Oregon Task Forceís Guidelines for Physician Assisted Suicide Likely to Have Broad Impact

By Elaine A. Lisko, Health Law & Policy Institute

On March 3, 1998, the Task Force to Improve the Care of Terminally Ill Oregonians publicly released a guidebook intended to help health care professionals and patients utilize Oregonís Death with Dignity Act. The Task Force is comprised of a number of health care experts and represents a cross-section of the health care community, state regulators and the Oregon State Bar. The guidebook addresses ethical, legal and moral issues which arise when a patient seeks the aid of his or her physician in obtaining a lethal dose of medicine to hasten death.

While the guidebook addresses the Oregon law providing for physician assisted suicide specifically, it is likely that states outside of Oregon will rely on it as well. Another four states have proposed bills allowing physician assisted suicide currently under consideration. The nature and status of these bills are as follows:
 
State Bill No. Status Brief Description
Illinois H.B. 691 Rereferred to House Committee on Rules on 03/21/97 (carried over to 1998 session). Creates Dignity in Dying Act; establishes procedures by which a terminally ill patient may request medical means to hasten death; authorizes physicians to provide means after following certain procedures; and relieves physician of any civil or criminal liability where acts in compliance with statute.
Michigan H.B. 5474 In House (to second reading) on 01/28/98. Allows for creation of Terminally Ill Patientís Right to End Unbearable Pain or Suffering Act, if approved by voters; authorizes physicians to prescribe medication to hasten death of terminally ill patient provided certain conditions are met; and relieves physician of civil or criminal liability where acts in good faith and in compliance with statute.
Rhode Island S.B. 2869 To Senate Committee on Judiciary on 02/10/98. Authorizes and regulates physician assisted suicide for individuals suffering from terminal illness or a bodily illness that is intractable and unbearable; and relieves physician of civil or criminal liability where acts in compliance with statute.
Wisconsin A.B. 32 To Assembly Committee on Health on 01/28/97 (carried over to 1998 session). Creates Death with Dignity Act; permits terminally ill patients to make written requests for medication for the purpose of ending their lives; and makes it lawful for physicians to prescribe medication provided certain conditions are met.
Additionally, until January 20, 1998, when it withdrew Legislative Bill No. 997 from further consideration, Nebraska was contemplating adopting the Voluntary Physician Aid-in-Dying Act which would have been effected through advance directives.

The outcome of the pending bills allowing physician assisted suicide will be extremely interesting to watch since three of the four states (i.e., Illinois, Rhode Island and Wisconsin) have statutes that criminalize assisted suicide currently on their books and two of the states (i.e., Illinois and Michigan) are considering other bills that amend or enact criminal statutes outlawing assisted suicide simultaneously with the bills allowing assisted suicide.

A large majority of the other assisted suicide bills under consideration during the 1998 session exempt licensed health care professionals from criminal liability where they administer or prescribe medication or treatment to alleviate pain even if the medication or treatment may hasten or increase the risk of death, provided the medication or treatment is not knowingly administered or prescribed to cause death. These types of bills are being considered in Alabama, Hawaii, Illinois, Kansas, Maryland, Missouri, Oklahoma, South Carolina, Vermont and Virginia. Colorado has a bill that contemplates a slight twist on this exemptionórelieving from criminal liability a health care professional who provides treatment or medication to ease the pain of a dying patient even though such treatment or medication may foreseeably hasten death (without reference to intent).

The increasing focus on physician assisted suicide and on the alleviation of intractable pain among the states makes the Task Forceís guidebook even more timely and useful than its authors may have intended.

03/05/98