How to Die in Oregon

In 1997, Oregon became the first American stateand the third place anywhereto legalize physician assisted dying.* Since then, eight other states and the District of Columbia have followed. The title of this post is the title of a documentary about the Oregon law. Frontline's The Suicide Plan, a related documentary, concerns assisted suicide in places where it's either illegal or a person doesn't qualify under current law. For example, the Oregon law requires that death be expected within six months and that the patient be able to take the required medication without assistance, the result being that some terminal people kill themselves before they wish, and that non-terminal people are excluded regardless of the severity of their condition.

While the American Medical Association and various handicapped rights groups oppose assisted dying (I was pleased to learn that my own doctor supports it), the bulk of the opposition comes from religious groups and is based upon the following: (1) God allows suffering in order to ennoble the afflicted and their caregivers, and (2) God alone can create life, so God alone must decide when to end life. Given their second argument, evangelical Christianity's military hawkishness and support for the death penalty is at best paradoxical, as is the fact that, this year alone, several states in America's so-called Bible Belt have passed laws to either end or severely restrict abortion and birth control, while also restricting financial assistance to poor families.

My own, very liberal, denomination, the Episcopal Church opposes assisted dying based upon the opinion of its General Convention that Christ, had he thought to address the issue, would have opposed it. I doubt that the church's position carries weight even among its own members, and I maintain that anyone who attempts to contribute to the public dialogue on the basis of authoritarian religious pronouncements has nothing of value to contribute to the public dialogue. "God said it; I believe it; and that settles it," only settles doubts regarding the speaker's intellectual earnestness.

But what of the slippery slope argument, the claim that assisted dying today will lead to outright euthanasia tomorrow? I certainly hope so. Under the Oregon law, if I fall victim to Alzheimer's, I will be too mentally compromised to kill myself by the time my life expectancy is within the six month limit, which means that I will be obliged to end my life early, while alone, and by means that are violent or degrading. Other sufferers—from ALS for examplemight retain their mental faculties but be unable to raise the glass to their mouths or swallow its contents. It would therefore take an enormous weight off the minds of many if the law permitted them to have help in dying or, where necessary, to outline in advance the conditions under which they would wish to be euthanized.

But why choose death rather than palliative care? (1) Not all pain can be relieved by narcotics, and some conditions cause excruciating pain for which palliative drugs are completely ineffective unless they are given in such high doses that the patient is rendered unconscious. For example, I was once told that I had Chronic Regional Pain Disease, a condition so horrifically painful that the patient must literally choose between suicide and insanity. (2) No drug can take away the misery and humiliation of having to have one's ass wiped, of needing to be bathed by others, of being too wretched to experience pleasure, and of losing all hope but the hope of a death that cannot come soon enough. (3) In America, the government will only pay for a person's long-term medical care after that person has nothing left to spend, and I, for one, have not spent my life saving only to leave my wife bankrupt so that I might prolong a nightmarish existence that is no longer worthy of the name life.

For those who, despite the things I just listed, continue to "say yes to life," I leave it to them to live, but how dare they deny me the right to die in a peaceful, timely, and dignified manner in the presence of my loved ones! Yet what rankles me most is not their arrogance but that they justify their arrogance by invoking the name of God without a smidgen of evidence to support that invocation.

It is no coincidence that all of the states (plus Washington D.C.) that have passed assisted dying laws are heavily Democratic and secular. The following list of Death with Dignity states*** includes the dates the laws took effect—the Maine law will become active in September. I'm confident that the day will come when the only states that lack such laws will be those of the Bible Belt, a reactionary region that never fails to go kicking and screaming behind the rest of the nation when it comes to the expansion of human rights.

District of Columbia—2017
New Jersey—2019

Finally, for my beloved Aussies who constitute the bulk of my active readership, I was pleased to learn that your state of Victoria has recently enacted a "Dying with Dignity" law.****

* The Death with Dignity lobby opposes the word suicide, so I will use their preferred terminology out of respect for those who have worked so hard to bring the laws about.





Strayer said...

