If you’re a diabetic in Oregon and refuse treatment, you may qualify for life-ending drugs under the state’s physician-assisted suicide law.
The state’s Death with Dignity Act limits aid in dying to those who suffer from a “terminal disease” and receive a prognosis of six months or less to live. Two physicians must sign-off on the diagnosis and confirm that the patient is capable of making the decision to end his life.
Dr. William Toffler, national director of Physicians for Compassionate Care, which opposes physician-assisted suicide, said there’s nothing in the law to prevent someone with a treatable condition from refusing medical care in order to obtain a terminal diagnosis and lethal prescription.
“If you’re a diabetic and you get discouraged and depressed and stop taking your insulin, you’re going to die,” Dr. Toffler said. “Now, if you go to an assisted-suicide doctor and you say, ‘I’ve got problems with kidney failure, I’ve got problem with pain, I want to exercise assisted suicide,’ you just have to find the right doctor.”
Jonathan Modie, lead communications director for the Oregon Health Authority, said the Death with Dignity Act is “silent on whether the patient” must exhaust “all treatment options before the prognosis of less than six months to live is made.”
“The determination on disease treatment — and, if appropriate, end-of-life care options — is made between the patient and his or her physician,” Mr. Modie said in a statement.
Under the law, “terminal disease” is defined as an “incurable and irreversible disease that has been medically confirmed and will, within reasonable medical judgment, produce death within six months.”
Diabetes, a disorder in which high levels of sugar remain in the bloodstream, has long been treated with insulin and other medications, and many diabetics have managed their illness with proper diet and exercise. Many diabetics have been known to survive for decades after their first diagnosis.
Fabian Stahle, a Swedish national who opposes euthanasia, released a report this month documenting “hidden problems” in Oregon’s physician-assisted suicide law.
The report quotes Craig New, a research analyst at the Oregon Health Authority who studies the Death with Dignity Act, confirming that diabetics are eligible for lethal prescriptions if they refuse treatment and receive a terminal diagnosis.
“The law is best seen as a permissive law, and states only that patients must have a terminal illness with six months or less to live,” Mr. New said. “It does not compel patients to have exhausted all treatment options first, or to continue current treatment. It is up to the patient and doctor to discuss disease and treatment options. But if the patient decides they don’t want treatment, that is their choice.”
He also said patients who cannot afford medical care may qualify for aid in dying.
“I think you could also argue that even if the treatment/medication could actually cure the disease, and the patient cannot pay for the treatment, then the disease remains incurable,” Mr. New said.
The report was first published by Wesley J. Smith, a senior fellow at the Discovery Institute.
Writing in the pages of National Review Online, Mr. Smith said Oregon’s interpretation of the law means “people who could live decades with treatment, can instead receive assisted suicide in some cases.”
“Here’s the thing: Assisted suicide was sold to Oregon voters as exactly the opposite — as a very restricted law that would merely serve as a safety valve when nothing else could be done to alleviate suffering,” Mr. Smith wrote. “It was always baloney.”
Oregon became the first state to legalize physician-assisted suicide for terminally ill, mentally competent adults in 1994 after voters approved a ballot measure. California, Colorado, Vermont and Washington also have enacted laws permitting the practice based on the Oregon model.
The Montana Supreme Court ruled that nothing in state law bars physicians from helping terminally ill patients to end their lives.
Dr. David Grube, national medical director for Compassion & Choices, an aid-in-dying advocacy group that helped write the model legislation, said the percentage of people with a terminal diabetes diagnosis who utilize medical aid in dying is infinitesimally small.
“In fact, I had a diabetic patient ask for aid-in-dying medication and I declined his request and offered to refer him to another physician,” Dr. Grube said in a statement. ”I don’t know any doctors who have written aid-in-dying prescriptions simply because the patient had diabetes.”
The Oregon Health Authority is the agency tasked with overseeing the state’s Medicaid and other health-related programs. It tracks data on participation in the Death with Dignity Act and issues an annual report.
Mr. Modie said there is no record of someone with a non-terminal, chronic ailment ever taking advantage of the law.
Dr. Toffler said there’s no way to know whether abuses are being committed in Oregon, because state record-keeping is insufficiently specific and all source documentation is destroyed after one year.
“Now, the diabetic patient may have had renal failure and the doctor put down renal failure — they can choose,” Dr. Toffler said. “It’s kind of subjective what you put on the death certificate. So the Oregon Health Division wouldn’t know. And what’s more, they couldn’t go back and check because they don’t have the records — they’ve destroyed them.”
Mr. Stahle, the Swedish anti-euthanasia activist, said Oregon voters were “deceived” when they approved the ballot measure legalizing physician-assisted suicide.
“Proponents want to sell the Oregon model along with the assurance that medically-assisted suicide only applies to dying patients where all hope is lost. But it is completely misleading,” Mr. Stahle wrote. “Surely vulnerable people in Sweden and all over the world deserve better than laws with such inherent dangers hiding beneath the surface.”