WEDNESDAY, March 5, 2003 (HealthDayNews) -- In the five years since Oregon passed the nation's first physician-assisted suicide law, the number of terminally ill people who've taken their own lives has steadily increased but remains relatively low.
According to new research, 129 people committed suicide between 1997, when the Death with Dignity Act took effect, and 2002. The report appears as a research letter in the March 6 issue of The New England Journal of Medicine.
Last year, 38 people in Oregon died from ingesting prescribed lethal medications, nearly twice the number who died in 2001, when 21 residents did so. The 2002 total is the highest since physician-assisted suicide became legal.
Despite annual increases most years, the overall number of terminally ill Oregon residents making use of the law remains small relative to the overall number of deaths, writes Dr. Melvin Kohn, the state epidemiologist for Oregon Public Health Services and one of the signers of the report.
Both sides of the physician-assisted suicide debate saw facts in the report to bolster their own argument about the controversial law, which has been challenged several times in court and by referendum. Attorney General John Ashcroft has tried to make it illegal and has threatened to revoke the licenses of doctors who take part. However, the courts have so far upheld the act.
Besides tracking deaths, the researchers tracked the number of people who obtain a lethal prescription, whether they decide to use it or hold onto it. In 2002, 33 physicians wrote such prescriptions for 58 residents, the highest number in the past five years. In comparison, 44 residents got the prescriptions in 2001, 39 in 2000, 33 in 1999, and 24 in 1998.
More likely than other patients to use the law were those with Lou Gehrig's disease, also called amyotrophic lateral sclerosis -- a progressive degenerative and always fatal disease that attacks nerve cells in the brain and spinal cord -- and those with cancer.
Most patients cited autonomy issues and the declining ability to participate in activities they enjoyed as reasons for seeking out physician-assisted suicide, Kohn says. "Both of these were cited by 84 percent of participants."
Patients who sought physician-assisted suicide, they also found, tend to be younger, better educated and more likely to be divorced or never married than patients with the same diseases who don't seek out the lethal medications.
While Oregon is the only state to have a physician-assisted suicide law, other states are trying, says George Eighmey, executive director of Compassion in Dying Federation, an organization in favor of the practice. Hawaii, Arizona and Vermont are trying to get similar legislation, he says.
The new report discredits some of the misgivings of the opposition, according to Eighmey. "During the campaign [to pass the legislation], the opposition said, 'Oregon will become the dying state. Thousands of people will come to Oregon to use the law.' That hasn't happened. The second prediction was that people would die in agony. 'They'd have to swallow all these pills.' [Opponents would] hold up a bag of 90 pills."
In reality, Eighmey says, the medications used are either liquids or capsules that are taken apart and mixed with liquid.
However, Dr. Kenneth Stevens, a radiation oncologist and president of the Physicians for Compassionate Care, an organization that opposes physician-assisted suicide, focuses on the fact that 33 doctors participated last year -- clearly a minority of the state's doctors.
When patients are turned down by their own doctor when they ask for a prescription for lethal medication, they are often referred by proponents to other doctors who don't know them well, Stevens says. These doctors may not be able to accurately assess a patient's state of mind, he says, or whether they might change their mind.
"These very sick, seriously ill people are vulnerable to the pro-assisted suicide movement," he says. "The danger is for those who are vulnerable and whose life may be ending far too soon."
More information
For information on both sides of the issue, go to the Compassion in Dying Federation and the Physicians for Compassionate Care Educational Foundation.
