The Portland-based Death with Dignity National Center (DDNC), along with Compassion & Choices (the former Hemlock Society), devised a plan in 2005 called "Oregon plus One" to break the logjam. It is based on the premise that, if just one more state follows Oregon's lead, then other states will fall in line.
The plan was put into effect in early 2006. In its 2007 annual report, the DDNC noted that it had spent a year "researching and collecting data to determine that state which is most likely to adopt a Death with Dignity law...Through these efforts we have identified Washington as the state." (Note that the assisted-suicide group chose Washington. Washingtonians were not in on the selection.)
After choosing Washington as the target state, the DDNC reported, "[W]e have never had such great odds of success as we have in Washington in 2008. That is why we will be directing $1.5 million over the next year and a half to the efforts....Our organization is providing leadership, political strategy, and financial resources to this monumental effort."
The political campaign was formally announced in late 2007 and, in mid-July 2008, Initiative 1000 (called the "Washington Death with Dignity Act," a measure virtually identical to Oregon's law) qualified for the 2008 general election ballot. Its advocates contend that Oregon's ten-year experience demonstrates that a Death with Dignity law not only works well, but is actually a benefit to patients. As proof they point to Oregon's annual official reports, to the law's "safeguards," and to studies in professional journals.
However, their claims are at best misleading. For example, under Oregon's law doctors participating in assisted suicide must file reports with the state. So the only physicians providing data for official annual reports are those who actually prescribe lethal drugs for patients. First, they help the person commit suicide and, afterwards, they report whether their actions complied with the law. Then, that information is used to formulate the state's official annual reports.
However, according to American Medical News, Oregon officials in charge of issuing the reports have conceded that "there's no way to know if additional deaths went unreported." (The official number of reported assisted-suicide deaths in Oregon is 341.)
Indeed, the official summary accompanying one annual report noted that there is no way to know if information provided by the physicians is accurate or complete. But, it stated, "[W]e, however, assume that doctors were being their usual careful and accurate selves." The reporting agency also acknowledged that it has no authority or funding to investigate the accuracy of those self-reports.
It would be nifty if the Internal Revenue Service allowed such unverified and unverifiable self-reporting.
The Oregon law's safeguards are equally problematic. They contain enough loopholes to drive a hearse through them. The safeguards certainly do have the appearance of being protective. They deal with requests for assisted suicide, family notification, and counseling or psychological evaluation. However, those safeguards are about as protective as the emperor's new clothes:
The oral requests, which must be separated by fifteen days, do not need to be witnessed. In fact, they don't even have to be made in person. They could be made by phone - even left on the physician's answering device. The written request must be witnessed, but it could be mailed or faxed to the doctor.
The law states that the physician is to "recommend that the patient notify next of kin," but family notification is not required. It is entirely possible that the first time family members find out that a loved one was contemplating suicide could be after the death has occurred.
Doctors can facilitate the suicides of mentally-ill or depressed patients without any prior counseling being provided. A psychiatric evaluation is required only if the physician believes that the mental illness or depression is causing impaired judgment. According to Oregon's latest official report, not one patient who died after taking the lethal drugs was referred for counseling prior to being given the prescription.
Additionally troubling are omissions in both Oregon's law and the Washington proposal. For instance, doctor shopping is not prohibited. If one physician refuses to prescribe assisted suicide because, for example, the patient is not competent to make an informed death request, that patient or a family member can go from doctor to doctor until finding one who will write the prescription.
Moreover, neither Oregon's law nor Washington's proposal has any type of protection for the patient once the prescription is written. While the requests for assisted suicide are to be made knowingly and voluntarily, there is no provision that the patient must knowingly and voluntarily take the lethal drugs. Dr. Katrina Hedberg, the lead author of most of Oregon's official reports, acknowledged that there is no assessment of patients after the prescribing is completed. She said that the "law itself only provides for writing the prescription, not what happens afterwards."
Read it all here.