Understanding Physician Assisted Suicide

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Right-2-Die Issues for Financial Planners

By Dr. David Edward Marcinko; MBA, CPHQ, CMP™

By Hope Rachel Hetico; RN, MHA, CPQH, CMP™

[Publisher-in-Chief and Managing Editor]dave-and-hope8

There are few topics in the field of medicine – and end of life financial planning – that are more controversial than physician assisted suicide.

Historical Review

So, let’s start with a little history for financial advisors [FAs] to understand. In the State of Oregon, the “death with Dignity act, a citizens initiative, was first passed by Oregon voters in November 1994.  While the margin was a close 51% to 49% the act was immediately delayed by legal injunction. The case was the product of the debate, moral, medical and political, over assisted suicide. But interestingly, the issue before the Supreme Court had to do with interpreting a federal statute, the “Controlled Substances Act,” to see whether it gave the attorney general the authority to prohibit physicians from prescribing regulated drugs for assisted suicide even when its state law allows them to do it. This was an important topic for both of us, as prescribers, and as FAs.insurance-book3

Center for Ethics in Health Care [CEHC]

While the appeals were underway, the Center for Ethics in Health Care [CEHC] convened a task force to improve the care for the Terminally-Ill Oregonians. Although remaining neutral on the issue of physician assisted suicide, the task force took on the objective of promoting excellent medical care for the dying. One of its goals was to promote professional standards related to the “Death with Dignity Act.”  The purpose therefore was to offer guidance to health care, and financial, professionals whose terminally ill patients and clients may have an interest in exploring their new options.dhimc-book10


After multiple proceedings and rejection by the US Supreme Court, the Ninth Circuit Court of Appeals lifted the injunction and physician assisted suicide became a legal option for terminally ill patients. So, as for Physician Assisted Suicide, it is not clear whether, or how many more states, will enact similar laws since the court wasn’t necessarily giving its support for the practice itself. And, this is a contentious topic for further debate; as is medical marijuana use for pain control, and others.


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8 Responses

  1. Please don’t confuse suicide or assisted-suicide with the Oregon (and now Washington) Death with Dignity laws.

    Suicide, as our clients point out, is about choosing death over life, an option that is no longer available to someone suffering from a terminal illness who, by definition, is already dying.

    Our clients tell us that given the choice they would want to live, but that choice no longer exists. Instead, they are seeking the power to have a good death versus a poor one if their suffering becomes too great.

    Several prominent organizations, including the American Psychological Association, the American Medical Women’s Association, the American Medical Student Association, the American Academy of Hospice and Palliative Medicine and the American Public Health Association, have issued position statements saying that the decision of a competent, terminally ill person to end their suffering is not the same thing as a death motivated by depression or other underlying cause that is treatable.

    We believe the term “aid in dying” is more respectful for those who make this difficult choice. In Oregon and Washington, where aid-in-dying is legal, the statues state that a death under the law is not a “suicide, assisted suicide or mercy killing,” and the cause of death on the death certificate is listed as the underlying illness (for example cancer).

    At Compassion & Choices we find what most people really want is assurance that if all else fails there is an option of last resort. Studies have shown that 90% of those initially interested in hastening their death choose another treatment alternative once their options have been explained (and as long as the option of last resort is still available). The number of people using the law is relatively low (on average 36 people a year in Oregon) and about 40% of those who get the medication never use it.

    Roland Halpern

    Compassion & Choices


  2. Roland,

    Good comments. Now, here is an essay on the rate of suicide in surgeons.




  3. Suicide on TV

    He sat on a sofa, drank a cup of barbiturates and, quite deliberately, let his life ebb away.

    His last act on this earth was to snore loudly, as he fell into the deepest sleep a human can ever have, the one from which you never wake up.


    Ann Miller RN MHA


  4. The U.S. Conference of Catholic Bishops’ policy on physician-assisted suicide approved June 16 is the latest move by Roman Catholic leaders to intervene in Americans’ personal health care decisions.

    The eight-page policy, which the bishops passed 191-1 at their annual spring meeting in Bellevue, Wa., is full of inaccurate and misleading statements about the Death with Dignity laws in Washington and Oregon and the policy positions of the laws’ supporters. It ignores 14 years of experience in Oregon and two years in Washington. The head of Compassion & Choices, the main group supporting those laws, rightly criticized the policy statement as “full of reckless, unsubstantiated accusations.”


    Ann Miller RN MHA


  5. Assisted Suicide Goes to Vote in Massachusetts

    Two states, Oregon and Washington, have legalized physician-assisted suicide through voter-approved ballot initiatives. Massachusetts will become the third if voters approve the so-called Death With Dignity ballot question.


    Ann Miller RN MHA


  6. Myths About Physician-Assisted Suicide

    Ezekiel Emanuel MD — an oncologist, vice provost and professor at the University of Pennsylvania — wrote in the NY Times that “the appeal of physician-assisted suicide is based on a fantasy.”


    He also said that “instead of attempting to legalize physician-assisted suicide, we should focus our energies on what really matters: improving care for the dying.”



  7. Scientist Stephen Hawking backs assisted rights

    Leading scientist Stephen Hawking says there must be safeguards in place if assisted-suicide rights are granted.




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