The state of affairs in nursing homes is so awful I cannot imagine existing in one incapacitated at the mercy of others, til death. It is down right horrifying to think about after knowing what goes on in nursing homes, the under staffing, the theft, the neglect, the awfulness, the horrendous food. Owners make the last bit of money possible off the dying. If one has a stroke or brain injury or Alzheimers, that's where they'll end up, me too. I wish it was not so. It's so cruel. If people want to pretend it isn't, they can have their little delusions. I wish assisted dying was legal, in other words, if a person signs off on it while still able to do so.

Elephant's Child said...

Hooray for Victoria. I cheered when the laws were passed, while being furious that our Federal Government has denied the Territory in which I live the right to even consider enacting similar laws.

Emma Springfield said...

To live a life with dignity and to end that life with dignity should not be questioned. I have no wish to be a burden to myself or my children. I don't look forward to dying but I also don't want to stay alive "at all cost". This is a well-thought out and well-stated post.

ellen abbott said...

just one one more item in the 'evil' column of religion. if we can tip Texas over into Blue perhaps we will be able to choose how and when we want to die.

Andrew said...

You saved me mentioning it. Dignity is a good word to use because that is what it is really about. At my age I have seen enough undignified deaths to know what I would prefer. There was an attempt in one of Australia's territories but because a territory is controlled by the federal government, it was stopped.

So Oregon has had such legislation since 1997? Amazing. As imperfect as your and probably our legislation is, at least it is something and can be amended.

Snowbrush said...

"I wish assisted dying was legal, in other words, if a person signs off on it while still able to do so."

But what would you do if they don't sign-off, yet it would take tremendous resources to keep them alive? While the issue at stake wasn't euthanasia, in the film about the Oregon law, there was a man with terminal prostate cancer who was irate because he wanted Medicaid to spend whatever it took to keep him alive for as long as possible, although his doctors said he would die within six months. When he got a letter from the state denying him treatment but suggesting that he take his life under the Oregon law, he started calling talk radio, and the state of Oregon reversed itself, but should it?

"I cheered when the laws were passed, while being furious that our Federal Government has denied the Territory in which I live the right to even consider enacting similar laws."

The funny thing about the opponents of the law is that they're almost invariably religious conservatives who champion states rights and individual rights over the rights of the federal government. They're the ones who wave the flag and get all misty-eyed when talking about "our brave boys who have died for freedom," even while doing their utmost to prevent abortion, birth control, marijuana use, freedom from religious oppression, and the right to die.

"This is a well-thought out and well-stated post."

Thank you.

"just one one more item in the 'evil' column of religion."

I can't tell that the balance book of religion stays on the positive side. I go to church (plainsong evening prayer) once a week, and I'm aware that many religious people are intelligence, educated, harmless, and well-meaning, but even so the evil is overwhelming, especially in the Muslim world.

"Dignity is a good word to use because that is what it is really about. At my age I have seen enough undignified deaths to know what I would prefer."

Another good word is timely because a death watch can go on and on and on at tremendous financial and emotional cost for all concerned. I have every confidence that I would avail myself of the law should the need arrive, as it did for the older of the two women on the cover of the DVD. Hers is really an extraordinary story, so if you can get the film, please do.

"So Oregon has had such legislation since 1997? Amazing."

The law was passed in 1994, but spent the next three years being challenged in court. The federal government has tried to stop such laws by threatening the doctors who prescribe the drugs, and some religious pharmacists have refused to fill the prescriptions. Meanwhile, Big Pharma has raised the price of the drugs many times over; hundreds have taken the lethal brew; hundreds more have gotten the prescription filled but died before using it; dying people have moved to Oregon to take advantage of the law; and other states were inspired by the success of the Oregon law to pass their own laws. Legalized dying is like legalized marijuana here, which despite the federal government's attempts to stop it has gained tremendous support. I've seen marijuana advertised on TV here in Oregon, and billboards and cannabis stores are everywhere.

Snowbrush said...

I just realized that part of my last comment got put online twice, so I deleted the redundancy. The reason it happened was that, for years now, I've been unable to comment on my own or anyone else's blog by writing in the comment box because the damned page is likely to reload in which case all that I've written will be lost. Today, I got distracted, and forgot that I had already copied, pasted, and posted some of my response. If anyone else has had this reloading problem and knows how to deal with it, please educate me.

rhymeswithplague said...

I hope you don't die anytime soon.

PhilipH said...

