Response to: Choosing when and how to die: Are we ready to perform therapeutic homicide?

The following article was published in the Canadian Medical Association Journal and titled: Response to Choosing when and how to die: Are we ready to perform therapeutic homicide?

Ken Stevens

Kenneth R. Stevens, Radiation Oncologist, MD

I am a cancer doctor in Oregon where physician-assisted suicide is legal. This letter responds to the editorial by Dr. Flegel and Dr.Fletcher, "Choosing when and how to die: Are we ready to perform therapeutic homicide?" (June 25 2012)

In Oregon, the combination of assisted-suicide legalization and prioritized medical care based on prognosis has created a danger for my patients on the government run Oregon Health Plan (Medicaid).

The Plan limits medical care and treatment for patients with a likelihood of a 5% or less 5-year survival. My patients in that category, who say, have a good chance of living another three years and who want to live, cannot receive surgery, chemotherapy or radiation therapy to obtain that goal. The Plan guidelines state that the Plan will not cover "chemotherapy or surgical interventions with the primary intent to prolong life or alter disease progression." The Plan WILL cover the cost of the patient's suicide.

Barbara Wagner

Under our law, a patient is not supposed to be eligible for voluntary suicide until they are deemed to have six months or less to live. In the well publicized cases of Barbara Wagner and Randy Stroup, neither of them had such diagnoses, nor had they asked for suicide. The Plan, nonetheless, offered them suicide.

In Oregon, the mere presence of legal assisted-suicide steers patients to suicide even when there is not an issue of coverage. One of my patients was adamant she would use the law. I convinced her to be treated. Now twelve years later she is thrilled to be alive. I hope that you can avoid Oregon's mistake.

[Support for this letter regarding Barbara Wagner and Randy Stroup can be found in these articles: http://www.katu.com/news/26119539.html & http://abcnews.go.com/Health/story?id=5517492&page=1 My patient's letter in the Boston Globe describing her then being alive 11 years later can be read here: http://articles.boston.com/2011-10- 04/bostonglobe/30243525_1_suicide-doctor-ballot-initiative]