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Doctor-Assisted Suicide Now Legal in Oregon

November 11, 1994

PORTLAND, Ore. (AP) _ As soon as Oregon voters passed a law allowing doctor-assisted suicide, AIDS patient Tim Shuck started planning to take advantage of it.

On Thursday, official tallies showed the ballot proposal had passed 52 percent to 48 percent. Shuck, who learned in April that the HIV virus is invading his brain, had talked to his doctor about suicide a day earlier.

″It allows me to have some control over my life,″ said Shuck, 45. ″My decision was based on what my needs are going to be. Once my brain is gone, I see no purpose for me to be around.″

When the measure on Tuesday’s ballot takes effect Dec. 8, Oregon will become the only place in the nation that lets doctors hasten death for the terminally ill.

A patient with six months or less to live will be able to ask a doctor to prescribe a lethal dose of drugs. At least two doctors must first agree that the patient’s condition is terminal, and the patient must ask three times, the last time in writing. Doctors must wait 15 days before filling the final request for a lethal prescription.

Doctors who follow the law’s guidelines cannot be prosecuted or sanctioned by professional organizations and licensing boards. Other health professionals, such as pharmacists, do not receive the same protection.

The law pushes Oregon to the forefront of the movement to give the dying the freedom to choose when and how to end their lives. But it also raises difficult questions for doctors who have been trained to heal, not kill.

″Nobody wants Oregon to become a drop-in center for death,″ said Dr. Susan Tolle, director of the Center for Ethics in Health Care at Oregon Health Sciences University.

The seeds of the national debate over euthanasia were sown on June 4, 1990, when Janet Adkins of Portland, a victim of Alzheimer’s disease, killed herself in Michigan with the help of Dr. Jack Kevorkian. Since then, Kevorkian has been present at 19 more deaths.

Kevorkian and his supporters are challenging a Michigan ban on assisted suicide. They argue that the Constitution guarantees ″the right not to suffer,″ and hope that the U.S. Supreme Court will eventually agree with them. But the Oregon law says nothing about suffering, and does not require patients to be in unbearable pain before requesting a lethal prescription.

Doctors in Oregon are split over the new law. The American Medical Association opposes it.

″We’re asked to be judge and jury, but I don’t think doctors are wise enough to be both,″ said Dr. Winston Maxwell, a Eugene, Ore., internist.

Maxwell says it’s difficult to predict how long a person has left to live. He said terminal patients often survive for years when it was believed they had only months.

Others worry about ambiguities. For example, the law lets a doctor refuse to write a lethal prescription, but it doesn’t say whether a pharmacist can refuse to fill one.

Fred Lyman, a pharmacist who voted against the initiative, said he would reject a request to fill a lethal prescription.

″If you assist someone in suicide, maybe their children are going to sue you,″ Lyman said. ″Someone who is injured by that death is going to sue you. Maybe the insurance company is going to sue you. ... You’re safer not to do it.″

Some doctors say physician-assisted suicide is already common among the terminally ill, and Shuck says it is prevalent among people with AIDS. With the new law, the practice can come out of hiding.

″It relieves my family, and certainly the medical people who were going to help me, of the stress of doing something illegal,″ Shuck said. ″It takes the burden off them and puts it on me, where it belongs, and on my physician.″

Similar measures were defeated in Washington state in 1991 and California in 1992, but those initiatives allowed a doctor to administer the drugs. Under Oregon’s law, it’s up to the patient to take the drugs.

Another ambiguity about the new law is whether state taxpayers will be paying for doctors to prescribe lethal drugs. Dr. Paul Kirk, chairman of the Oregon Health Services Commission, said he believes the practice is covered under the state heath care plan’s provision for ″comfort care″ for the terminally ill.

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