Citizens of the state of Washington will be voting in the next few weeks on ballot measure Initiative-1000 (1-1000), which if passed would legalize physician-assisted suicide in that state. This Washington state measure is based on the Oregon physician-assisted suicide law that was passed in 1994 and became operational in 1998. Oregon is the only state that has legalized assisted suicide in the U.S. The Death with Dignity National Center has directed over $1.5 million towards the campaign. The Washington Coalition Against Assisted Suicide is a broad-based coalition which opposes I-1000 and which includes members of the disability community, doctors, nurses, minorities, people of faith – and those without, and politicians from both parties.

This is the first of a series of articles to provide educational background regarding this vital life and death issue.

The author, Dr. Kenneth R. Stevens, Jr., M.D., is a cancer doctor in Oregon with 40 years experience in caring for cancer patients at the Oregon Health & Science University in Portland . He has extensively studied and reported on the experience of physician-assisted suicide in Oregon . He and his wife served as the LDS missionaries as Australia Area Medical Director for 18 months in 1996-97. He also has experienced cancer in family members. He is the vice-president of Physicians for Compassionate Care Education Foundation, an organization which promotes compassionate care for severely-ill patients without sanctioning or assisting their suicide.

This article provides information regarding definitions of terms, the use of euphemisms, and policy and ethical statements from church and professional organizations regarding this issue.

Future articles in this series regarding legalization of assisted suicide will deal the issues of medical ethics, trust, pain, life-support, depression, choice and autonomy, disability, societal inequality, minorities, health finances, effect on end-of-life care, slippery slope, so-called safeguards, and information regarding the organizations which are sponsoring 1-1000. The experiences with legalized physician-assisted suicide in Oregon will be detailed and reported.

Definitions:

Physician-assisted suicide is when the patient self-administers a lethal drug overdose that has been prescribed by a physician.

Euthanasia is the active causing of death of the patient by a physician by lethal injection or other means.

Euphemisms:

The proponents of assisted suicide and euthanasia use euphemisms to cloud the issue. A euphemism is a substitution of a mild or indirect expression in place of an expression thought to be offensive and blunt. These euphemisms for assisted suicide and euthanasia include: “hastening death”, “death with dignity”, “comfort care”, “aid in dying” and “act of self-determination”.

Statements by Church and Medical Organizations

Public Issues - Official Statement of The Church of Jesus Christ of Latter-day Saints

“Euthanasia and Prolonging Life”

“The Church of Jesus Christ of Latter-day Saints believes in the sanctity of human life, and is therefore opposed to euthanasia. Euthanasia is defined as deliberately putting to death a person who is suffering from an incurable condition or disease. Such a deliberate act ends life immediately through, for example, so-called assisted suicide. Ending a life in such a manner is a violation of the commandments of God.

The Church of Jesus Christ of Latter-day Saints does not believe that allowing a person to die from natural causes by removing a patient from artificial means of life support, as in the case of a long-term illness, falls within the definition of euthanasia. When dying from such an illness or an accident becomes inevitable, it should be seen as a blessing and a purposeful part of eternal existence. Members should not feel obligated to extend mortal life by means that are unreasonable. These judgments are best made by family members after receiving wise and competent medical advice and seeking divine guidance through fasting and prayer.”

Hippocratic Oath

“I will give no deadly medicine to any one if asked, nor suggest any such counsel.”

American Medical Association

“Physician-assisted suicide is fundamentally incompatible with the physician's role as healer, would be difficult if impossible to control, and would pose serious societal risk…Instead of participating in assisted suicide, physicians must aggressively respond to the needs of patients at the end of life. Patients should not be abandoned once it is determined that cure is impossible. Multidisciplinary interventions should be sought including specialty consultation, hospice care, pastoral support, family counseling, and other modalities. Patients near the end of life must continue to receive emotional support, comfort care, adequate pain control, respect for patient autonomy, and good communication. (1997 AMA Code of Medical Ethics, p. 56)

Washington State Medical Association

“The Washington State Medical Association (WSMA) opposes Initiative-1000, the measure to legalize physician-assisted suicide in Washington state. The opposition was emphatically voted on at the WSMA's annual meeting last year [1997]. The WSMA has opposed assisted suicide since 1991 when a similar initiative was proposed and defeated.

‘We believe physician-assisted suicide is fundamentally incompatible with the role of physicians as healers,' said WSMA President Brian P. Wicks, MD . ‘Patients put their trust in physicians and that bond would be irrevocably harmed by the provisions of this dangerous initiative.'

‘Initiative-1000 gives doctors power which we do not want and which we believe is contrary to good medical practice,” said Wicks. ‘The initiative is a dangerous distraction from symptom-directed end-of-life care that provides comfort for dying patients and their families. Our focus should remain on caring for terminally ill patients and should never shift toward helping them kill themselves.'” (Press Release from the WSMA, July 2, 2008)

Future articles by Dr. Stevens will provide further in-depth information regarding assisted suicide