Every word of your post is spot on and in complete sync with my own disgust with the way the law on "assisted dying" tortures so many folks in the UK. As Dickens put it, in Oliver Twist, " the Law is an Ass!"

Up until mid-1961, you could be charged if you failed in your attempt to commit suicide. Suicide was illegal. How ridiculous that law was then, just as assisted dying is now. In 50 years time belief in religious dogma will, I hope, be laughable.

I read of how Anthony Trollope wrote a book called "The Fixed Period" published in 1882 in which it forecast mandatory euthanasia at age 67 would be the norm in Britannula. I think Aldous Huxley in "Brave New World" had something similar in mind, but I've not read either book.
I am wondering if such ideas may eventually come about as populations age at the rate of today and tomorrow. Once a person becomes of little or no use to society because of illness, disability, dementia and so on the cost of keeping them in hospitals, nursing homes and old peoples homes will be unbearable. Growing old and infirm is no joke, for them or for those who have to support and tend them.

Thank goodness I shall not be around in even ten years hence, let alone fifty years.

Snowbrush said...

"I hope you don't die anytime soon."

Thank you, and may you also hold out for a long while yet. I would like to outlive Peggy and the cats so as to spare them the trauma of my death.

The following verse is from the 39th Psalm: "O Lord, let me know my end, and the measure of my days, what it is; I would know when I will cease." I remain a faithful attendee of the Gregorian Chant Evening Prayer service, and while many of the Psalms are but a combination of self-pity and pleading with God to destroy the Psalmist's enemies, there are days when one of them appeals to me, and the 39th Psalm is among those.

"I read of how Anthony Trollope wrote a book called "The Fixed Period" published in 1882 in which it forecast mandatory euthanasia at age 67 would be the norm..."

Which is pretty much what the Nazis did to those that the government deemed to be liabilities, although their standards often had more to do with racial, physical, or political purity, than with the measured value of a person's contribution to society. It would surely take a brutal government to enact or carry out Trollope's scheme, but for sake of argument, even if "mandatory euthanasia" were legalized, I think you are correct in suggesting that more factors than age would need to be considered (for instance, health and productivity) in order to reach anything approaching a rational assessment of whether a person's value to society outweighed his or her expense, and it would surely be an easy jump from killing the aged to killing criminals, the sickly, the disabled, and anyone else who didn't measure up to someone else's idea of what makes a life valuable. Last night, I watched a nature show that depicted a lovely family of Arctic foxes--the pups were all vigorous with black fur except for a single brown one. The announcer stated that the parents would be unable to feed every member of their large brood once the birds they relied upon migrated south, and so the ones who survived would be the ones who had the strength and cunning to steal from their siblings. Such might well be what would happen in a human society stretched to the breaking point, and like you, I am pleased to note that I am likely to be dead before such a scenario occurs. If such a thing did happen during my lifetime, it might well be in response to the magnitude +9 earthquake that is expected to hit the America's Northwestern Coast at any moment now.

"Thank goodness I shall not be around in even ten years hence, let alone fifty years."

I have heard of people who, in times of great uncertainty (Brexit, for example), do their utmost to hold onto life a bit longer in order to see what happens next. I hope your belief in your early demise is misplaced. Truly, I do. You are my valued friend.

Jim said...

I belong to one of those conservative religions but that won't stop me from an assisted death. God forgives sin if I will have sinned doing it. But since reading your nice blurb I will shop the other states also.
Then too there's always Old Trusty waiting for me to pull the trigger. Texas way.

PhilipH said...

"I hope your belief in your early demise is misplaced. Truly, I do. You are my valued friend."

Thanks, Snowy. I've no real idea as to when the final curtain falls of course. I'm well past the three-score-years-and-ten, as I reminded my doctor in Scotland, when, back in 2010, he called an ambulance because of a supersonic heartbeat. A dose of Digoxin soon sorted the problem, pro tem, but repeat performances persist. I can live with this; there are far more chronic complaints. I doubt if I could tolerate any of the cruel diseases you mention in your post. It's hard enough to read of such things as you quoted let alone living with them.

My generous friend and employer, the late John Haddington, was struck down with PNP (progressive supranuclear palsy) in his mid-70s. He was freed from this soon after the onset by dying in his sleep. It was the best result for him, in my view.

