Scaremongering, with no basis in fact, contributes nothing to this important debate. For example
“[Compassion in Choices] is trying to persuade all the other states in the USA to enact similar laws and is unwilling to support further changes in Oregon until more states have followed suit.”
The law has not changed in Oregon because the State legislature recognises that the current law is operating safely and fulfills the needs of dying patients. Compassion in Choices campaign in other States because they believe all dying Americans should have the right to access an assisted dying law if they meet the law’s criteria. To suggest that once this is done they will then campaign to extend these rights to those who are not dying is pure speculation.
“There is also clear evidence of untreated depression among those who have died by assisted suicide in Oregon, and a clear decline in the numbers of psychiatric evaluations, down to 2.9% in 2014.”
The number of referrals have declined, not because physicians in Oregon are displaying a lack of concern for their patients’ well being, but because they are becoming more confident in screening out patients who do not meet the safeguard of mental capacity. Doctors in this country display the same level of competency when they assess a patient’s mental capacity to make decisions concerning the right to refuse treatment. Of course there may be a small number of cases where further assessment is necessary, and this is why the Assisted Dying Bill mandates a referral to a specialist should either assessing doctor have doubt as to a person’s capacity.
“In Oregon between 1999 (two years after the law was introduced) and 2010 the suicide rate among those aged 35-64 increased by a massive 49% in Oregon (compared to 28% nationally).”
It is unclear why Professor Jones cites figures for a specific age range and stops at 2010. When the suicide rate is viewed as a whole up until the most recent data from 2013, it is clear that there have been small rises and falls in the suicide rate since 1997, and indeed prior to 1997, yet overall figures have been relatively consistent since 1980 (1). There is absolutely no evidence that legislating for assisted dying has affected the suicide rate in Oregon.
“There is also evidence that those assisting suicide are not doctors who know the people well but are a small number of zealous advocates. Between 2000 and 2007 almost a quarter of all lethal prescriptions in Oregon (62 out of 271) were provided by just three doctors.”
Again, it is important to use the most relevant and recent data, rather than selecting data that suits one’s argument. The most recent data show that there were 155 prescriptions for life-ending medication written in 2014, and these prescriptions were written by 83 different physicians.
One major barrier to more doctors being involved in the process is the large number of hospitals in Oregon owned by the Catholic Church, and the fact that these hospitals prohibit any staff members from considering or participating in a request for assisted dying (2). (It is worth noting at this point that the purpose of the organisation of which Professor Jones is a director, the Anscombe Bioethics centre, is to “serve the Catholic Church”) (3).
“The claims of Margaret Battin and others that the Oregon law does not impact on vulnerable groups have been answered by Ilora Finlay and Robert George”
I would like to direct readers towards the authors’ reply to Baroness Finlay and Professor George’s analysis of their work (4). In summary, they “welcome further attempts to examine what really happens where physician assistance in dying is legal […] However, [they] do not welcome the seemingly ideologically biased assumption evident in the Finlay and George critique”.
Of course some people have genuine concerns about this Bill and I, like Professor Jones would encourage those people to examine the evidence for themselves. But, as Fiona Godlee, editor in Chief of the BMJ, has reiterated (5), there needs to be a full and fair debate on this issue. Our patients deserve no less and blanket opposition ignores the fact that not only the Supreme Court but also the majority of our patients are calling for a change in the law
Rapid Response:
Response to Prof David A Jones
Scaremongering, with no basis in fact, contributes nothing to this important debate. For example
“[Compassion in Choices] is trying to persuade all the other states in the USA to enact similar laws and is unwilling to support further changes in Oregon until more states have followed suit.”
The law has not changed in Oregon because the State legislature recognises that the current law is operating safely and fulfills the needs of dying patients. Compassion in Choices campaign in other States because they believe all dying Americans should have the right to access an assisted dying law if they meet the law’s criteria. To suggest that once this is done they will then campaign to extend these rights to those who are not dying is pure speculation.
“There is also clear evidence of untreated depression among those who have died by assisted suicide in Oregon, and a clear decline in the numbers of psychiatric evaluations, down to 2.9% in 2014.”
The number of referrals have declined, not because physicians in Oregon are displaying a lack of concern for their patients’ well being, but because they are becoming more confident in screening out patients who do not meet the safeguard of mental capacity. Doctors in this country display the same level of competency when they assess a patient’s mental capacity to make decisions concerning the right to refuse treatment. Of course there may be a small number of cases where further assessment is necessary, and this is why the Assisted Dying Bill mandates a referral to a specialist should either assessing doctor have doubt as to a person’s capacity.
“In Oregon between 1999 (two years after the law was introduced) and 2010 the suicide rate among those aged 35-64 increased by a massive 49% in Oregon (compared to 28% nationally).”
It is unclear why Professor Jones cites figures for a specific age range and stops at 2010. When the suicide rate is viewed as a whole up until the most recent data from 2013, it is clear that there have been small rises and falls in the suicide rate since 1997, and indeed prior to 1997, yet overall figures have been relatively consistent since 1980 (1). There is absolutely no evidence that legislating for assisted dying has affected the suicide rate in Oregon.
“There is also evidence that those assisting suicide are not doctors who know the people well but are a small number of zealous advocates. Between 2000 and 2007 almost a quarter of all lethal prescriptions in Oregon (62 out of 271) were provided by just three doctors.”
Again, it is important to use the most relevant and recent data, rather than selecting data that suits one’s argument. The most recent data show that there were 155 prescriptions for life-ending medication written in 2014, and these prescriptions were written by 83 different physicians.
One major barrier to more doctors being involved in the process is the large number of hospitals in Oregon owned by the Catholic Church, and the fact that these hospitals prohibit any staff members from considering or participating in a request for assisted dying (2). (It is worth noting at this point that the purpose of the organisation of which Professor Jones is a director, the Anscombe Bioethics centre, is to “serve the Catholic Church”) (3).
“The claims of Margaret Battin and others that the Oregon law does not impact on vulnerable groups have been answered by Ilora Finlay and Robert George”
I would like to direct readers towards the authors’ reply to Baroness Finlay and Professor George’s analysis of their work (4). In summary, they “welcome further attempts to examine what really happens where physician assistance in dying is legal […] However, [they] do not welcome the seemingly ideologically biased assumption evident in the Finlay and George critique”.
Of course some people have genuine concerns about this Bill and I, like Professor Jones would encourage those people to examine the evidence for themselves. But, as Fiona Godlee, editor in Chief of the BMJ, has reiterated (5), there needs to be a full and fair debate on this issue. Our patients deserve no less and blanket opposition ignores the fact that not only the Supreme Court but also the majority of our patients are calling for a change in the law
(1) Public health Oregon, Vital statistics annual report Vol.2, http://public.health.oregon.gov/BirthDeathCertificates/VitalStatistics/a...
(2) A. Gumbel. Assisted dying: legal in Oregon since 1997, but still surrounded by taboos. The Guardian, 12 July 2014
http://www.theguardian.com/society/2014/jul/12/assisted-dying-legal-oreg...
(3) Anscombe Biotethics Centre, About Us http://www.bioethics.org.uk/page/about_us/our_history
(4) M. Baton et al. Legal physician-assisted dying in Oregon and the Netherlands: The question of “vulnerable” groups. A reply to I.G. Finlay and R. George. 21 July 2011 http://jme.bmj.com/content/37/3/171/reply
(5) F. Godlee. Assisted dying—time for a full and fair debate. BMJ 2015;351:h4517 http://www.bmj.com/content/351/bmj.h4517
Competing interests: No competing interests