Physicians for Compassionate Care Education Foundation





Euthanasia: A doctor or other person administers a lethal agent, such as an overdose of medication or gas, to another person, with the intent of causing the other person's death.

Physician-assisted suicide: A doctor prescribes a drug or other agent for the express purpose of a patient's committing suicide.

Palliative Sedation: A patient is sedated for the purpose of relieving his or her pain prior to death.  When properly used, palliative sedation is not euthanasia.  There have, however, been reports of misuse, especially in the UK.  Palliative sedation is sometimes referred to as "continuous deep sedation" (CDS) or "terminal sedation."

  1. Who gets the Rights and Protection with Assisted Suicide?
    The legalization of physician-assisted suicide in Oregon does not give any new rights to patients. The Oregon Law only protects physicians from criminal and civil prosecution for medical killing. This immunity for physicians does not apply to any other medical practice. By asking for a "right to die" Oregonians have given physicians the "power to kill".

  2. What about Cancer and Pain and Assisted Suicide?
    There is an inverse relationship between cancer patients experience with pain and their favoring assisted suicide. People with cancer are less in favor or assisted suicide than is the general public. Patients with pain want doctors to treat the pain, not kill the patient. In Oregon, a small minority of patients dying of assisted suicide chose it because of fear of pain in the future, not because they were actually having pain.

  3. What is the relationship between Depression and Physician-assisted Suicide?
    Thinking about suicide is a cardinal feature of depression, and there is a direct relationship between depression and favoring physician-assisted suicide. Depression is frequently overlooked in patients with serious physical illness and Oregon has high rates of depression and suicide to begin with, especially among the elderly. Between 1999 and 2002, Oregon had a rate of suicide (excluding the physician assisted suicides) among those >65 years of age, that was 6th highest in the nation and 156% that of the national average. [Elder Suicide in Oregon. CD Summary. Oregon Dept. of Human Services. Feb. 22, 2005]

  4. Does Physician-assisted Suicide lower the standard of medical care?
    Once a patient has the means to take their own life, there can be decreased incentive to care for the patient's symptoms and needs. The case of Michael Freeland is an example. Michael had been given a lethal prescription and when his doctors were planning for his discharge to his home from the hospital, one physicians wrote that while he probably needed attendant care at home, providing additional care may be a "moot point" because he had "life-ending medication". His assisted suicide doctor did nothing to care for his pain and palliative care needs. This seriously ill patient was receiving poor advice and medical care because he had lethal drugs. [Hamilton & Hamilton, Competing paradigms or response to assisted suicide requests in Oregon. Am J Psychiat 2005;162:1060-1065]

  5. Does Physician Assisted Suicide Destroy the Trust between Patient and Doctor?
    This is a personal story of Dr. Ken Stevens. "We had been married for 18 years and had 6 children. For three years my wife had been suffering from advancing malignant lymphoma. It had spread from the lymph nodes to her brain, to her spinal cord and to her bones. She had received extensive chemotherapy and radiation treatments. She required considerable pain medication, antidepressants and other supportive measures. In late May, 1982, we met again with her physician to review what more could be done. It was obvious that there was no further treatment that would halt the cancer's progressive nature. As we were about to leave his office, her physician said, "Well, I could write a prescription for an 'extra large' amount of pain medication for you." He did not say it was for her to hasten her death, but she and I both felt his intended message. We knew that was the intent of his words. We declined the prescription. As I helped her to our car, she said, "He wants me to kill myself." She and I were devastated. How could her trusted physician subtly suggest to her that she take her own life with lethal drugs? We had felt much discouragement during the prior three years, but not the deep despair that we felt at that time when her physician, her trusted physician, subtly suggested that suicide should be considered. His subtle message to her was, "Your life is no longer of value, you are better off dead." Six days later she died peacefully, naturally, with dignity and at ease in her bed, without the suggested lethal drugs. Physician-assisted suicide does destroy trust between patient and physician.

  6. How Do People in Oregon Die with Assisted Suicide?
    In Oregon, we are dependent on self-reporting of physicians, and since physicians are rarely present at the time of the lethal ingestion, we really don’t know. The Oregon Department of Human Services publicly states that they do not have "authority to investigate individual Death with Dignity cases”. The Oregon law actually prohibits investigation of many details of these deaths.

