Vote NO on Bill No. 6425, An Act Concerning Aid in Dying for Terminally Ill Patients
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| Dr Kenneth Stevens |
Professor Emeritus, Radiation Oncology, Oregon Health & Science University, Portland, OR
February 24, 2021
To Members of the Committee on Public Health,
I have been a cancer doctor in the practice of Radiation Oncology for 52 years in Oregon, treating cancer patients from 1969 to 2019.
I have studied and closely followed the implementation of Oregon’s assisted-suicide law since its passage in 1994. I have also continued to teach and practice medicine in a society where there exists such a law, taking note of its tragic results. The more I have learned and witnessed, the more I realize the significant harm and danger of assisted suicide to the vulnerably ill and to society. The following includes some of those harms and dangers.
There has been a profound negative shift in attitude towards terminally ill patients in Oregon. The commitment to care has become a commitment to the option of killing. There has been a distinct change of attitude in society and in members of the medical profession to patients who are terminally ill and eligible for assisted suicide. There is reduced incentive to evaluate and provide for the palliative care needs of patients who are eligible for assisted suicide. The legalization of assisted suicide results in a deterioration of caring for patients’ medical needs and symptoms.
Oregon’s assisted suicide law is not necessarily for only patients who are dying. Many who request/use the law are not dying already. The mere presence of legal assisted suicide steers patients to suicide.
As in Oregon, Bill 6425 supposedly applies to patients predicted to have less than six months to live. In 2000, I had a cancer patient named Jeanette Hall. She was referred to me with an inoperable low rectal cancer. She plainly told me that she did not want to be treated, and that she was going to “do” our law, i.e., end her life with a lethal dose of barbiturates. She had voted for the law and it was a very much settled decision for her. Her referring surgeon, who had determined that her cancer was inoperable, informed her that without treatment (radiation & chemotherapy) that she had a six month to one year life expectancy, so she qualified for Oregon’s assisted suicide law. Patients refusing appropriate treatment may be deemed “terminal” under current interpretation of the Oregon law. After consulting with her, I informed her that her cancer was treatable with chemotherapy and radiation and her prospects were good. She was not interested in treatment. She had made up her mind, but she continued to see me. On the third or fourth visit, I asked her about her family and learned that she had a son in his late 20s. I asked her how he would feel if she went through with her plan. Shortly after that, she agreed to be treated, the cancer melted away, and she is alive and active today. Twenty years later, she says “It’s great to be alive”. For her, the mere presence of legal assisted suicide had steered her to suicide. An 18-year-old girl with insulin-dependent diabetes would be eligible, if she stopped taking life-sustaining insulin.
Pain is not the issue. It is very significant that there are many cases of assisted suicide being used to address psychological and social concerns, but it is very rare for assisted suicide to be used in the case of actual untreatable pain.
Depressed people are dying from assisted suicide in Oregon. In 2008, researchers at Oregon Health & Science University reported 25% of terminally ill patients pursuing assisted suicide in Oregon met criteria for depression. Yet, the Oregon Health Department annual reports for the years 2018 and 2019 reported that only 1% (4 of 366) of patients dying from assisted suicide had a psychiatric evaluation. Your bill dangerously permits social workers to evaluate patients’ mental status.
There is no real monitoring of Oregon’s assisted suicides. When David Prueitt’s failed suicide was made public in 2005, the Department of Health Services (DHS) publicly stated that they had “no authority to investigate individual Death with Dignity cases. The state law authorizing physician-assisted suicide neither requires of authorizes investigations by DHS.”
We are dependent on self-reporting by doctors, and in in most cases the prescribing doctor is not present when the drugs are taken.
There are financial and societal dangers that assisted suicide may be pressured as a cost savings. The Oregon Health Plan (Medicaid) pays for assisted suicide and does not pay for some cancer treatment to extend life. In 2008, cancer patients Barbara Wagner and Randy Shoup received letters from the Oregon Health Plan that the Plan would not pay for beneficial chemotherapy, but would pay for [among other things] physician-assisted suicide. Ms. Wagner’s comment to the media was “they will pay for me to die, but won’t pay for me to live.”
Oregon’s regular suicide rate has increased since the legalization of assisted suicide. According to the U.S. Center for Disease Control (CDC), Oregon had the 2nd highest suicide rate in the U.S. for the years 1999-2010.
I urge you to vote no on this bill. Do not follow Oregon’s example. It is dangerous for patients and society.
Thank you,
Dr. Kenneth R. Stevens, Jr., M.D.
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