Suicide Unlimited in Oregon
SMITH, WESLEY J.
Suicide Unlimited in Oregon The result of legalizing physician-assisted suicide is bad medicine and bad policy. BY WESLEY J. SMITH LAST WEEK, Congress took up the issues of pain control and...
...The poison that killed Cheney cost Kaiser approximately $40...
...This sad story illustrates many profound and unsettling truths about assisted suicide: Protective guidelines don't protect...
...She died a mere two and a half weeks later from the poison pills...
...Death doctors are a malevolent twist on the draft doctors of the Vietnam war era who kept young men from being inducted by finding physical anomalies to obtain medical deferment for their "patients...
...On October 17, 1999, the Oregonian published an account of one patient who committed suicide with the assistance of medical professionals...
...According to the New England Journal of Medicine, at least five other people who died by assisted suicide in Oregon in 1998 went to multiple physicians before finding one willing to help kill them...
...A major selling point of assisted-suicide advocacy is that close personal relationships between doctors and patients will prevent "wrongly decided" assisted suicides...
...This raises the appearance, if not the actuality, of a terrible conflict of interest...
...Doctors who prescribe lethal drugs for the purpose of Wesley J. Smith is an attorney for the International Anti-Euthanasia Task Force...
...Doctor-shopping becomes the key to obtaining death...
...Allen smiles ruefully and says, "Yeah, but she was so pretty, I got another psychiatrist...
...After grandchildren were called to say their goodbyes, Cheney took the poison...
...At the same time, 59 percent of the doctors who kill patients fail to report them as required by the guidelines...
...Thus, in the Netherlands, not only are terminally ill patients who ask for euthanasia killed by doctors, but so are chronically ill patients, and depressed patients who have no disease...
...He also determined that she did not have the "very high capacity required to weigh options about assisted suicide...
...But Oregon proves the utter emptiness of this promise...
...But no one pretended that draft doctors were practicing medicine...
...The psychiatrist wrote in his report that while the assisted suicide seemed consistent with Cheney's values, "she does not seem to be explicitly pushing for this...
...This is reminiscent of the woody Allen line from the movie, Manhattan...
...Oregon's assisted suicide law continues to demonstrate that permitting doctors to help kill patients is bad medicine and even worse public policy...
...Several states, including California, have legislation pending, while Maine voters will likely face a legalization initiative in November 2000...
...This has certainly happened in the Netherlands, where euthanasia has been permitted since 1973...
...And what was seen as a last resort, something that might be considered if palliative treatment failed, becomes an alternative to treatment...
...That is a serious problem to be sure, but one which experts on treating dying people are adept at relieving...
...Like the first doctor, the psychologist found Cheney had memory problems...
...So, rather than prescribe lethal drugs, her doctor referred her to a psychiatrist, as required by law...
...She died with her daughter at her side, telling her what a courageous woman she was...
...The same phenomenon is now happening in Oregon, only instead of trying to save lives, death doctors ideologically support the taking of life...
...BY WESLEY J. SMITH LAST WEEK, Congress took up the issues of pain control and physician-assisted suicide, with the House voting 271-156 to pass the Pain Relief Promotion Act...
...Goldstein's demand for a second opinion was acceded to by Kaiser Per-manente, Cheney's HMO...
...Cheney's case is not the only example from Oregon in which doctor-shopping has hastened death...
...It could have cost the HMO $40,000 to care for her properly until her natural death...
...Accordingly, he nixed the assisted suicide...
...They were engaged in politics, pure and simple...
...The patient's family had provided the newspaper with the details of the assisted killing, unintentionally showing how Oregon's law endangers those who are the least capable of defending themselves...
...The potential for economically driven death decisions is too obvious to be denied and is likely to become more pronounced as people become desensitized to doctors' acting as killers...
...killing their terminally ill patients would be subject to losing their federal licenses to prescribe...
...The legislation, if passed, would improve pain control while deterring physician-assisted suicide...
...Moreover, physician-assisted suicide means doctors who refuse to "assist" are subject to emotional blackmail...
...Oregon Medicaid, which rations health care to the poor, pays for assisted suicide...
...This means that even the most secure and long-lasting doctor-patient relationships provide zero protection against assisted suicide...
...For example, she could not recall when she had been diagnosed with terminal cancer...
...This time a clinical psychologist rather than an MD-psychiatrist examined her...
...Richardson interviewed Cheney, who told him she wanted the pills not because she was in irremediable pain but because she feared not being able to attend to her personal hygiene...
...HMOs are a lethal part of the mix...
...As reported in newspapers and bioethics journals, the first woman known to have legally committed assisted-sui-cide in Oregon went to her own doctor when her breast cancer prevented her from doing aerobics and gardening...
...According to repeated reports on Dutch euthanasia, at least 1,000 patients are killed each year who did not ask to die...
