Ashcroft has attempted to overturn the actions of Attorney General Janet Reno, who ruled in favor of Oregon's interpretation of the federal Controlled Substances Act as allowing physicians to prescribe lethal levels of drugs.
In large measure because of her support, the "Death with Dignity Act" went into effect in October 1997. This law includes a variety of safeguards to prevent the kinds of abuses that opponents of physician-assisted suicide often argue will become all too common. These guidelines imposed on physician-assisted suicide include a requirement that the patient be competent; that that voluntariness of the request be documented in writing and confirmed by two witnesses; that the request be confirmed by a second physician; and that the physician and patient observe certain waiting periods, as Reno noted.
Once the request has been properly documented and the required waiting periods have expired, Reno wrote, the patient's physician may prescribe, but never administer, medications to enable the patient to take his or her own life. The doctor remains a caregiver, not an executioner.
Those who support physician-assisted suicide point to the experiences of those in Oregon with the law and the lack of abuse that has occurred since its passage there. Support for the measure in Oregon has been strong from its governor, a former emergency room physician. Governor John Ditzhaber has said that "I believe an individual should have control, should be able to make choices about the end of their life... As a physician, I can tell you that there's a clear difference between prolonging someone's life and prolonging their death."
An important argument for physician-assisted suicide is the fact that many people never use the prescriptions given to them to end their lives. If abuse were in fact occurring, one would not expect this to be the case. According to New York Times article titled "As Suicide Approvals Rise In Oregon, Half Go Unused" published in February 2002, reporter Sam Verhovek describes a trend of increased number of patients that received prescriptions for lethal dosages but have chosen never to use them. Verhovek reports that "out 44 patients who received lethal medications last year only 21 people actually ended up using lethal medication to end their lives." Clearly there is no untoward pressure on these individuals to end their lives.
Susan Okie's Washington Post article from Jan. 1 of this year also suggests that many patients want to have the option of suicide through an overdose but do not necessarily plan to end their lives. She writes:
Oregonians who used the law to obtain lethal prescriptions have tended to be highly educated, well insured and as likely to be married as those who died naturally of similar diseases. They place a high value on control and independence. Compromise is not in their vocabulary...Nobody who knows them is surprised by the request.
Opponents of the physician-assisted suicide argue that prescribing lethal drugs to terminally ill patients goes against the bylaws and ethics of practice of medicine. The AMA and its partners would like to put the focus back on what they consider the essence of practicing medicine, which must always center on finding cures and improving ways to manage pain, specially for terminally ill patients.
Today, pain management and improvement in palliative care is receiving much needed focus because of discussions of physician-assisted suicide. This is certainly all to the good. However, while better pain management may help prolong quality of life for many, it cannot substitute for the need to establish the right to physician-assisted suicide.
Callahan, Daniel, "Good Strategies and Bad: Opposing physician-assisted suicide," Commonweal, December 3, 1999, sec1. 7+.
Cassel, Christine K. "AMA Guidelines for Caring for Patients in the Last Phase of Life.," CQ Researcher 7 (1997): 774. (http://www.ama-assn.org/sci-pubs/amnews/amn_97/edit0721.htm)
Humphrey, Derek. Euthanasia: Essays and Briefings on the Right to Die. Los Angeles: Hemlock Society, 1991. http://deathwithdignity.org/euth_us2htm.
Orric, Sarah. "House Judiciary Committee Rationale." Congressional Digest 77 (1998); 263-264.
Okie, Susan. "I Should Die the Way I Want To." The Washington Post, Jan 1, 2002.
Reno, Janet. "Oregon Law and the CSA." Congressional Digest 77 (1998); 262.
Robinson, Bruce A., "Physician-Assisted Suicide: Activity in States other than Oregon," Mar. 15, 2002.
Rosenblatt, Stanley. Murder of Mercy: Euthanasia on Trial. New York: Prometheus, 1992.