The statistics from Oregon are clear: the people who have the "choice" of assisted dying are disproportionately white, wealthy and well-educated. Who pays the price for their choice?

So who wants assisted suicide? 

In Oregon, the poster child for New Zealand advocates of euthanasia and assisted suicide, the statistics after 17 years of the Death With Dignity Act are emphatic[1]:

White                                                               97.1%
Bachelor degree or higher                               45.9%
Private medical insurance                                60.2%
Concerned about being “less able to
engage in activities making life enjoyable”       88.7%

That is, the people who are doing the choosing are disproportionately white, wealthy, and well-educated. Having had a good life they want control of how they would face a terminal illness.

Fair enough, you might think, but who pays the price for their ‘choice’?

People like 64-year-old Barbara Wagner, who received a letter from the Oregon state health insurer helpfully advising her that they wouldn’t pay for the chemotherapy drugs she needed, but they would pay $50 for her assisted suicide.[2]

And let’s not forget that the general suicide rate in Oregon has been increasing since 2000, and at last count was 41% above the United States average.[3] That’s a fair warning that when you assist suicide for one group, you are endorsing it as an appropriate response to suffering for everybody.

It is also disabled people who pay the price.  Not Dead Yet, an American disability rights group says: “In a society that prizes physical ability and stigmatizes impairments, it’s no surprise that previously able-bodied people may tend to equate disability with loss of dignity. This reflects the prevalent but insulting societal judgment that people who deal with incontinence and other losses in bodily function are lacking dignity.”[4]

David Seymour’s private members bill would allow terminally ill people and those with a “grievous and irremediable medical condition” to ask a health professional to supply and/or administer a lethal dose of drugs.

What’s “grievous” and what’s “irremediable”?

Multiple sclerosis? Paraplegia? Autism? Impaired sight or hearing? Depression?

Such words matter supremely in this issue because it is, literally, a matter of life and death.

Assisted suicide advocates like to talk of ‘assisted dying’, ‘physician-assisted dying’ and ‘rational suicide’. 

George Orwell warned us why they do this[5]:

political language has to consist largely of euphemism, question-begging and sheer cloudy vagueness. Such phraseology is needed if one wants to name things without calling up mental pictures of them.

Exactly. The advocates do not want the public to have accurate mental pictures of the reality. That is why Mr Seymour’s bill would ensure that the actual cause of death is not recorded on the death certificate.

Last year the Scottish and UK parliaments rejected assisted suicide bills by large margins.  The Scottish select committee report, in particular, is a must-read overview of all the competing issues at stake.[6] (For the record, the committee had 5 SNP, 3 Labour and 1 Conservative members.)

The Guardian columnist Giles Fraser recently wrote “let us not pretend that this ‘personal choice’ is unaffected by wider economic realities.”[7]

“by eroding the long-term mutual obligations we have to each other, in sickness and in health, we have arrived at the existential equivalent of a zero-hours contract with life, a contract that can be terminated at will.”

Euthanasia and assisted suicide – or whatever your euphemism of choice – is not a progressive issue.


[1]https://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Documents/year17.pdf

[2] http://abcnews.go.com/Health/story?id=5517492

[3] http://www.oregon.gov/oha/amh/CSAC%20Meeting%20Shedule/Suicide-in-Oregon...

[4] http://www.coloradoindependent.com/151598/rights-group-assisted-suicide-...

[5] George Orwell, ‘Politics and the English Language’, Horizon, April 1946.

[6] http://www.scottish.parliament.uk/S4_HealthandSportCommittee/Reports/her...

[7] http://www.theguardian.com/commentisfree/belief/2015/aug/28/assisted-dyi...

Comments (22)

by Andrew Geddis on January 20, 2016
Andrew Geddis

A few comments.

(1) If the statistics showed a large number of non-white/poorer/uninsured people accessing aid in dying, wouldn't the argument be that it is the under-privileged who are being "coerced"/"forced" into taking this option? Seems that statistics can be spun in very different ways.

(2) That letter to Ms Wagner is terrible - but how is her experience with the Oregon Health Plan any different to what cancer sufferers here go through with Pharmac? It's a stretch to say that the refusal to fund the cancer drugs was because of the existence of aid in dying as an option ... we have exactly the same issues here already.

