March 4, 2010
2009 Annual Physician Assisted Suicide Report: “More Conspiracy and Control”
The annual report from the Oregon Department of Human Services (DHS) regarding physician-assisted suicide (PAS) in Oregon for the 2009 year was released March 3, 2010. ( 1 )
It reports that 95 prescriptions were written in 2009 by 55 doctors, resulting in 59 PAS deaths in 2009. In the 12 years from 1998 to 2009, there have been 460 reported PAS deaths in Oregon.
PCCEF is concerned with several areas of the DHS report for the 2009 year.
- The report is very brief, consisting of a two-page summary report and a 2 ½ page Table. This is not consistent with the “surveillance” responsibility of the DHS regarding assisted suicide in Oregon. There are no true investigations of assisted suicides in Oregon by the DHS.
- None of the 59 patients was referred for psychiatric evaluation. Over the past three years in Oregon, only 1% (2 of 168) of patients committing assisted suicide were referred for psychiatric evaluation. This is in marked contrast to the report by OHSU researchers in 2008 that 25% of patients requesting assisted suicide were considered to be depressed. ( 2) This year’s report confirms there is no protection for depressed patients in Oregon.
- Only 6 of the 60 PAS death patients had “inadequate pain control or concern about it” as an end-of-life concern. As has been reported previously, pain is not a major reason for assisted suicide.
- The prescribing physician was present at the time of lethal overdose ingestion for only 3 of the 59 deaths, and was present at the time of death for only one patient. Medical details of that time and knowledge of complications for the other 58 patients was obtained second- or third-hand. How do we really know what happened in the majority of the deaths? Why are the prescribing physicians not present at this critical time?
- The median duration of patient-physician relationship was only 9 weeks. Some patients had no prior relationship with the prescribing physician. Many patients have prescriptions for lethal drugs written by other than their personal physician.
One organization is responsible for 97% of the assisted suicide deaths this past year. Compassion & Choices, the assisted-suicide-proponent organization, are authors of Oregon’s physician-assisted suicide law and proclaim they are its steward. 78% (359/460) of all Oregon assisted suicide deaths are their cases. In the past two years they have been involved in 92% of Oregon’s assisted suicides. They reported involvement in 53 of 60 deaths in 2008, and in 57 of 59 deaths in 2009. (3) The Oregonian editorial board correctly stated in 2008 that “a coterie of insiders run the [assisted suicide] program, with a handful of doctors and others deciding what the public may know.” ( 4 ) As is particularly evident for the 2009 year, they control the assisted suicide market; 97% (57 of 59) of physician assisted suicide deaths in 2009 were their cases! As was noted in The Oregonian in 2008 ( 5 ), “the initials ‘C &C’ of this organization more properly reflect its repeated public behavior – that is, ‘Conspiracy and Control’ ” .
Very few doctors are involved in most physician assisted suicides. Oregon Department of Human Service officials reported in 2009 that there were 109 physicians who wrote 271 prescriptions resulting in assisted suicide deaths in the years 2001 to 2007 (6). 165 of the prescriptions were written by 20 physicians, and 62 of these 165 prescriptions were written by only 3 physicians. In other words, 61% of the fatal suicide barbiturate overdose prescriptions were from 18% of the prescribing doctors; and 23% of the fatal suicide prescriptions were from less than 3% of prescribing doctors.
In this same article, the DHS authors expressed concern regarding the “worrisome trend” over the years in the decline in requests for formal psychiatric evaluation, they stated: “the decline in formal evaluation raises concerns that depression remains undiagnosed in some patients who request and receive a prescription under the DWDA.”
Physicians for Compassionate Care Educational Foundation promotes the ethic that all human life has inherent value and that physician-assisted suicide:
- Undermines trust in the patient-physician relationship
- Changes the societal role of the physician from healing to medical killing
- Endangers the value that society places on life, specifically for those who are most vulnerable, those who are frail, elderly, and at the end of life.
- 2009 Summary of Oregon’s Death with Dignity Act, March 3, 2010.
2. Ganzini, L, Goy ER, Dobscha SK. “Prevalence of depression and anxiety in patients requesting physicians’ aid in dying: cross sectional survey”. British Medical Journal 2008:337:a1682.
3. Personal email from Sue Porter to Kenneth Stevens, February 14, 2010, for the 2009 year data.
4. The Oregonian, “Washington state’s assisted suicide measure: Don’t go there. September 20, 2008, http://oregonlive.com/opinion/index.ssf/2008/09/washington_states_assistedsuic.html.
5. Stevens, KR, and Toffler, WL. “Assisted Suicide: Conspiracy and Control” , Oregonian, 9-24-08, www.oregonlive.com/opinion/index.ssf/2008/09/assisted_suicide_conspiracy_an.html
6. Hedberg, K, Hopkins, D, Leman, R, Kohn, M. “The 10-Year Experience of Oregon’s Death with Dignity Act:1998-2007”, The Journal of Clinical Ethics, Summer 2009; 20:124-132.
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