Death is the friend of all such sufferers. I cannot see the point in living with so many of these cruel happenings. Why the law and religion forbid the merciful despatch of such sad sufferers is a total nonsense.

The Goddess of Dawn, Eos, asked Zeus to grant her human lover, Tithonus, immortality. This request was granted, and Eos and Tithonus were thus able to live forever. Sadly, she forgot to ask for eternal youth. Poor Tithonus got older and older and older, but could not die. So much for longer and longer life.

It should NOT be "Death, where is thy sting", but "Death, where is your blessing, or gift, or kindness.

Heidrun Khokhar, KleinsteMotte said...

In Canada there has been change too. And it requires the person wishing a termination to be of sound mind while making a request and being terminally ill. It too limits those with severe dementia lying in diapers calling out for their moms. Really we should be allowed to create a POA along with a statement of how we may die when our life is too altered and we cannot decide. That ought to be a choice. God gave us free will. We use it to kill without penalty in political wars so what is the difference if we opt to be terminated at a time when we are ready?
As for all those anti abortion issues it shows how blind faith can muddle the words of scriptures dating back 2019 years or more if Old Testament is included. Way back then God’s world in human eyes was flat and America did not appear to be in any passages. Love Jesus but also know science is real and God made it that way so we could learn. We all have to die as it is part of a process and the way and date we die is really not an issue. God will still be there either way. It is His universe.

Marion said...
This comment has been removed by the author.
Starshine Twinkletoes said...

I agree sweetie, and hope you, Philip and Rhymes hang on in there for another twenty odd years, unless you want to pop off in which case I shall be very sad but understand why, for no-one should have to endure pain to the level is makes them suicidal and be unable to end their life, nor should someone who feels they have lived the best and happiest of lives and feels they've had enough as it is be denied the option. Of all things our bodies and minds are truly our own, . . . or should be. Great post, as ever X

Snowbrush said...

"there's always Old Trusty waiting for me to pull the trigger. Texas way."
As did Texan Robert E. Howard (who shot himself in the head in his car in his father's driveway), but what a horrible image with which to leave ones family. Please see my comment to Marion because that which can be used for pain can also be used to kill oneself.

"I'm well past the three-score-years-and-ten, as I reminded my doctor in Scotland, when, back in 2010, he called an ambulance because of a supersonic heartbeat."
Peggy is reading an excellent book entitled "How We Die," in which the author/doctor tells of talking a 94 year old woman with multiple problems into having a surgery she didn't want for a condition that would have quickly killed her (he did this by withholding vital information about the severity of the recovery period). That story will stay with me if I'm ever beset with horrible problems, and some doctor tries to talk me into something about which I am in rebellion.

I agree with your comments Twinkletoes and Heidrun--thank you

Marion, my internist suddenly stopped prescribing narcotics to ANYONE for chronic pain, leaving me to wonder if he got a letter from the DEA, and forcing me to go to a pain specialist. if I were in severe pain for which I could get no legal relief, I would order Fentanyl for cheap off the Dark Web, and order a test kit from Amazon to verify that what I received was really Fentanyl. The downside, of course, is that you would be taking a drug that's fifty times stronger than heroin; you would be hooked on it for the rest of your life; and it would be likely to shorten your life. Another downside is that you could be arrested, although it would be unlikely. I've taken Fentanyl on at least a few occasions, and I can assure you that it's really, really good. Heroin addicts who no longer get high on heroin (they take it simply to avoid going into withdrawal), can get wasted on Fentanyl, but the thing about narcotics is that once you get used to them, you can carry on a normal life. At least that's been true for me, and I've that my experience is the norm.

rhymeswithplague said...

Please post something, Snow. Your absence worries us.

Snowbrush said...

"Please post something, Snow. Your absence worries us."

Us? In any event, I'm honored by your concern. I've written several posts since this one, but simply haven't put them online. Upon receiving your comment, I'm working on one that I hope to put online today or tomorrow. Thank you.

Starshine Twinkletoes said...

Rhymes knows how many on here care for you, he speaks for many of us when showing concern. Especially if it's because you were seen running down the high street wearing naught but a casserole pot on your head singing 'I'm a spankee doodle dandy'.