(3) Yes, the suicide rate in Oregon has increased between 1999 and 2010, by 49.3%. However, the suicide rate in Wyoming - which doesn't have aid in dying - increased by 78.8% in that time period. The rate in Rhode Island - again, no aid in dying allowed - increased by 69.1%. The rate in Hawaii - which also doesn't have aid in dying - increased by 61.2%. The rate in Vermont - which only introduced aid in dying in 2013 - increased by 57.9%. So it's difficult to draw the conclusion that you seem to about the effect of the availability of aid in dying (all statistics available here.)

(4) Your claim (or, rather, your repeating of others' claim) that allowing people aid in dying somehow demeans or insults those with disabilities is problematic. Does research to cure locked-in syndrome also demean or insult those who are reliant on others to meet their basic needs? Are those searching for a way to treat Motor Neurone Disease making an "insulting societal judgment that people who deal with incontinence and other losses in bodily function are lacking dignity”? Or, let's flip the situation. Let's say there appeared a pill that could remove some given disability. If a person refuses to take that pill - says "I'd rather live the life I have been living, thanks" - does that represent an "insulting judgment" on my life as a non-disabled person?

(5) Your quote from Giles Fraser seems contradicted by the statistics you provide at the start of your post. Whatever it means that "this ‘personal choice’ is [ ]affected by wider economic realities”, in Oregon it isn't the poor who are dying. That was what you started off by saying - so why not finish with it?

by Graham Adams on January 20, 2016
Graham Adams

As Matthew Jansen unintentionally illustrates, Oregon’s experience is never going to be much help in arguing a case against assisted dying because it upturns many of its opponents’ cherished arguments... “the slippery slope”, “a duty to die” and so on.

Criticising the effect of the legislation for not being “progressive” seems odd for someone against assisted dying. The whole point about voluntary euthanasia, of course, is that it is voluntary. It will appeal strongly to some sections of the community and not others (including the deeply religious). 

As he points out, the legislation in Oregon has largely been used by a particular section of the population: whites, the university educated, the privately insured...  After nearly 20 years of the legislation being in force, if there were a “slippery slope” at work (as Jansen has alleged elsewhere), wouldn’t a far greater cross-section of the community be using it? 

The argument about diminishing the value of disabled people is also weak. What makes life worth living is a very personal matter; that I may decide my life is not worth living has no implications for anyone else, able-bodied or otherwise. 

Blaming increasing rates of suicide on Death with Dignity legislation is very muddled thinking. There is a world of difference between someone condemned to an imminent death wanting to hasten that process, and someone afflicted with temporary suffering (say, a young person inconsolable after a love affair sours) ending their life. Conflating the two is a pretty obvious and unconvincing trick. Of course, the state itself doesn’t record the former deaths as suicides because anyone using the fatal medicine is already dying.

 

by Fentex on January 20, 2016
Fentex
Assisted suicide is not a progressive issue

Good. Arguments regarding it need not be constricted by ideological allegiances then.

by Jude on January 20, 2016
Jude

Graham, just last year, Belgian doctors granted a depressed 24 year old woman the right to end her life. She contemplated suicide on a number of occasions, as do many others who experience depression. 

Is she 'dying' so as to qualify for the fatal medicine, as you suggest? What sort of precedent does this set for other depressed Belgians who might be contemplating suicide? Is it really a matter of conflating suicide rates and legalised assisted suicide, or is there actually a distinct relationship between the two?

by Andrew Geddis on January 21, 2016
Andrew Geddis

@Jude,

Belgium is not Oregon. It has a far, far broader application of aid in dying. If we don't think such a broad application is desirable, then we don't have to adopt it.

Graham's point is that it is possible to create a system of aid in dying that doesn't have  "slippery slope" consequences, such as permitting people suffering from depression to "qualify for the fatal medicine". Oregon shows this - it has had its system in place for twenty-some years without expanding the group of individuals able to use it. And it's worth noting that other US jurisdictions (Washington/Vermont/California) that have adopted aid in dying regimes since then have similarly put in place quite restricted qualification criteria.

