Wesley Smith who is a lawyer, associate director of the International Task Force on Euthanasia and Assisted Suicide and senior fellow at the Discovery Institute has published an article in the Telegraph of the experience of Oregon and its “assisted suicide” law.

“Imagine that you have lung (or prostate cancer, I know it is rare, but some of us might have it! – my addition) cancer. It has been in remission, but tests show the cancer has returned and is likely to be terminal. Still, you do have some hope to survive. Chemotherapy could extend your life, if not save it. You ask to begin treatment. But, you soon receive more devastating news. A letter from the government informs you that the cost of chemotherapy is deemed an unjustified expense for the limited extra time it would provide. However, the government is not without compassion and you are also informed that whenever you are ready, it will gladly pay for your assisted suicide.

That is exactly what happened last year to two cancer patients in Oregon, where assisted suicide is legal!

Barbara Wagner had recurrent lung cancer and Randy Stroup had prostate cancer. They both were on Medicaid. The state informed them that it would not pay for the chemotherapy treatment, but it would pay for their assisted suicide. “It dropped my chin to the floor,” Stroup told the media. “

[How could they] not pay for medication that would help my life, and yet offer to pay to end my life?”

I personally am in favor of the legalization of assisted suicide in certain medical situations, but I am forced to gasp and take a second look at when you hear about this type of abuse. Advocates still insist that Oregon’s assisted suicide law can be carried out with out abuses, but these actual cases do shake my belief and confidence.

Some individuals now have likened the Oregon law allowing euthanasia to be more a duty to dye as opposed to a right to die.

A study published in the Journal of Internal Medicine last year claimed that many doctors in Oregon write lethal prescriptions for patients who are not experiencing significant symptoms at the time the prescriptions are written. It concluded that assisted suicide practice has had little do with any inability to alleviate pain which was one of the main motivations for legalizing assisted suicide.

According to the study, family members often described their loved ones who elect to pursue “physician-assisted death” as individuals for whom being in control is important. Their concerns were in the anticipation of the negative aspects of dying because they believe the impending loss of self and quality of life will be intolerable. They also often cited the fear becoming a burden to others, yet they also wanted to die at home. Their concerns about what the future may hold was substantially more powerful for them than what they experienced at that point in time.

Shockingly, when a depressed patient asks their doctor’s to write a lethal prescription it is rare that a physician refers them for a psychiatric consult! Hospices are geared to address such concerns, but with a lethal perscription in hand these individuals never enter into the hospice system.

Mr. Smith’s major concern is that the current guidelines do not protect depressed people. The law does not require treatment when depression is suspected, and very few terminal patients who ask for assisted suicide are referred for psychiatric consultations. Shockingly, in 2008 not one patient who received a lethal prescription was referred by the prescribing doctor for a mental health evaluation. Try and explain this.

Dr Kathleen Foley, who is a palliative care physician and psychiatrist Dr. Herbert Hendin, an expert on suicide prevention, wrote in a scathing exposé of Oregon assisted suicide that “physicians are able to assist in suicide without inquiring into the source of the medical, psychological, social and existential concerns that usually underlie requests … even though this type of inquiring produces the kind of discussion that often leads to relief for patients and makes assisted suicide seem unnecessary.”

I continue to believe that we should legalize doctor assisted suicide, but the Oregon model needs to be re-evaluated and it needs to re-examined now.

By the way, Wagner eventually received free medication from the drug manufacturer, but she has since died. The denial of chemotherapy to Stroup was reversed on appeal after his story hit the media.

Joel T Nowak MA, MSW