Life after Death with Dignity: The Oregon Experience

Abstract

This article offers a framework for examination and overview of Oregon's Death with Dignity Act after its first year of implementation. This law became public policy on October 27, 1997, when all legal barriers were lifted. The law allows a terminally ill person to request a prescription to end life if she or he qualifies under the law's requirements. According to records, 23 Oregonians have received such a prescription, and 15 have used it. The effect of physician-assisted suicide (PAS) on clients and families, professional health care providers and agencies, and society and culture is explored through two questions: (1) What is known about PAS? and (2) What needs discovery and exploration? The reality of this end-of-life option has forever changed care of terminally ill individuals, and social workers may benefit from the Oregon experience.

Aktív eutanázia Kolumbiában és asszisztált öngyilkosság Kaliforniában

“…Ez lélektani kér-dés, amelyet a jogalkotás során figyelembe kell venni. Az amerikai egyesült államokbeli Oregon államban az aszszisztált öngyilkosság jogi lehetőségének megteremtését követő egy évben 23-an kérték az asszisztált öngyilkossá-got, de csak 15-en vitték véghez az öngyilkosságukat [1].…”

Conversations at the End of Life

“…All of these practice tenets continue in an environment in Oregon that also allows the consideration and the act of taking a lethal dose of medication. When Oregon's law was implemented in 1997, there was little education or training to guide practitioners in any discipline and so the clinical skills and knowledge for end-of-life care, with DWD as an option, have expanded and improved over time (Miller, 2000;Miller & Hedlund, 2005). For social work professionals in particular, practice knowledge that included DWD as an option has been obtained through experience, workshops, and conferences sponsored by health systems, academic institutions, and expert individuals.…”

“…End-of-life care already required some adjustment to the fact that suicidal ideation in the terminally ill was not uncommon and did not necessarily connote pathology or clinical depression (Block, 2000;Rosenfeld, 2000). Now, to know that a capable and competent patient could take a lethal and legal dose of medication to end his or her life on a specified day opened new clinical challenges to social work's education and knowledge of mental health and terminal illness (Miller, 2000;Miller & Hedlund, 2005;Miller, Hedlund, & Murphy, 1998). A model by Van Loon (1999) provides a framework for assessment and intervention in "desire to die talk."…”

“…Another area that needs further research is the impact of DWD on families (Miller, 2000). Because of the confidential nature of the lethal prescription, combined with residual fears about judgment or other ramifications, many families do not feel free to discuss their experiences.…”

Take Some Time to Look Inside Their Hearts

“…There are numerous avenues for future research in this area of end of life care because of so many unknowns (Miller, 2000). There remains enormous and heated debate about whether PAS is right or wrong or if it belongs in end of life care at all.…”