in Oregon, an assisted suicide on medical prescription

Perched in the northwest of the United States, Oregon was the first American state to adopt a law on assisted dying: the Death with Dignity Act (or DWDA, the “law on death with dignity “). To be precise, he did it twice. In 1994, the voters adopted it by referendum with 51% against 49%, but the text was suspended by the courts following disputes. Three years later, it received another favorable popular vote. With a bigger margin, this time: 60% against 40%.

A quarter of a century later, Oregon is still an exception in a country where only ten states have similar laws. The DWDA authorizes any patient over 18, with a life expectancy of less than six months, to self-administer a lethal dose of drugs (morphine, diazepam, etc.) prescribed by a doctor. Until last March, the applicant had to reside in Oregon, but this requirement has been waived.

A very structured process

The process, which the state is careful not to call “assisted suicide”, is very supervised. The patient must make two oral requests to his doctor fifteen days apart, as well as a written request in the presence of witnesses. Two medical professionals working in Oregon must also establish that he can make his health decisions independently and that he has little time left to live. Physicians are not required to participate in the program. In 2021, they were only 133.

The law withstood a challenge in the United States Supreme Court. In 2004, High Court judges ruled by a vote of six to three that the federal state could not prevent doctors from offering drugs regulated by federal law when assisted suicide is legal in a state.

In 2021, 218 patients used the law

Today, the DWDA is little invoked. According to the Oregon Department of Health, there have been 2,159 people who have died from prescriptions received under the program since its inception. Another thousand had the drugs but did not use them. In 2021, 218 patients – 0.5% of deaths in Oregon – mostly suffering from cancers, resorted to the law to hasten their death. Contrary to the fears of the text’s detractors, the population that benefits from it is not poor and unqualified. Most have gone to university and do not cite the cost of care to justify their decision, attributed instead to the loss of autonomy.

The emergence of this right to medically assisted death did not come at the expense of palliative care: at the time of their death, 97.5% of patients who had recourse to it in 2021 were receiving such care. “Dying with the assistance of a doctor must be the ultimate solution. I tell my patients that they should explore all other possibilities to relieve their symptoms, explains Charles Blanke, oncologist and professor in a medical school in Portland (Oregon). But there are situations that do not lend themselves to palliative care. There are patients who suffer permanently and who want to regain control of their destiny. »

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