...This physician also refused to help kill her, diagnosing her as depressed...
...As soon as she returned home, she declared her desire to take the pills...
...In Kate Cheney's case, the final authority was a Kaiser HMO medical ethicist...
...But that isn't the end of Kate Cheney's story...
...Babies born with disabilities are also killed at the request of parents who allege their children are incapable of a "livable life...
...And so, eligibility for physician-assisted suicide steadily expands to permit the killing of increasing categories of ill and disabled patients...
...One awful truth about assisted suicide is that it will be performed in the context of managed care where profits are made from cutting costs...
...Kate Cheney, age 85, was diagnosed with terminal cancer and wanted assisted suicide, but there was a problem...
...Then, Cheney went into a nursing home for a week so that her family could have some respite from care giving...
...The same can be said about government-financed health care...
...The same pattern is already developing in Oregon, where assisted suicide has only been permitted legally for two years...
...On the floor of the House and in comments to media, supporters of the bill referred specifically to the example of Oregon, where assisted suicide is legal...
...Most, like Kate Cheney, were worried about being a burden and requiring assistance with the tasks of daily living...
...Kate Cheney and her family were not deterred in the least by a psychiatrist's refusal to approve her self-poisoning...
...Cheney was accompanied to the consultation by her daughter, Erika Goldstein...
...After the interview, satisfied that she was competent, Richardson gave the okay for the assisted killing...
...Even more worrisome, it appeared that her daughter had more of a vested interest in Cheney's assisted suicide than did Cheney herself...
...Legalizing assisted suicide thus distorts medical care for patients near the end of their lives...
...The length of time between meeting with the prescribing doctor and death in at least a few cases was 15 days—the exact waiting period required by law...
...The time in the nursing home seemed to have pushed Cheney into wanting immediate death...
...The final decision was left to an ethicist/administrator who works for Kaiser named Robert Richardson...
...Advocates of legalization might, at this point, smile happily and point out that such refusals are part of the way the law operates...
...Yet, despite the warning signs, advocates continue to press legalization throughout the nation...
...When Allen's character bemoans his marriage breaking up, a friend reminds him that his psychiatrist warned him that his soon-to-be ex-wife would be big trouble...
...After speaking on the phone with her, the group's medical director referred her to a "death doctor" who was known to the group for being willing to issue lethal prescriptions...
...When he refused to help kill her, she consulted a second doctor...
...Rather than being strictly reserved for the rare case of irremediable pain, as Oregon voters were told it would be when they legalized the practice, it turns out that none of the patients reported to have undergone assisted suicide were in untreatable agony...
...According to the Ore-gonian, Cheney appeared to accept the psychiatrist's verdict, but her daughter did not...
...Cheney did not take the pills right away...
...So, she shopped for another doctor...
...They simply went to another doctor...
...They were right to do so...
...The most recent assisted suicide in Oregon is a case in point...
...At one point, she asked to die when her daughter had to help her shower after an accident with her colostomy bag, but she quickly changed her mind...
...Once the legal view of killing is shifted from automatically bad to possibly good, it becomes virtually impossible to restrict physician-assisted suicide to the very narrow range of patients for whom proponents claim it is reserved...
...Still, despite these reservations, the psychologist determined that Cheney was competent to kill herself and approved the writing of the lethal prescription...
...The psychologist also worried about familial pressure, writing that Cheney's decision to die "may be influenced by her family's wishes...
...Goldstein viewed the guidelines protecting her mother's life as obstacles, a "roadblock" to Cheney's right to die...
...The only question is whether we will respond to terminal illness with better medical care, in which case last week's House vote is a positive sign, or ignore the horrors of the Netherlands and Oregon and step intentionally off of the ethical cliff...
...The "protective guidelines" allegedly designed to guard the lives of vulnerable people soon become scorned as obstacles to be circumvented...
...She may have had dementia, which raised questions of mental competence...
...Thus, an act that is supposed to be "rare" is likely to become more common...
...His next book will be Culture of Death: The Destruction ofMedical Ethics in America...
...Patients can simply tell their physicians: Either you give me the pills or I go to a doctor who will...
...One recent study of the Dutch experience puts the matter grimly, saying physician-assisted suicide is "beyond effective control...
...Primary care physicians who would prefer treating a patient who wants to be killed are jettisoned in favor of doctors with an ideological predisposition toward assisted suicide...
...The Dutch law, in fact, contains much stronger guidelines than Oregon's, yet these protections have long ceased to be of any practical use and are routinely ignored with impunity...
...The psychiatrist found that Cheney had a loss of short-term memory...
...Oregon illustrates the danger of redefining killing as a medical act...
...Cheney's family wasn't so much looking for a medical opinion as an opinion that confirmed what they had already decided...
...So, she went to an assisted suicide advocacy group...
Vol. 5 • November 1999 • No. 8
