Oregon Defends Assisted Suicide

Richard Holmes was two days away from getting the piece of paper that would have allowed him to take his own life. Then, with the stroke of a bureaucratic pen, the death warrant got snatched away. And Holmes got mad.

“I want the option. I want a choice. That’s all I want,” Holmes, who is suffering from inoperable liver cancer, said Wednesday.

The 72-year-old Portland man is one of dozens of terminally ill patients in Oregon whose applications to commit suicide were abruptly thwarted this week by Atty. Gen. John Ashcroft’s ruling against the state’s doctor-assisted suicide law.

On Wednesday, the Oregon attorney general went to court here to block the federal ruling, which threatens to hold doctors liable if they write prescriptions for lethal doses of barbiturates under the state’s four-year-old statute.

State officials asked a U.S. district judge to immediately suspend implementation of the ruling and consider whether the federal government overstepped Oregon’s right to determine the legitimate medical use of controlled drugs within the state.

A judge was tentatively scheduled to hear the request today. In the meantime, doctors throughout Oregon said they would stop writing prescriptions for assisted suicides, leaving several dozen patients, such as Holmes, who have already started the application process, in a discomfiting limbo.

“I was going to be able to get the prescription on Friday. The doctor has to see you, then you wait 15 days. This is the 13th day of those 15 days. So he was going to write the prescription on Friday, and now, he probably can’t write it at all,” Holmes said Wednesday.

Holmes sold swimming pools for years in the San Fernando Valley, then moved to Portland and sold burglar alarm parts until he retired. But he has been in and out of hospitals since 1994. Two years ago, he was diagnosed with colon cancer, and after surgery and a lengthy course of chemotherapy, the cancer spread to his liver, where it is now inoperable.

He figures he has four to six months to live. And while he feels pretty good now, he’s not sure he wants to live through what may lie ahead.

“I just want the option to have assisted dying, in case I get to the point where I can’t take care of any bodily functions, or do anything for myself, and I have to be drugged so heavily that I’m out of it most of the time,” Holmes said.

Oregon is the only state in the country where terminally ill patients can get a doctor’s help to end their lives. Voters endorsed the assisted suicide law in two statewide votes, and 70 citizens have used it since 1997.

Proponents said Ashcroft’s ruling that assisted suicide is not a “legitimate medical purpose” for prescribing federally controlled drugs will make doctors fearful of prescribing pain medication and drive assisted suicide back underground.

“This is the equivalent of driving legal abortions back into the alleys. This drives what was a legal, humane, dignified way back into that covert way of handling end-of-life decisions where we all have to be secretive and cautious and never talk about it,” said George Eighmey, executive director of the Compassion in Dying Federation of Oregon.

Peter Goodwin, a doctor who has consulted on a number of legal assisted suicides, said patients before the law often attempted to take overdoses of drugs not guaranteed to bring about a hasty, comfortable death. Instead, he said, there were numerous “tragedies” of suicides gone wrong, of patients who put themselves into endless comas or vegetative states.

“I know of a case where a patient was left in a total catatonic state and finally died, but it was a tragic death,” Goodwin said. “There are going to be disasters. Not a lot, but there are going to be disasters.”

But doctors in Oregon who have opposed the assisted suicide law say it opens equally unsettling possibilities for abuse.

“You worry that people will be manipulated into committing suicide, either through withdrawal of medical care, or being told that tomorrow will be worse because of this or that, or having medications withheld that could make a person feel better, or [the family] finally giving up or pulling away and not being supportive,” said Dr. William M. Petty, who represents Physicians for Compassionate Care, which has fought assisted suicide in Oregon.

Eighmey, who has attended eight legal suicides, said family members have in every case been loving and supportive and have offered patients numerous opportunities to change their mind.

“After handing the glass to the person, we again reiterate, ‘You have the right to change your mind, please don’t feel any pressure from us.’ Nobody, but nobody, has changed their mind. And then the person drinks the mixture in less than a minute, is still awake and is able to make their final goodbyes,” he said.

“It is very emotional, very tense, I guess, because this is the final moment. Normally, the person will say, ‘I don’t feel anything. What’s going to happen?’ . . . Normally, within two or three minutes, they do fall into a deep coma, and they die shortly thereafter.

“There are no adverse effects, no seizures, no loss of bodily functions of any type. The death is very, very peaceful.”

Oregon state officials say the median age of the 27 patients who took lethal medication in 1999 was 71 years. Most died in about 30 minutes, but one lingered 26 hours in a coma.

Many Oregon residents seem incensed that the federal government stepped in on an issue that has been voted on twice. At a storefront senior citizen center in Portland’s Hollywood district, there was near unanimity about Ashcroft’s ruling.

“We already went through this thing twice. They have no right to take it away. Now, the doctors have to worry about people looking over their shoulder when they try to do their job,” said Pat Williams, program director.

Barbara Markus, a 75-year-old client at the center, said her husband was kept pain-free while dying of heart disease. Now she fears doctors may be reluctant to prescribe adequate pain medications. “I can’t imagine how hard it would be to watch someone die, and wonder if the doctors were really doing everything they could to relieve his pain,” she said.