  7. Are the Assisted Suicide "Safeguards" in Oregon being followed?
    The stated "safeguards" in the Oregon law include: being capable, not being depressed, no coercion, self-administration, and life expectancy of less than 6 months. Yet, reports in the public press have described that among those who have died from assisted suicide there are: patients who are depressed; patients who are demented; patients and families "doctor-shopping" until they find a doctor who will write a prescription; patients with swallowing problems requiring assistance in taking the medication (not self-administered); coercive family members; doctors being coerced/intimidated into writing the lethal prescription; patients living as long as a year after being determined eligible. There is no protection for the depressed or mentally ill. Between 2003 and 2005, less than 5% of those dying from assisted suicide had a mental health consultation. There are published reports of a patient diagnosed by a psychiatrist as having dementia, and still receiving a prescription for lethal drugs. The drug is supposed to be self-administered and we have newspaper reports of patients being assisted in taking the drugs, because they were not able to be self-administered.

  8. Is Physician Assisted Suicide a "policy of privilege"?
    Proponents of assisted suicide tend to be upper middle class or higher; white, well educated, and have high income. African-American and Hispanic organizations are very opposed and fearful of the legalization of assisted suicide because of their minority status and more limited resources. The arguments favoring assisted suicide are demeaning to people with disabilities: Proponents of legalizing assisted suicide say, "there are situations that are worse than death." This has mobilized the disability community against the legalization of assisted suicide. People with disabilities have expressed fear that they may become the next targets of the assisted-suicide movement.

  9. Are there Financial issues in Physician Assisted Suicide?
    The financial and societal dangers; assisted suicide may become the only choice for some patients. There is concern nationally and within Oregon regarding the rising costs of health care. Financial conditions may lead to assisted suicide as an answer to those rising costs. Oregon Medicaid, the Oregon Health Plan, covers the costs of assisted suicide with state dollars, but it does not cover the costs for curative or local medical treatment for patients with cancer with a less than 5% chance of living 5 years, even when that treatment can prolong valuable life. In 2003, the Oregon Health Plan stopped paying for medicines for 10,000 poor Oregonians; this included patients with AIDS, bone marrow transplants, mentally ill and seizure disorders. In 2004 and the first half of this year, an additional 75,000 Oregonians were cut from the Oregon Health Plan, to keep the state budget balanced. Assisted suicide may become the "only choice" for some vulnerable patients. Even if a patient has Medicare or Medicaid health coverage, there is limited access to health care in Oregon. Sixty percent of Oregon physicians limit or do not see Medicaid patients, forty percent of Oregon physicians limit or do not see Medicare patients. Seventeen percent of Oregonians are without health insurance, and the share of Oregonians without health insurance has grown faster than in any other state over the past four years.

  10. Does Physician Assisted Suicide lead to Euthanasia?
    The prospect of euthanasia was raised by Mr. David Schuman, then an Oregon Deputy Attorney General in 1999, in a letter to a state senator. He wrote that Oregon's assisted suicide law would in effect be discriminatory because of the Americans with Disabilities Act, because the Oregon law requires self-administration and not everyone is capable of that. "The assisted suicide law would be treated by the courts as though it explicitly denied the 'benefit of a 'death with dignity' to disabled people," Mr. Schuman wrote. Many doctors are writing prescriptions for lethal drugs to patients for whom they have not previously cared. Dr. Rasmussen had reported that "75% of the patients who come to him regarding assisted suicide are patients he has never seen before." Regarding the "slippery slope" of assisted suicide, Dr. Rasmussen said, "I think all involved in the Oregon law must recognize that we are on a slippery slope, and we have to be careful with every step. But just because it's a slippery slope doesn't mean we shouldn't go there. [Robeznieks. Oregon sees fewer numbers of physician-assisted suicides. American Medical News. April 4, 2005]

  11. Is PCCEF affilicated with a religious organization?
    No. Physicians for Compassionate Care Education Foundation is not affiliated with any religious or political organization.  What unites PCCEF members is the conviction that human life has value and the physician-assisted suicide is wrong.
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