'Death With Dignity' Measure May Make Oregon National Battleground
By William Claiborne
With the U.S. Supreme Court ruling that physician-assisted suicide is not a constitutional right but should be decided by the states, Oregon is bracing itself to become a national battleground for the highly emotional issue, with a voter referendum set for November.
It is a battle that, in the words of a leader in the fight against allowing doctors to help terminally ill patients kill themselves, "touches the soul of the nation."
The campaign over another "Death With Dignity" referendum here involves such powerful forces as the Roman Catholic Church, the American Medical Association and the national antiabortion movement in a state with traditionally liberal leanings and the second-lowest church enrollment in the country.
Advocates and opponents of the measure say it could be the most expensive referendum in the state's history, far surpassing the $2 million that the opposing sides spent on the previous assisted-suicide referendum, which was approved in 1994, and possibly reaching $10 million.
In a sense, the November vote will be about not only the right to die on one's own terms, but also about the right to vote for any of the escalating number of initiatives appearing on the Oregon ballot with the expectation that the will of the majority will be carried out if they pass. Some legislators say the ballot initiative process should be amended to make it more difficult to qualify measures for a vote and, thereby, reduce the number of referenda.
With the 1994 referendum, Oregon became the only state in the nation to make it legal for doctors to help terminally ill patients die by prescribing self-administered lethal overdoses of medication such as barbiturates. The initiative was passed by 51 percent of the voters at least partly because it explicitly precludes a physician or any other person from ending a patient's life by lethal injection, thereby removing the taint of mercy killing or euthanasia that helped defeat broader initiatives in Washington state in 1991 and California in 1992.
Shortly after its adoption, a federal judge in Eugene barred the Oregon law, called Measure 16, from taking effect. But in February of this year the U.S. Court of Appeals in San Francisco reversed that injunction, ruling that the law's opponents were in no personal danger of injury and therefore lacked standing to file a lawsuit. The plaintiffs appealed to the U.S. Supreme Court, which has not yet announced whether it will hear the case.
Meanwhile, the Republican-controlled state legislature, citing what it said was newly discovered scientific data on the unreliability of lethal overdoses of drugs, earlier this month voted to put Measure 16 back on the ballot in November to remedy what it called "defective" provisions. It was the first time in more than 90 years that the legislature sent an approved referendum back to the people, and the move was widely viewed by right-to-die advocates as a thinly veiled attempt by conservative legislators to get the measure repealed.
Apart from reviving the debate over physician-assisted suicides, the legislators' action appears to have fueled deep voter resentment, which supporters of the practice say they will exploit to win an even larger majority for the measure this time. A recent poll showed that 81 percent of those questioned felt the legislature was wrong to make Oregonians vote on the same ballot measure a second time.
"Death with dignity may not be the central issue this time," said Barbara Combs Lee, a nurse and lawyer who heads the advocacy group Compassion in Dying. "The voters have already expressed their will on that. The issue may be how vulnerable citizens' initiatives are to a legislature that thinks it has a special moral authority."
However, Robert J. Castagna, executive director of the Oregon Catholic Conference, said that although the issue of "constitutionally suspect" ballot initiatives and the proliferation of hastily drafted measures is important, the real issue in Measure 16 is more fundamental.
"The killing of one person by another person, purportedly for humane reasons, does touch the very essence of why we have a government," he said. "It is fundamental in our law and social relationships."
He said the legislature voted to send the right-to-die question back to the voters only after the Oregonian newspaper published an interview with a physician in the Netherlands who concluded from a study that 25 percent of lethal overdoses of medications administered to patients there failed to cause death and frequently left the patient in a vegetative state.
"So we have a situation where an essentially flawed ballot initiative was adopted by the people without them having the benefit of this information. The conclusion we reached is that pills don't work," Castagna said. He said a necessary component of doctor-assisted suicides utilizing self-administered lethal overdoses of sleeping pills is the use of a plastic bag over the patient's head to cause asphyxiation, which he said could require the participation by a person other than the patient.
But Elven O. Sinnard, the chief petitioner for Measure 16, described in an interview how he helped his terminally ill wife, then 68, commit suicide eight years ago without him actively participating in the final stages of her death.
Sinnard, 80, a retired greeting card franchise owner, said his wife, Sara, had suffered from a debilitating heart condition when she decided to end her life by taking an overdose of tranquilizers and sleeping pills she had hoarded from prescriptions. "She said, `I'm alive but I'm not living,' " Sinnard recalled.
After obtaining instructions from the Hemlock Society, a suicide advocacy group, Sinnard said he put the contents of sleeping capsules in a glass of water, gave it to his wife and then left the house "when she told me to go to the office while she put the bag over her head." Sinnard said that when he returned, "she was peaceful."
Sinnard said police detectives who questioned him told him that if they could prove he played an active part in putting the plastic bag over his wife's head, they would arrest him on a homicide charge.
"That's when it struck me that the law was wrong," he said. "What I did was an act of love, not a criminal act. I made up my mind to do something about that."
Eli Stutsman, a lawyer who has led the legal battle for the measure, said that hoarding sleeping pills or painkilling drugs, sometimes with the tacit knowledge of physicians, is far more common than opponents of physician-assisted suicide will admit. "So we drafted Measure 16 around that," he said.
The measure allows doctors to prescribe lethal doses of medications such as barbiturates for mentally competent patients diagnosed as having six months or less to live and whose terminal condition has been confirmed by a consulting physician. The patient must initiate the request, have no documented evidence of depression and agree to a two-week wait between his or her verbal request and the signing of a lengthy consent form that allows for changes of mind and for doctors who object to the process to opt out.
William Toffler, who heads the advocacy group Physicians for Compassionate Care, said it was a myth that it is already common for terminally ill patients to commit suicide with hoarded or over-prescribed medicines. "In 20 years as a physician, I can't recall a single case like that, unless it was a depressed patient who committed suicide," he said.
"Killing one another is not compassionate, it's abandonment. Why are we judging these lives as worthless when in fact their lives aren't worthless? They have the right to live."
© Copyright 1997 The Washington Post Company