So we can have a discussion - do we think it is a good idea to allow people suffering from ongoing, untreatable depression to end their lives through aid in dying? And if we think it isn't, then we can exclude such people from being able to use the process. Just like Oregon has.

by Stewart Hawkins on January 21, 2016
Stewart Hawkins

The subheading of Jansen's article suggests that poor people are somehow "paying" for the assisted suicide of white wealthy and educated people in Oregon. Jansen provides absolutely no evidence to support that suggestion. What he is cleverly missing from his discussion is that wealthy, white educated Oregonians choose assisted dying disproportionately (not grossly- whites are 88% and degree-educated 30% of the Oregon population).

If only we could provide high quality education for all members of the community: at least then the poor would have the equal opportunity to choose assisted dying like their rich neighbours, eh Mathew?

by Jude on January 21, 2016
Jude

Andrew, I agree Belgium has lowered the bar more than Oregon has. My point was more that I am unconvinced that legalising assisted suicide/ aid in dying has no effect on the total number of suicides - notwithstanding the presence or absence of safeguards in a particular jurisdiction. 

I'm equally unconvinced as to the actual effectiveness of the safeguards in Oregon and other states - and the apparent immunity these safeguards bring from 'slippery slope' consequences. For example, take Oregon's requirement that candidates seeking assisted suicide be referred for psychiatric assessment if there is any doubt as to the candidate's mental capacity. Psychiatrists themselves testify to how difficult this assessment is, yet in 2014, there were only 3 referrals for psychiatric assessment from the 105 candidates who died after receiving the fatal prescription. This is at odds with studies published in 2008 that found that 1 in 6 candidates who received the fatal prescription were clinically depressed - something quite likely to undermine capacity.

Further, because doctors can opt out of the physician-assisted suicide regime, candidates are often being assessed not by their own doctor who has known them for years, but by a doctor who they have just met. To me, these factors undermine the integrity of an assessment for physician-assisted suicide.

Perhaps some of such defects could be catered for in designing legislation here, but I think we would still be opening the door to unintended consequences that outweigh the potential benefits.

It also speaks volumes to me that the World Medical Association, NZMA, the NZ Health Professionals Alliance, the Australia and New Zealand Society of Palliative Medicine and Hospice New Zealand (amongst others) all oppose assisted suicide as something contrary to the core of their profession.

A further point on Oregon: assisted suicide candidates' top three 'end of life concerns' in Oregon Public Health Division's 2014 edition of its annual report on physician-assisted suicide were: losing autonomy (96% of candidates), losing ability to engage in enjoyable activities (91%) and loss of dignity (75%). Inadequate pain control arising from their condition was a concern shared by only 33% of candidates. If the inability to control pain (and the supposedly corresponding inadequacy of palliative care) is such a driver behind legalising assisted suicide, why is this not equally reflected in the 'end of life' concerns of those who have actually sought such assistance? 

by Andrew Geddis on January 22, 2016
Andrew Geddis

@Jude,

"My point was more that I am unconvinced that legalising assisted suicide/ aid in dying has no effect on the total number of suicides - notwithstanding the presence or absence of safeguards in a particular jurisdiction."

But where's the evidence the availability of aid in dying does have an "effect"? For example, that SMJ article you linked to appears to simply show that it doesn't decrease the rates of suicide amongst those not able to access it - and that there is a small increase in overall "suicide" rates when you include those who are accessing aid in dying in the figures.

Of course, in itself that's a controversial thing to do - it equates those choosing aid in dying with "suicide", which is problematic.  But note what the article doesn't appear to show (as far as I can see from the abstract, as I can't access the body of it) ... that allowing aid in dying causes an increase in the rates of suicide of persons not able to access it. So I'm not sure we can say that (in the US at least) that the availability of aid in dying has any "effect" at all on the phenomenon of suicide.

On your point about medical capacity - why is your concern not generalisable across all end of life decisions? Let's say I suddenly am diagnosed with cancer, with a prognosis of death within weeks. My doctor informs me that there is an experimental treatment that looks to give a reasonable chance (let's say at least 50/50) of prolonging life for up to years - but Pharmac doesn't cover it and so it is very expensive to access. I tell my doctor that no, I don't want to spend my family's inheritance on taking this risk and that I'm over life anyway (displaying a number of depressive symptoms). What then? Should a doctor be able to say that I am not competent to decide to refuse a treatment because of the possible existence of family pressure (they are maybe greedy for my cash) and uncertainty about my mental state (assuming that depressed people can't decide their best interests for themselves)? I don't think she/he could (or even should be able to), right?

