Volume 1

Assisted Dying for the Terminally Ill Bill (HL) / Select Committee on the Assisted Dying for the Terminally Ill Bill.

  • Great Britain. Parliament. House of Lords. Select Committee on the Assisted Dying for the Terminally Ill Bill.
Date:
2005
Catalogue details

Licence: Open Government Licence

Credit: Assisted Dying for the Terminally Ill Bill (HL) / Select Committee on the Assisted Dying for the Terminally Ill Bill. Source: Wellcome Collection.

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    physician’s role is just one step further back” (Q 849). Ms Barbara Coombs Lee, of Compassion for Dying, a voluntary organisation which supports people who opt to take advantage of the ODDA, agreed. “Having that last firewall, if you will, of having very clear self-administration, in this society, in this state, at this time is important to people, to have that reassurance that it really is a volitional act that a patient must take. The trade-offs are minimal” (Q 849). 147. Assisting suicide outside the terms of the ODDA remains a crime in Oregon. But those who qualify and avail themselves of the Act’s provisions are not regarded as having committed suicide. We were told by Dr Melvin Kohn of the ODHS that “by statute these deaths are not called suicide, they are not listed as such on the death certificate and they do not have the ramifications for insurance reimbursement and other kinds of issues that suicides have” (Q 565). Nor, we were told, are autopsies required because deaths under the terms of the ODDA are regarded as “predicted deaths” (Q 957). 148. According to Dr Hedberg, public opinion in Oregon was fairly relaxed after seven years experience of the ODDA. “It is not much of a debate any more because people have seen this has happened in this state but... we are still in double digits. Last year there were 42 out of 30,000 deaths. We have a large number of deaths in our state and very few people participating. It is not that controversial in Oregon, both because lots of people are not participating and because there have not been any really egregious events” (Q 619). Dr Gideonse told us that “it seems to have been assimilated into the social fabric” (Q 839). Dr Robert Richardson, Director of the Kaiser Permanente Ethics Service, said that implementation of the law had showed “that this is not physicians taking charge, this is patients who have taken charge” (Q 855). 149. Nonetheless there remained people who were unhappy about the Act. Ms Glidewell observed that “there are some physicians who are passionately opposed” (Q 630) and that federal and religious health care organisations had declined to offer services falling within the terms of the ODDA (Q 670). Barbara Coombs Lee believed that “there are 20-30 per cent of people whose opinions really are based on their own ethical standards and their own religious beliefs, and those are not moveable. However, there are 30-40 per cent of the population in the middle who are willing to be persuaded, who have fears about abuse and coercion and whether the safeguards actually work and things like that and are persuaded by the Oregon data” (Q 855). 150. The ODHS has the responsibility for recording the rate of uptake of the law, for checking that the basic requirements of the Jaw are being observed and for reporting any discrepancies to the Oregon Board of Medical Examiners (OBME)”™. It is the responsibility of the OBME, as the regulatory body for the Oregon medical profession, to investigate any apparent irregularities and to decide whether, and if so what, action should be taken on them. The ODHS’s role is simply to record what is happening, which includes compiling an annual report giving the number of lethal prescriptions issued and the number actually ingested. The monitoring does not begin, however, until the stage where a patient has been confirmed to be terminally ill (defined as having a life expectancy of six months or less), has made two written requests (separated by a 15-day interval) for assistance with suicide 54 Equivalent to the United Kingdom General Medical Council