THE VIRGINIAN-PILOT
Copyright (c) 1994, Landmark Communications, Inc.
DATE: Thursday, December 8, 1994 TAG: 9412080025
SECTION: DAILY BREAK PAGE: E1 EDITION: FINAL
SOURCE: Jon Frank, staff writer
LENGTH: Long : 165 lines
TODAY IN OREGON, the future finally catches up to Kurt Vonnegut Jr.
Twenty years ago, Vonnegut wrote about ethical suicide parlors in his short story ``Welcome to the Monkey House.'' Hostesses dressed in body stockings and boots helped clients in the fine art of ending one's life.
That's not quite the reality in Oregon. But it's close enough. Last month Oregon became the only place in the world where physician-assisted suicides are legal. Voters there narrowly passed the Death With Dignity Act. Similar measures in Washington and California have gone down to defeat. The Netherlands won't interfere with physician-assisted suicide, but it is still illegal.
The Oregon law that takes effect today allows physicians to write a Hemlock-like barbiturate potion for people who want to commit the ultimate act of surrender. Death is as close as the prescription counter.
Actually, it won't be quite that easy. The details of the Oregon law are still being written.
Numerous restrictions were part of the law when it appeared on the ballot. Patients must be diagnosed with an illness that will kill them within six months. A second physician must confirm the diagnosis. The barbiturates must be requested more than once - 48 hours before the prescription is written and again before it is received.
But other questions remain unanswered: the kind of barbiturate to use; residency requirements. And what happens if the dose is not large enough?
There is also some doubt about the law's future. It's already being challenged in court. Chief opponents of physician-assisted suicide include some of the same groups against abortion, such as the National Right to Life Political Action Committee, a national organization with 3,000 local affiliates.
But those who worked to pass the Oregon law are predicting it will revolutionize the way we die. The law, they say, will end the monopoly of death held by doctors and hospitals by giving more control to dying patients. And, they say, the Oregon law is just the beginning. They predict other states will soon enact their own physician-assisted suicide provisions.
Conservative Virginia is an unlikely candidate to legalize doctor-assisted suicide, according to those who deal with terminally ill patients. But they say there is a pressing need for something more than what already is available for the terminally ill.
``We are a society that has not grown up in regards to death,'' said Susan Garvey, a clinical psychologist in Norfolk who counsels terminally ill patients and abuse victims. ``Choosing to die is not such a horrible thing to do in certain situations. For someone who is terminally ill, or in great pain, I think it is not necessarily a crazy idea or a product of depression. That person may just want to exert more control over their life, and therefore, more control over their death. We need to begin seeing death as a more natural thing, not such a horrible thing, that needs to be put off at all costs.''
Rev. James M. Downing, pastor at the All God's Children Community Church on Independence Boulevard in Virginia Beach, agreed. Downing, whose church does most of its outreach in the Hampton Roads gay and lesbian community, believes that a more open approach to death and dying would greatly benefit the AIDS patients he counsels. He blames the Catholic Church for much of the problem.
``The church is responsible for this today,'' Downing said. ``For making suicide such a taboo subject.''
The Oregon law set off a debate about ethics in the medical profession that goes to the root of what it means to be a doctor. After all, the Hippocratic Oath - which is still sworn to by a large portion of American physicians - prohibits doctors from doing what the Oregon law allows: prescribing a deadly dose of medicine to patients whom physicians are sworn to protect.
During the 1994 campaign, the fight over the Oregon law split the state's medical community and created a forum for debate that may have been the most critical factor in determining the election-day result.
The American Medical Association strongly opposed the initiative. But the Oregon Medical Association refused to fall in line. The state's doctors openly debated the issue. Eventually, Oregon's doctors decided to remain neutral. Most observers say the decision allowed the measure to pass.
``It was an incredible triumph for medicine and patient care,'' said Dr. Peter Goodwin, chairman of the Oregon Right To Die Committee. ``We were able to say that this is what the physicians have, after due consideration, decided is best for Oregon - let's at least look at the issue.''
``When the state medical association remained neutral, that was the key,'' admitted Pat McCormick, campaign director for the Coalition for Compassionate Care, the major organization formed to oppose the measure. ``In the absence of organized medicine opposition, the proponents were able to shape it as a religious issue.''
That cast the Catholic Church as the main agent opposing change. Supporters and opponents of the law say the church put up most of the money in the effort to defeat the initiative.
The church predicted dire consequences if the measure passed: specialty death clinics; patients misdiagnosed and encouraged to end their lives to save money; non-terminal patients being allowed to commit suicide.
And in what might have been a fatal mistake, Goodwin said, the church tried to make it a patient versus doctor debate.
``The Catholic Church was able to fix on the idea `How can you give this kind of power to your doctor? Your doctor is going to kill you,' '' Goodwin said. ``I looked at it from another perspective. I had become convinced that assisting a patient to die was an ethical response to patient care. Physicians already have too much power. I wanted this to be an initiative that empowers patients.''
Surprisingly, Michigan physician Dr. Jack Kevorkian, the man the media calls ``Dr. Death'' for helping more than 20 people commit suicide during the past several years, is credited by Goodwin for bringing the issue of assisted-suicide before the public.
``He has had a huge impact,'' Goodwin said.
The original petitioner for the Oregoninitiative, 77-year-old Elven Sinnard, whose wife killed herself in 1989 after a long illness, says the church failed to convince even its own members.
``In one poll, 67 percent of the Catholics questioned supported the measure,'' said Sinnard, who is affiliated with the Hemlock Society, the pro-suicide group that helped get the Oregon law passed.
But opponents now are most concerned that the law will spread to other states, McCormick said.
``That is most troubling,'' McCormick said. ``That Oregon will be a model for other states.''
Downing, the All God's Children Community Church pastor, believes the Catholic Church is again displaying that it is out of touch with its members and that ``there is a revolution going on in the American Catholic Church.
``But social change,'' he said, ``is slow.''
And change is not necessarily good, even for physicians who deal with death and dying every day. Dr. S.P. Roundtree, a Virginia Beach physician whose caseload is about 80 percent AIDS patients, believes that even if Virginia were to pass an Oregon-style, assisted-suicide law, she would not be able to help her patients kill themselves.
``It is almost impossible to say how long a person is going to live,'' she said. One of her AIDS patients, she said, was once given a month to live by another doctor. That was two years ago.
But beyond that, she said, is the oath that doctors have historically been committed to upholding.
``We have pain and suffering and we have to tolerate the good with the bad,'' said Roundtree, who is a practicing Catholic. ``Life for me is so precious that to end it or even help to end it when we have sworn to preserve it is something that I could not do.'' ILLUSTRATION: Color staff illustratiohn by Sam Hundley
Photo
Dr. Jack Kevorkian has helped more than 20 people commit suicide in
past years.
[Copy of form/application: Request for medication to end my life in
a humane and dignified manner. Form appears on page E6]
[Quote from the Hippocratic Oath, demanded of the physician about to
enter practice. For copy of entire quote, see microfilm.]
KEYWORDS: OREGON RIGHT TO DIE PHYSICIAN ASSISTED SUICIDE SUICIDE
LAW JACK KEVORKIAN DEATH WITH DIGNITY ACT by CNB