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Northwest Voices

Seattle Times letters to the editor

October 14, 2008 at 5:02 PM

Initiative 1000: death with dignity / assisted suicide

Take it from someone who knows

I am an Oregon doctor who is quoted in The Times article about assisted suicide [“How we die: the Oregon experience,” page one, Oct. 13].

As I was characterized as “fiercely” opposed, I feel obligated to share at least one reason (of many more than space permits) for my stance.

In Oregon, the “safeguards” are like a sieve. Although patients are supposed to have mental-health evaluations when indicated, there were no mental-health referrals at all last year — none!

AP Photo/Courtesy Yes on I-1000

In this still frame from a TV advertisement produced by supporters of Washington state’s assisted suicide ballot initiative, Nancy Niedzielski, who lost her husband Randy to brain cancer, is shown. The emotionally charged battle over end-of-life decisions has taken to the airwaves as Washington state voters decide whether to allow doctors to prescribe lethal medication to terminally ill patients.

At the same time, a recently published [Oregon Health & Science University] study confirmed that more than 48 percent of study patients seeking assisted suicide last year had either major depression or anxiety. At least three of 18 who actually took their overdoses had major depression, a condition that commonly leads to suicidal thoughts.

It saddens me that these individuals were given overdoses rather than care and treatment for their depression. Whether depressed or not, just hearing the “option” of assisted suicide from their doctors can further a patient’s sense of isolation.

Doctors who give this option are encouraging patients to not value themselves and give up hope. This is corruption of our traditional medical ethic that protects patients.

Vote “no” on I-1000.

— William Toffler, Portland

Change the mood; don’t end a life

Great story about Initiative 1000 Monday. You covered many of the contentious points.

You pointed out quite accurately that referral for mental-health evaluation or counseling hardly ever occurs in Oregon, even though studies show that many patients requesting euthanasia are in fact depressed.

Many of them are not tired of living, but tired of living as they are.

With better comfort and treatment for depression, many of them would not be asking for help with suicide.

You stated that in Oregon and under Initiative 1000 “patients who might be suffering from mental illness are supposed to have a psychiatric evaluation.” This actually is not true. The initiative says that the physician shall refer the patient for counseling only if he or she believes that the patient “may be suffering from a psychiatric or psychologic disorder or depression causing impaired judgment.” The last three words are the crucial ones. If a patient is depressed but capable of making decisions for themselves, as most depressed patients are, then there will be no need to refer.

Patients seeking help with suicide under Initiative 1000 are highly unlikely to first receive treatment for their depression. I suppose that initially, there will be some referrals, but as time goes by, these will cease (as they have in Oregon).

Throughout history, the desire to commit suicide has always been considered de facto impaired judgment, and society has always intervened to prevent suicide whenever possible.

This will now be changed.

As long as a physician thinks the patient can make decisions for himself or herself, Initiative 1000 for the first time makes the decision to commit suicide a rational one, even if the patient is depressed. The initiative further empowers physicians to assist in their depressed patients’ suicides.

This doesn’t sound like much of a safeguard to me.

— Doug Trotter, Snohomish

Pays to die, not live

Oregon Health Plan (Medicaid) patients have received health insurance letters informing them that cancer chemotherapy is not covered, but assisted suicide is covered. Advocates of assisted suicide stress choice, but what happens when assisted suicide is your only choice?

Barbara Wagner of Springfield, Ore., received such a letter this summer. The Oregon Health Plan will not pay the cost of surgery, chemotherapy or radiotherapy for patients with a less than 5 percent expected 5-year-survival — even when that treatment is intended to prolong life or alter disease progression. However, such patients are eligible to receive comfort care, which in Oregon includes assisted suicide.

The message from Oregon, so aptly stated by Barbara Wagner, is, “We’ll pay for you to die, but not pay for you to live.” You have the choice.

The New York State Task Force on Life and the Law studied assisted suicide and concluded: “No matter how carefully any guidelines are framed, assisted suicide will be practiced through the prism of social inequality and bias that characterizes the delivery of services in all segments of our society, including health care.”

Assisted suicide saves HMOs money.

I-1000 endangers your health. Vote “no.”

— Kenneth Stevens, Sherwood, OR

Do the right thing

I am an Oregon doctor and I would like your readers to know the true cost of I-1000, the assisted-suicide law.

My own patient developed cancer and became depressed, but instead of addressing the issues underlying suicidality, a colleague simply gave him a lethal dose of a medication to end his life.

Washingtonians need to learn the real lesson from Oregon’s doctor-assisted-suicide law. Despite all of the so-called “safeguards,” there have been numerous instances of inappropriate selection, coercion, botched attempts and active euthanasia that have been documented in the public record.

This, however, is not the worst of it.

The real tragedy in Oregon is that instead of doing the right thing, which is to provide excellent medical care, patient’s lives are being cut short by physicians who are ignoring the things that lead to suicidality at the end of life.

This change in our profession — away from “cure when possible, comfort always, but never harm” — has me concerned.

This should concern Washington residents as well.

Don’t follow Oregon’s lead. Vote “no” on I-1000.

— Charles J. Bentz, Portland

Where are these doctors?

I always thought Martin Sheen was a progressive individual.

For someone who lives in the Malibu Colony, he must be strapped for cash and will say what the going rate will pay.

What kind of doctors is he referring to that will not recognize depression?

Our government may be unskilled. There are no board requirements to be a president or a legislator, but are our doctors just a bunch of schlocks?

— Leo Shillong, Bellingham

Comments | More in Election, Health care

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