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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    (as laid down in the statute) and has been issued with a prescription for lethal medication. We were told by Dr Richard Leman, a medical epidemiologist at the ODHS, that “through to the end of 2003 there were 265 prescriptions actually written and 117 people who chose to take them” (Q 577). There has been some increase in the numbers of people who take the prescribed medication—from 16 in 1998 to 42 in 2003, though the number for 2004 was expected to show a fall (Q 558). According to Mr David Hopkins of the Center for Health Statistics, “males and females are equally likely to use the medication. Asians are about three times more likely than whites. College graduates, educated folks, are about seven times more likely than those who have high school degrees. Urban folks are a bit more likely than those east of The Cascades, which is a very rural area, to use the medication” (Q 559). According to Dr Gideonse, “one in six dying patients in Oregon talk with their families about their options and whether they might want to use the Act, one in fifty begin the eligibility process but only one in a thousand eventually use the Act to hasten their death” (Q 839). Many people, we were told, take the prescription but do not use it. They keep it as an “insurance policy”, to be taken if their suffering becomes more than they can bear. We asked whether the figures of reported deaths under the terms of the ODDA could be relied on as accurate. Dr Hedberg told us that “physicians in the State of Oregon have a vested interest. If they follow the steps and report them, they are protected under the law; but, if they carry out actions outside the law, then they are assisting suicide and that is not part of this. We do get pretty good data because, if anything else, it is insurance for physicians to report” (Q 617). Ann Jackson, Executive Director of the Oregon Hospice Association, agreed: “Oregon is a very, very small state and we have hospices all over, and they have big mouths! I think if there were any abuses in the law, we would hear of it” (Q 834). We asked also about any medical complications in those cases where the prescribed medication had been ingested. The OBME had “not heard of any complications of any significance or any complications period. It may be true, but we have not heard them” (Q 929). The OBME had investigated four cases, which appeared to be concerned with procedural aspects, such as a missing witness signature, but had no evidence that serious breaches of the law might be taking place. On the other hand, some witnesses who appeared before us believed that the law was being abused. Dr William Toffler, a general practitioner and a professor at OHSU, said that “every case that we know about, and it is close to a dozen cases now, has serious problems”, among which was “patients who have a known history of depression, only one out of 20 of the patients in the last year got referred for formal psychiatric evaluation” (Q 949). Dr Greg Hamilton, a psychiatrist, told us that medical complications occurred in 15-20 per cent of cases but that these were “not in the records” (Q 955). There was no investigation of deaths under the terms of the ODDA. Ms Karen Bell, a nurse and a director of a Portland hospice programme, told us that “in Oregon, if a patient is terminally ill and dies, one of my hospice nurses can call the medical examiner and the coroner, and all it takes is for the hospice nurse to say ‘This patient has died’. It is not a medical examiner case, there is no autopsy required or anything because it is considered a predicted death” (Q 957). It appeared however that none of these perceived abuses had been reported formally to the OBME for investigation.