were terminally ill, including the hospice movement. However, supporters noted that Oregon has the highest rate of morphine use in the United States, which suggests that hospice care is well known but was felt to be insufficient. According to state and medical officials, no one has yet requested suicide.
Political experts see the vote as dealing not only with patients who are terminally ill. They cited voters' anger at having to vote again on an issue that was passed three years ago. Furthermore, Jim Moore, a political science professor at Portland State University, said that Oregon was a western state, where libertarian values ran high. He said that the supporters were a mixed group of liberals who had traditionally favoured doctor assisted suicide, bolstered by conservatives who thought that the government had no place in such personal decisions.
Neither he nor other experts expect Oregon's law to spread across the United States, which has been hesitant to relax the laws against doctor assisted suicide. Only Michigan, home of Dr Jack Kevorkian, who has helped several people to die, is considering any kind of liberalisation.