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Oregon ends its residency rule for medically assisted suicide

State Capitol in Salem, Ore.
The state Capitol in Salem, Ore.
(Andrew Selsky / Associated Press)
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Oregon will no longer limit medically assisted suicide to the state’s residents after a lawsuit successfully challenged the restriction as unconstitutional.

In a settlement filed in U.S. District Court in Portland on Monday, the Oregon Health Authority and the Oregon Medical Board agreed to stop enforcing the residency requirement and to ask the Legislature to remove it from the law.

Advocates said they would use the settlement to press the eight other states and Washington, D.C., that allow terminally people to end their own lives with medical help to drop their residency requirements.

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“This requirement was both discriminatory and profoundly unfair to dying patients at the most critical time of their life,” said Kevin Diaz, an attorney with Compassion & Choices, the national advocacy group that sued over Oregon’s requirement.

Laura Echevarria, a spokeswoman for National Right to Life, which opposes such laws, warned that, without a residency requirement, Oregon risked becoming the nation’s “assisted-suicide tourism capital.”

But Diaz said that was unlikely, given safeguards in the law, such as the requirement that physicians determine whether patients are mentally competent. He said it was extremely difficult for terminally ill people to make extended trips to another state and that many people would want to die in the presence of loved ones near home, not in another part of the country.

The action comes five years after a California law allowed doctors to prescribe lethal doses of drugs to terminally ill people who want to ingest them on their own to end their lives.

Sept. 10, 2021

“There’s no tourism going on,” Diaz said.

Enacted in 1997, Oregon’s first-in-the-nation law allows terminally ill people deemed to have less than six months to live to end their lives by voluntarily taking lethal medications prescribed by a physician for that purpose.

Compassion & Choices sued on behalf of Dr. Nicholas Gideonse, a Portland family practice physician and associate professor of family medicine at Oregon Health and Science University. A longtime supporter of medical-aid-in-dying laws, Gideonse had been unable to write prescriptions for lethal medication for patients who lived just across the Columbia River in Washington state.

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While Washington has a law similar to Oregon’s, healthcare providers willing to participate can be difficult to find in the southwestern part of the state, where many hospital beds are in religiously affiliated healthcare facilities that prohibit assisted suicide. Requiring his patients to find other doctors to provide assistance in ending their own lives can compound their suffering, Gideonse said.

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.

March 26, 1998

“Any restriction on medical aid in dying that doesn’t serve a specific medical purpose is difficult,” Gideonse said Monday. “In no other way is my practice restricted to Oregon residents, whether that’s delivering babies in the past or other care that I provide.”

The lawsuit argued that the residency requirement violated the U.S. Constitution’s Commerce Clause, which gives Congress the right to regulate interstate commerce, and the Privileges and Immunities Clause, which forbids states from discriminating against citizens from other states in favor of its own citizens.

The Oregon Health Authority and the medical board declined to comment on why they settled the case. The state attorney general’s office did not immediately respond to an interview request.

Under Oregon’s law, terminally ill patients must make two verbal requests, at least 15 days apart, to their doctor for lethal medication, as well as a written request signed in the presence of two witnesses. The attending physician and a consulting physician must confirm the patient’s diagnosis and prognosis, and determine whether the patient is capable of making healthcare decisions; if either doctor believes the patient to be suffering from depression or another mental disorder, they can refer the patient for a psychological exam.

Since the law took effect, 2,159 people have used it to end their lives, according to data published last month by the Oregon Health Authority.

California, Colorado, Hawaii, Maine, New Jersey, New Mexico, Vermont, Washington state and Washington, D.C., have approved similar laws, all with residency requirements. Montana’s Supreme Court has ruled that state law does not prohibit medical aid in dying.

National Right to Life is concerned that people might be able to travel to Oregon without having much of a relationship with a doctor in the state, thus chipping away at protections limiting the use of the law, Echevarria said.

“The hope is that doctors will continue to evaluate patients, but it certainly creates a situation where there could be more abuse of that law,” she said.

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