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The Honolulu Advertiser

Posted on: Monday, March 10, 2003

EDITORIAL
Oregon not deluged with assisted suicides

A report just published in the New England Journal of Medicine suggests that Oregon's five-year-old "Death with Dignity" law has not — as critics predicted — opened the floodgates to abuse. On the contrary, physician-assisted suicides accounted for just 0.1 percent of all deaths.

If families, physicians and others were using the law to goad burdensome relatives or patients to end their lives, we'd presumably be seeing much higher numbers than the following:

A total of 129 terminally ill Oregonians have committed physician-assisted suicide since the law went into effect in 1998. Last year, 38 people died by way of prescribed lethal medications.

The numbers suggest to us that Oregonians who voted for the law did so not because they planned to end their lives, but because they wanted the comfort of knowing they had that choice. And experts have drawn similar conclusions.

"People say they want the option, but very few people are really interested in availing themselves of this option," says Dr. Steve Miles, director of the Center for Biomedical Ethics at the University of Minnesota Medical School.

Most Oregonians who opted for physician-assisted suicide were well-educated cancer and Lou Gehrig's disease patients. And most cited as their primary reasons: loss of independence, inability to participate in activities that make life enjoyable and loss of control of bodily functions.

According to Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania School of Medicine, the law has forced Oregon's healthcare system to improve palliative care and pain management. That's a positive side effect that must certainly play a role in Hawai'i's debate over physician-assisted suicide.

We're not saying that the drumbeat for physician-assisted suicide in Hawai'i would be entirely silenced if palliative care and pain management were vastly improved. But these areas certainly deserve attention, and bettering them would remove some of the incentives for terminally ill patients to end their lives.

Ideally, "Death with Dignity" in Hawai'i would work the same way as it does in Oregon, with few people opting for physician-assisted suicide yet having the comfort of choice.