So that general background approach to end of life choices then feeds through into situations where a person is affirmatively seeking aid in dying - yes, we have some "safeguards" intended to weed out any outlier cases where (say) someone's kids are fed up with them and demanding they end it all against their will, or where a person has so lost mental capacity/perspective that their very "rationality" is in question. But that has to be a pretty high bar, doesn't it, given our generalised commitment in a medical context to allowing the patient's informed consent to govern decisions? In which case, you wouldn't expect to see a huge number of referrals for psychiatric evaluations.

Finally, on the "why" of aid in dying, allowing individuals to retain a sense of control is an important part of reducing suffering at the end of life ... just as much as enabling them to avoid forms of physical pain that cannot be medicated away. That's why a high proportion of those who request aid in dying in Oregon don't actually use the medication ... simply knowing the choice exists is sufficient for them. So those statistics neither surprise nor bother me.

by Graham Adams on January 22, 2016
Graham Adams

@Jude 

The medical bodies you mention may have an official position against assisted dying but this doesn’t necessarily reflect the views of their members. I know that the NZMA, for one, doesn’t poll doctors on their views.

In 2010, Dr John Pollock – a 61-year-old Auckland GP facing death from metastatic melanoma – noted in New Zealand Doctor that the NZMA’s official position didn’t tally with his experience of talking to fellow doctors (and, for that reason, he had resigned from the association several years earlier).

“The New Zealand Medical Association is against euthanasia,” he wrote. “To me this is unfathomable. I have discussed it with many, many of my colleagues over the years and have found that the vast majority are for it. Indeed, I have met many who, at great risk to themselves, have succumbed to a patient’s begging for a merciful release.

“Is it really likely that the profession that sanctions the termination of the lives of thousands of healthy unborn babies each year would criminalise the shortening of the lives of suffering, dying patients who ask for that last merciful service?”

by Lydia Gunn on January 22, 2016
Lydia Gunn

I notice that dear Andrew Geddis has exposed his singular lack of understanding about disability with a series of misleading and medical-model  propositions in the comments section. Sigh.
Some day somebody who is pro-AS will come up with a coherent and intellectually rigorous argument about why AS is safe for disabled people, but if Tom Shakespeare (British disabled theorist and pro AS man) can't come up with anything convincing, I suppose I shouldn't expect too much from someone who is non-disabled.

by Rosemary McDonald on January 22, 2016
Rosemary McDonald

@Lydia Gunn

Some day somebody who is pro-AS will come up with a coherent and intellectually rigorous argument about why AS is safe for disabled people,

Phillip Patson has attempted to do just that here..http://www.ves.org.nz/page-1792893 , on the Voluntary Euthanasia Society website.

Legalising assisted dying generally is unlikely to exacerbate disenfranchisement of disabled people. To the contrary, the process of legalisation would have great benefits. This is because it would bring society's attitudes of discrimination towards disabled people into the public consciousness through debate in parliament and the media. 

There is much more to the piece,  and I advise all to read it.

To be honest,  I'm not convinced that legislation permitting voluntary euthanasia will have the necessary safeguards to protect disabled New Zealanders from coercion.

The new Zealand government has demonstrated that it does not respect the rights of people with disabilities,  and moreover this government has made a particular point of targeting that lack of respect for rights at those disabled New Zealanders who have the highest support needs levels.  (Exclude ACC Serious Injury Service clients as they have legislation protecting their right to the supports they need)

Phillip Patson's (who is himself disabled) claim that disabled people will benefit from legalisation of euthanasia because of increased media coverage of disability issues is,  I respectfully suggest,   a tad disingenuous.  Or maybe the almost constant narrative of the "unendurable suffering of being incapacitated,  incontinent,  dependant on others for managing bodily functions,  the terrible loss of mental acuity...etc etc of the 'better dead than disabled' lobby in various comments sections of MSN and blogsites has passed him by.

Some of those comments are really painful to read.

I am not sure how someone who is dependent on others for their most intimate care is supposed to respond when it appears that the majority of the voting population seem to prefer death to that level of disability.

I have no fundamental issue against voluntary euthanasia.

I do have a problem with proponents using terminology associated with disability as grist to their mill.

