In 1970 a man with terminal bone cancer came to see Dr. Peter Goodwin, who practiced family medicine in Portland, Ore. The man had intractable pain and saw no point in prolonging his suffering. He pleaded with Goodwin for pills to end his life.
His request plunged the doctor into an ethical wilderness. If Goodwin granted the man’s request, he knew he could face felony manslaughter charges. If he refused, he was turning his back on a dying man.
“It was as if somebody was presenting themselves to me with a disease that I had never heard of, and no resources existed which could help me make my decision,” Goodwin, recalling the dilemma, told the Anchorage Daily News in 1995. “I look back on that experience to this day with absolute desolation and regret. I could do nothing.”
Two decades after turning down the patient desperate to die, Goodwin took a different course, one that ignited impassioned debates about patients’ rights and the sanctity of life. He played a leading role in crafting and promoting Oregon’s pioneering Death With Dignity Act, which made Oregon the first state in the nation to allow physicians to prescribe lethal drugs to the terminally ill with less than six months to live.
On March 11 he used the law to end his own life.
Goodwin, 83, was in the late stages of corticobasal ganglionic degeneration, an incurable, Parkinson’s-like disease that causes dementia and the gradual loss of movement. He received the diagnosis in 2006.
Four days before his death, he told Time magazine his balance was impaired, his right hand had lost all function and his left hand was quite weak. The law requires that the dying person be able to take the drugs without assistance, so he knew his time to act was short.
He obtained his prescription after receiving a prognosis of six months to live from his doctors and completing the two-week waiting period required by the law. With his children at his side, he died peacefully at his Portland home less than half an hour after taking the drugs, according to a statement from Compassion & Choices, a Portland nonprofit Goodwin helped establish to promote the Death With Dignity Act and support those who wished to use it.
A longtime faculty member of Oregon Health and Science University and past president of the Oregon Academy of Family Physicians, Goodwin brought mainstream credentials to his controversial advocacy of doctor-assisted suicide. The first physician to publicly support the Death With Dignity measure, he was widely credited with persuading the Oregon Medical Assn. to take a neutral stance as the proposal headed to the ballot in 1994.
“There was no way anyone could discount him as someone who didn’t understand clinical medicine or wasn’t a caring physician. So he spoke with great authority,” said Barbara Coombs Lee, president of Compassion & Choices.
Between 1997, when the law was enacted, and 2011, 596 Oregon residents have died by ingesting medications prescribed under the Death With Dignity Act, according to a recent report by the Oregon Health Authority. Goodwin told Time that he helped three people die under the legislation.
Even before he became ill, Goodwin was certain he would take advantage of the law if his alternative was a slow and agonizing death.
“I don’t want to go out with a whimper,” he told the Oregonian years before he received his grim diagnosis. “I want to say goodbye to my kids and my wife with dignity. And I would end it.”
The son of a car salesman, he was born in London on April 11, 1928, and grew up in South Africa. He got through college on scholarships and odd jobs, graduating from the University of Cape Town medical school in 1951.
He established a practice for blacks in Queenstown in Eastern Cape province and learned the native language, Xhosa. His wife, Erica, was an anti-apartheid activist. When a local paper identified her as an advocate of rights for blacks, Goodwin was warned that some of his Afrikaner patients were “sick and tired” of her politics. After four years in Queenstown, he told his wife it was time to leave.
In 1957 they moved to England, where Goodwin studied surgery. In 1962, they immigrated to the United States and he established a practice in Camas, Wash. In 1980, he moved to Portland and joined Oregon Health and Science University as a full-time professor in family medicine.
“He got along extremely well with people,” said Dr. William Toffler, a friend and colleague who later became his chief medical adversary in the end-of-life controversy. “One-on-one and small-group teaching was his forte. He was an excellent doctor and caring person.”
A few years after Goodwin’s disturbing encounter with the bone cancer patient, he found himself in grave conversation with another terminally ill man. This time, he wrote the prescription. He was “terrified” of being found out, yet his belief in “aid in dying,” with safeguards prescribed by law, did not wither.
“I believe that physicians in general are not trained to listen and assess what’s going on in a [dying] patient’s mind and environment, so they make arbitrary decisions,” he told The Times in 1997. “Patients deserve more power.”
In 1990 he began meeting with a group interested in legalizing doctor-assisted suicide. It evolved into Oregon Right to Die, which put the Death With Dignity measure on the 1994 state ballot. With Coombs Lee and attorney Eli Stutsman, Goodwin became a chief petitioner for the groundbreaking measure.
Critics argued that it violated the physician’s obligation to do no harm and warned of abuses, but the measure passed with 51% of the vote. In 1997, 60% of voters affirmed it by turning down its repeal.
“They called us murderers, equated us with Jack Kevorkian,” Stutsman said of the measure’s opponents. “Here was Peter, in the prime of his career, and he could have cared less about those attacks. He had the courage to stand up and say it was the right thing to do.”
Goodwin beat a diagnosis of non-Hodgkins lymphoma in 2002. Four years later, when he learned he had the rare neurological disease, he knew he would not be so lucky.
As his health deteriorated, he spent his last months holding small gatherings for relatives and friends, including Toffler.
“He was vibrant, holding court with all of us,” said Toffler, who did not know Goodwin was soon going to use the law he had helped write. “I’m saddened there was a premature ending to his life.”
Goodwin, whose wife of 50 years died in 2008, said his four children regretfully supported his decision to die on his own terms. “It will be so sorrowful,” he told Time, “but it will be a way of saying goodbye that they will all understand.”