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This article provides a simplistic perspective, relying heavily on correlation, not causation, to make unproven claims about Oregon’s medical aid-in-dying law and erroneously comparing it to euthanasia laws outside the United States.
Claim: “...there was an increase in patients feeling a burden and describing financial concerns as reasons for choosing an assisted death.” (p. 1) “Detailed studies are needed to explain the marked change in medical funding for PAS patients in Oregon.” (p. 5)
Facts: While the Oregon Health Authority (OHA) reports insurance status, it doesn’t report whether patients used their insurance for medical aid in dying. Only 5.1% of people in Oregon who qualified for medical aid in dying since 1998 noted the financial burden among their reasons for requesting it.
Claim: "The 2022 report states that the combinations [of medications] have resulted in longer times from ingestion to death…" (p. 3)
Facts: The median time has risen, but it is still typically less than an hour from ingestion to death. Very few patients experience a significant delay between ingestion and death. Otherwise, there would be a higher median time.
Claim: “Unfortunately the destruction of OHA records after 1 year makes retrospective analysis impossible.” (p. 4).
Facts: OHA’s public explanation: “The State KC does collect the names of patients in order to cross-check death certificates. However, the law guarantees the confidential...
Facts: OHA’s public explanation: “The State KC does collect the names of patients in order to cross-check death certificates. However, the law guarantees the confidentiality of all participating patients (as well as physicians) and the Oregon Health Authority does not release this information to the public or media. The identity of participating physicians is coded, but the identity of individual patients is not recorded in any manner.”
Claim: “This steady reduction in the physician–patient relationship in Oregon may have made it more difficult to identify treatable factors influencing the wish to die, but there is a lack of recent data on how many Oregon PAS patients have a treatable depression." (p. 5)
Facts: Both the attending and consulting physicians are required to screen patients requesting medical aid in dying for depression causing impaired judgment and document their findings in writing. Doctors’ training makes them fully capable of finding depression when they look for it and the Oregon law requires them to do so. If either physician has any doubts, they must refer the patient for a psychiatric evaluation.
Regarding the time reduction in patient-provider relationships, anecdotal evidence shows that sometimes the patient’s doctor says they will “support” them when they become eligible under the law, but discover later that supporting them means keeping them comfortable in hospice care or referring them to another doctor without sufficient time to navigate the process.
Claim: ”...there is a lack of data on why they [patients] refused treatment and how they were advised and counseled. For example, in 2021 anorexia nervosa was one of the diagnoses listed … Anorexia nervosa in any young adult with capacity is terminal if it persists, but it can be challenging to determine the point at which treatment cannot succeed.” (p. 5).
Facts: Numerous oversight boards and enforcement agencies govern the practice of medical aid in dying, not just OHA: the medical board is responsible for investigating allegations about unethical practice of medicine; the police are responsible for investigating crimes; the health department is responsible for monitoring and collecting the data. The authors fail to cite any criminal convictions, or even prosecutions, for abuse.
Claim: The lack of information…makes it difficult to evaluate whether adequate palliative care was received before PAS in Oregon." (p. 6)
Facts: Oregon is a top-rated U.S. state for equitable access to palliative care, according to the latest Report Card by the Center to Advance Palliative Care.
1. Oregon Death with Dignity Act: 2022 Data Summary. Accessed at: https://www.oregon.gov/oha/PH/PROVIDERPARTNERRESOURCES/EVALUATIONRESEARC...
3. Frequently Asked Questions: Oregon’s Death With Dignity Act. Accessed at: https://www.oregon.gov/oha/PH/PROVIDERPARTNERRESOURCES/EVALUATIONRESEARC...
4. Oregon Death with Dignity Act 2018 Data Summary, page 3. Accessed at: https://www.oregon.gov/oha/PH/PROVIDERPARTNERRESOURCES/EVALUATIONRESEARC...
5. America’s Care of Serious Illness: A State-by-State Report Card on Access to Palliative Care in Our Nation’s Hospitals, Center to Advance Palliative Care and the National Palliative Care Research Center, September 2019. Accessed at: https://www.capc.org/documents/download/2/