Death Called 1st Under Oregon’s New Suicide Law

An elderly woman whose breast cancer left her housebound and unable to easily breathe swallowed a fatal dose of barbiturates and died in her sleep, becoming the first known person to utilize Oregon’s landmark doctor-assisted suicide law, advocates announced Wednesday.

“I am looking forward to it, being that I was always active, and I cannot see myself living a few more days like this,” the woman, a grandmother and avid gardener in her 80s, said in a scratchy tape recording made two days before her death Tuesday night.

“I will be relieved of all the stress I have,” she said.

The death of the woman, whose name was not released by her family, ended five months of uncertainty over application of the nation’s first law legalizing doctor-assisted suicide.

Oregon voters decisively rejected an attempt to repeal the law in November, but the measure has been tied up since then in disputes between doctors and pharmacists and a warning by the federal Drug Enforcement Administration that doctors could face sanctions for prescribing lethal drugs to their dying patients.

“I think one of the remarkable things about this story is that it’s taken us five months to have a confirmed death under the Death with Dignity Act,” said Barbara Coombs Lee, head of the Compassion in Dying Federation, which was one of the law’s primary proponents.

“That certainly is counter to the predictions that this was going to be flagrantly used and abused, and there would be many deaths under the act,” she said.

State health officials have said they will not release any information about patients who elect to utilize the law until at least 10 patients have done so--and even then, individual cases will be kept confidential. State epidemiologist Dr. David Fleming said he was not aware of the details of the current case, but confirmed that there have not been the requisite 10 suicides to trigger an initial state report.

“My sense is that there have been several ambiguous or confusing issues around the law, and both patients and providers have been waiting for some of those issues to become clearer-cut,” Fleming said in an interview.

“This is without precedent, and I think there is some question about what the demand for this service actually is,” he said.

Opponents of the law condemned its initial application.

“I am deeply saddened at this news. The suicide of this elderly woman can only bring anguish to those who have resisted the public policy initiatives that changed the law in Oregon,” John Vlazny, archbishop of Portland for the Roman Catholic Church, said in a statement.

Oregon Right to Life said it expects to revive a lawsuit still pending in federal court challenging the law, initially adopted by voters in 1994.

“My reaction is one of profound sadness. This marks a historic day, a day where society for the first time, to my knowledge, is sitting by watching and condoning someone kill herself with the legal help of her doctor,” said Gayle Atteberry, spokeswoman for the group.

She said the unidentified woman’s assertion that her suicide would relieve her “stress” was an indication that she suffered from depression, not unrelieved pain. The law requires doctors to refer patients suffering from depression for counseling before going ahead with a suicide.

“She said she was looking forward to death because she would be relieved of the stress, not the terrible agonizing pain, but the stress. Does not that point to depression?” Atteberry said.

“It’s important to recognize that this woman’s family doctor of longstanding would not write the prescription for her,” she added. “I don’t know why, but one thing we could speculate on is he did not think this was the right thing for her to do.”

Lee, who held a press conference in Portland announcing the suicide, said the woman had battled breast cancer for 20 years. In recent months, she found herself unable to enjoy favorite pastimes like gardening and was having trouble breathing when she decided to end her life. She had been told by her doctor that she likely had two months to live.

Surrounded by family members and a physician who agreed to prescribe the drugs, she died 30 minutes after taking a lethal dose of barbiturates, washed down with a glass of brandy.

“I’ve always been able to get around and do things. Suddenly, I’m in a position I can’t walk very good and I’m having trouble breathing,” the woman said in her audio recording. “I can’t see myself living a few more months like this.”

“For the first time to our knowledge, a terminally ill patient has ingested a lethal dose of medication and died as a result,” Lee told reporters.

Dr. Patrick Dunn, head of a state task force that developed a guidebook for physicians on assisted suicide, said it was never expected that there would be a rush to use the law.

“I think that although there were those concerns about patients immediately undertaking the provisions of the act . . . the medical community in general has felt this would be a relatively rare event.”

He said only about 2% of all terminally ill patients are believed to have pain and suffering that cannot be relieved by any other means.

“It’s very rare that you really cannot meet those comfort care needs of patients who are dying,” he said.

Even after development of the physician guidebook, a number of questions surrounding implementation of the law have remained hazy, he said. Among them are uncertainties over who is considered an Oregon resident under the law’s residency requirement and options for patients who have no access to hospice care.

He said physicians still have not come to terms with a demand by the Oregon Board of Pharmacy that doctors include a specification on prescriptions that drugs are to be used for ending a patient’s life.

Pharmacists say this would allow practitioners opposed to the law to opt out of filling the prescription, but doctors say it would risk breaching the confidentiality of both the physician and the patient.