In 1997 the people of Oregon voted to introduce the world’s first assisted dying legislation. 19 years on there have been no cases of abuse and no widening of the law’s eligibility criteria. The fears expressed by opponents to a change in the law in this country are the same ones expressed in Oregon in 1997. Data published last week confirms what we already knew – that none of these fears have been realised.
The latest annual report shows that 132 people had an assisted death in 2015. Although a relatively small number, accounting for just 0.39% of total deaths in Oregon, this is the most people that have had an assisted death in any year since the law was passed. Does this mean the law is no longer working? No, it means more terminally ill people are exercising their choice to be able to control the manner and timing of their deaths, subject to upfront safeguards. As a result, fewer terminally ill people are being forced to endure suffering that they consider unbearable.
More prescriptions for life-ending medication were written last year than in any previous year, yet 39% of people who received a prescription did not use it, rather they went on to die from their underlying illness. Additionally, those who did have an assisted death waited an average of 45 days from their first request to self-administrating the life-ending medication. Together these figures disprove the claim that people who request an assisted death feel compelled to because of a ‘duty to die’. In reality this small number of dying people remain in control every step of the way – they decide when they want to die. Many thousands more gain peace of mind simply by knowing the law exists (1 in 6 dying people in Oregon discuss the option of assisted dying with their friends and family, yet only 1 in 150 go on to make a request and have it approved). The collective effect of this is that dying people are able to enjoy their final weeks and days without the fear that they will suffer against their wishes.
In contrast to the unsubstantiated claim that palliative care provision would be undermined by assisted dying legislation, 92% of those who had an assisted death in Oregon last year were enrolled in hospice care.
Further to this, 90% died at home. No organisation that promotes palliative care in the UK would deny that increased access to palliative care and a greater number of people being able to die in a place of their choosing are good things. So these organisation must now acknowledge that assisted dying and palliative care go hand in hand and fulfil their duty to dying people to engage with the process of developing workable legislation.
Healthcare professionals in Oregon appear to have accepted this responsibility, as more physicians than ever are now supporting patient choice through assisted dying – 106 wrote the prescriptions for life-ending medication in 2015. Troublingly, doctors working in Catholic institutions are forbidden from being involved in any aspect of assisted dying and beds in Catholic hospitals account for 1 in 9 of the total hospital beds in America. This has the potential to deny dying people access to the law but also denies many doctors from being able to respect their patients’ wishes. It is important that religious organisations in this country do not hold undue influence in the assisted dying debate; this is especially true given an overwhelming majority of religious people actually support assisted dying.
Opponents to a change in the law should examine these figures and acknowledge what they truly mean. Isolating relatively small percentage increases and presenting them without context is nothing more than scaremongering.
Oregon, Washington, Vermont and most recently California have introduced safe and effective legislation. It should not be beyond the wit of our Parliament to do the same.