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Frequently Asked Questions: Death with Dignity Act.
Our study has several sources of bias and potential error. We do not know the experiences of the 35 percent of physicians who did not return the questionnaire. We may have underestimated duplicate patient information if physicians erred in reporting the demographic characteristics of patients. Physicians who were opposed to or uncertain about the Oregon Death with Dignity Act were significantly less likely to provide complete information about patients than were physicians who favored the act. Because of this response bias, it is difficult to make general statements about the perceptions and interventions recommended by physicians in our sample who were opposed to assisted suicide. Finally, although the physicians were instructed to base information about patients' reasons for requesting assistance with suicide only on conversations with the patients, this method of obtaining information is not as reliable as surveying patients directly.
However, a likelier explanation may be that the ODDA served as a catalyst to improved end-of-life care among Oregon practitioners — including the increased use of hospice and palliative care, and the easing of restrictions on the drugs practitioners could provide to relieve pain. This is a very significant possibility, because it implies that ensuring a dignified death may not be a matter of changing the laws so much as a matter of changing medical practices and professional education. Moreover, it suggests that, for most people, a pharmacologically-induced death is not a precondition of a dignified death, nor that the possession of a right entails its subsequent use.
Dying With Dignity: Understanding Euthanasia.
To qualify, patients must be at least 18 years of age, a resident of Oregon, mentally competent in his/her ability to make and communicate informed health decisions, and diagnosed with a fatal illness that will likely lead to death within six months.
The ODDA aimed to end this ban on the grounds of patient self-determination and “choice.” The act’s advocates saw the conferral of a right to choose the manner and timing of one’s death as a logical extension of the expansive rights terminally ill patients possessed to refuse treatment. That is, they saw no principled difference between, on the one hand, refusing medical treatment in a way that would inevitably bring about death and, on the other, hastening death with a lethal drug. Once the outcome of death for a patient had already been accepted as a medically legitimate precedent in the context of patient refusals of treatment, then the question of the means to death should be settled not by the state, by medical professionals, or by religious institutions, but by the terminally ill patient.
Death with Dignity can refer to
hen the Oregon Death with Dignity Act first passed, it was heralded by some commentators as a “bold experiment.” The first decade of that experiment’s results are in: it seems that the practice of prescribing lethal drugs to terminally ill patients is effective and generally without further medical complications. Consequentialist objections to the act have largely been refuted by experience. Insofar as objections continue to be voiced by various advocacy groups or medical practitioners, they tend to rely on non-consequentialist appeals to the intrinsic value or sanctity of human life, or to the moral vocation of health care professionals. Similar consequentialist arguments have been articulated against Washington I-1000 — but if experience is any guide, they cannot be long sustained. Moreover, since public policy (including health care policy) primarily depend upon utilitarian assumptions, it will be very difficult for non-consequentialist principles to gain much footing in debates over legalization.
The state has two forms of advance directives, which can be used independently or in conjunction with each other, and which are comprehensive with respect to termination of medical treatment or appointment of a proxy. However, these advance directives are separate from the ODDA application process: terminally ill persons seeking lethal drugs must use an additional request form specific to the provisions of the act. An advance directive that includes a request for physician assistance in dying is unlikely to be honored. This is a point on which there seems to be significant confusion. Although there seems to be broad public consensus that certain kinds of death can be degrading and demeaning to dignity, and most people seem to want to avoid a persistent vegetative condition or a Terri Schiavo-like death, it is not clear in the minds of many citizens that the advance directive process that would apply in those circumstances is separate from the physician-assisted suicide process. There remains a compelling need for public education.
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Oregon Death with Dignity Act, Rev. Stat. §§ 127.800-.897.
A second argument for the Oregon Death with Dignity Act focused on the roles of participating physicians, seeking to provide physicians and other health care providers with immunity from prosecution. At stake in this rationale was professional autonomy — that is, the freedom of physicians to practice medicine according to their own standards of best practice in the care of the terminally ill — but also a shifting conception of professional integrity.
A Debate On Death With Dignity - Forbes
The longstanding professional objection to physician participation in euthanasia and to physician assistance in hastening death had been associated with an understanding that physician integrity entailed a commitment to healing and a prohibition of medical killing. However, supporters of the ODDA argued that the integrity of the medical profession was not entirely subsumed by a commitment to healing but should, at the very least, be complemented by a contractual model of physician respect for the choices of autonomous patients. Once professional integrity is not understood as commitment to an abstract ideal, such as healing, but to collaboration with patient self-determination, then the prospect of professional conflict is diminished. The act’s proponents also pointed to reports of extensive physician participation in hastening death outside the purview of the law. Thus, they argued, a “death with dignity” law would give de jure sanction to what was, in many instances, de facto practice, and would acknowledge the changed conceptual and ethical parameters of the physician-patient relationship.
11/9/2013 · A Debate On Death With Dignity
However, this rationale remains contested a decade after the ODDA became law. For example, the Bush administration led an effort to overturn the act, initially spearheaded by Attorney General John Ashcroft, and then by his successor, Alberto Gonzales; it leaned on the argument that physicians who prescribed substances regulated under the federal Controlled Substances Act, for the purpose of hastening the death of terminally ill patients, were not engaged in medically legitimate actions and should be sanctionable at some level (licensure, prosecution, etc.). This was not resolved in the legal system until January 2006, when the U.S. Supreme Court ruled 6-3 in that federal authority over the regulation of controlled substances did not give the government the power to determine the medically legitimate purposes of drugs that were not otherwise prohibited.
Death with Dignity - Research Paper - …
If it succeeds, the petition initiative would place the Massachusetts Death With Dignity Act before the State Legislature. But no legislature has ever passed such a law. It’s a safe bet that Massachusetts lawmakers will duck the subject, leading to a ballot question in November 2012, leading to a major emotional clash in this heavily Catholic state.
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