The Journal Editorial Report | September 30, 2005 | PBS
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briefing and opinion
September 30, 2005

Doctor-Assisted Suicide Debate

Shortly after it opens its new term next week, the Supreme Court, led by its new Chief Justice, John Roberts, will hear arguments on whether doctors should be able to help terminally ill patients end their lives. The Bush Administration is challenging Oregon's Death With Dignity Act, the only state law in the country that authorizes physician-assisted suicide. Correspondent Barry Serafin reports on the case.

Don James
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For Don James, every day is a struggle. James is a 79-year old retired school administrator, who has advanced prostate cancer, which has spread to other parts of his body. But because he lives in Oregon, he can decide how he will die. "I have a tremendous will to live. But right now, I say six months is what the deal is," says James. "If I'm in unbearable pain and sense that I will lose the ability to communicate, to read, to understand, I would just rather check out. I am not rushing to death, but the kind of living I have described is not really living."

His wife of nearly 60 years, Claire, agrees. "It is a personal decision," she says. "It is not for everybody. But for him? Yes."

Since the assisted suicide law was enacted in 1997, only 208 Oregonians have ended their lives that way -- most of them highly-educated. College graduates are eight times more likely than those with high school diplomas to die by doctor-assisted suicide. "The early fears that depressed, uninsured, poor people would somehow be preyed upon by this law, that particular fear has not come to pass." says Don Colburn, a reporter at THE OREGONIAN.

Before a patient can get the lethal dose of drugs, he or she must make two oral requests and one written request, signed by witnesses. Two doctors must determine that the patient is mentally competent and has less than six months to live. But despite these safeguards, the issue that is still being debated here is whether assisted suicide is a proper role for doctors.

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Dr. Kenneth Stevens, an oncologist and founder of the Oregon group called Physicians for Compassionate Care, says no. "I consider that assisted suicide is contrary, and really incompatible with the doctor's role of really caring for a patient," says Stevens. "That is not what doctors are trained for, it is not what doctors are trained to do. It is just medically wrong. It is not medicine."

Barbara Coombs Lee, a lawyer and former nurse practicioner, is head of Compassion and Choices, an organization that helps terminally ill patients navigate the complex legal requirements.

"I think that doctor's duty is to comfort," says Lee. "I wouldn't say that any physician should violate his or her own beliefs and values. But nor should they stand in the way of their colleague -- for whom it is absolutely consistent with their ethical framework and their moral construct -- to provide this kind of assistance for their patients."

In fact, doctor-assisted suicide is not a new phenomena, she says. "It has gone on and it does go on. Yes doctors, out of their compassion, do often provide medications that can be used for a peaceful death. Data indicate that aid in dying might be as high as one in 250 deaths throughout the nation. Well in Oregon it is one in 2,000."

Oregon's Death With Dignity Act has already survived two legal challenges by former U.S. Attorney General John Ashcroft, who contended that prescribing lethal drugs to terminally ill patients was a violation of the Federal Controlled Substances Act. Now his successor, Alberto Gonzales, will take the case before the U.S. Supreme Court this fall.

Oregon's argument before the Supreme Court will be a simple one -- that this is a case of state's rights and the federal government has no business meddling in medical practices.

"The feds just ought to leave us alone," says Don James. "People can still take their lives. I used to laugh about how I could create an Ashcroft kit, a strong plastic bag, and some duct tape. But that is not the proper way to do it."

When the terminal patients such as Don James are ready to take the final life-ending step, there is one more condition in the law. George Eighmey is head of a group called Compassion in Dying of Oregon. He has assisted and observed more than two dozen such suicides. "The person drinks the medicine and within a few minutes is into a deep coma," he says. "It is very peaceful. There is no pain. It's simply a very peaceful way to go to sleep. And generally they die shortly thereafter."
Barbara Coombs Lee and others
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What do most patients want at this point other than family? "Most of these people have detached from the physical," says Eighmey. "It is not things any more. It is people. It is their loved ones. That is what they want around them."

For patients such as Don James, it is about their right to intensely personal decisions. It is about options. James is still unsure whether he would take advantage of this freedeom. "I just want the comfort of having it," he says. "I am not afraid to use it, if the circumstances are those I described. I feel empowered. I don't want to be in a helpless state. I would not want someone patting my cheek 15 years later saying, 'Well you're still with us dear.'"

"We all still want to live as long as we can," says James. "Well, that's paramount. But if certain circumstances pertain, I will open the cabinet, gather the people around, put on some good music, and maybe a glass of wine, and do her."