 

 


 


by Jude on January 22, 2016
Jude

Andrew, I certainly agree that that SMJ article is far from conclusive (and for the same reason as you, I have only read different abstracts of it too), though a larger summary of it concludes that American States that legalized PAS were characterized by higher rates of nonassisted suicide. I also accept that terminology/ nomenclature is a tricky one in this area, but I think the assisted vs. unassisted terminology the article adopts is for ease of reference rather than as a loaded term.

Analysis and terminology in this area (effect of PAS on total number of suicides) is made harder by a faulty reporting regime in Oregon.

On capacity: without wading too deeply into it, there is quite a bit of literature out there on the distinction (which is a largely ethical one, though that makes it no less important) between, on the one hand, health professionals allowing high-risk procedures, palliative care and a patient's decision to turn off life support, and on the other hand, PAS. NZ medical bodies are big on this. So, I could understand if the mental capacity assessment/ safeguards in place differed according to the treatment in question. However, I don't really see a problem with generalising such safeguards, as you propose. Looking at your example, I don't think I would have a problem with an Oregon-like approach of two doctors assessing my request (for a high-risk procedure [or not], moving from curative to palliative care, or turning off life support), and if they had doubts as to my mental capacity, referring me for psychiatric assessment. There might need to be exceptions to such a regime, but wouldn't that seem like a prudent, professional approach to a critical healthcare decision?

On the appropriate threshold for mental capacity in the medical context (and I really am out of my depth here), I'm not sure how high the bar is or should be. But I think an obvious point is that if I don't have capacity, I'm not in a state to give informed consent. The Code of Health and Disability Services Consumers' Rights here in NZ seems to take a pragmatic approach to this. In Oregon, the threshold for psychiatric referral is met if there are any concerns about the patient's mental capacity. Again, in the context of a critical healthcare decision, I would expect an appropriate level of prudence and professionalism.

 

by Jude on January 22, 2016
Jude

Graham, I take your point that views on PAS are going to vary at an individual level within the healthcare profession. However, I struggle to see how the profession's democratic, representative bodies could have held and articulated such anti-PAS views for the amount of time that they have, without a solid consensus across the profession as a whole. Yes, NZMA and these other representative bodies (and their individual members) might not be elected or unseated on the basis of their stance one single issue. However, the longstanding nature of that stance and the unequivocal manner by which these bodies have expressed it strongly points towards a solid support base for it.

 

by Andrew Geddis on January 22, 2016
Andrew Geddis

@Jude,

...though a larger summary of it concludes that American States that legalized PAS were characterized by higher rates of nonassisted suicide.

From those graphs I read the data simply as showing states that have aid in dying had higher rates before introduction of PAS (with continuing higher rates after PAS). But without having the underlying data, or at least the full discussion of that data from the article, it's hard to say much more.

On capacity - I do have a real problem with the purported ethical difference between a person refusing to undergo treatment that they know will save (or extend) their life and a person positively requesting a means of ending their life. I know a lot gets hung on an asserted distinction between them, but I'm just not convinced by it. If you want to read a long philosophical discussion of why that is so (written for the US context), there's this.

I'd also note that the NZ Code of Health and Disability Services Consumers' Rights sets the bar for an inability to give informed consent pretty high (see para 21):

In some circumstances it may not be possible to obtain the patient’s informed consent. For example, the patient may be a young child, be unconscious, suffer dementia or have an intellectual disability.

That's a lot stronger than "may be under some family pressures" or "may exhibit some depressive symptoms".

by Graham Adams on January 22, 2016
Graham Adams

Jude, The NZMA is a union and union politics are often opaque to outsiders (and often, unfortunately, to members). Both Maryan Street and Peter Brown told me when I researched an article on euthanasia in 2013 that they had been approached by doctors, nurses and hospice workers who didn’t agree with their professional association’s position on assisted dying. (Similarly, many Catholics don’t agree with the church hierarchy on a range of progressive causes from abortion to gay rights to same-sex marriage...as well as assisted dying.) Until members of professional organisations are polled (with no fear of recrimination), how are we to know how many are in favour or not? 

That was Dr John Pollock’s point: the NZMA’s position didn’t tally with his experience of discussing the topic with colleagues over many years, “with the vast majority in favour”. You might surmise that he decided to break ranks and state his concerns publicly only when he was dying and had nothing to lose professionally.

It would certainly change the weight that members of the public give to the NZMA’s stated position if it was qualified by adding that a significant minority of doctors (say 35 per cent) supported PAS. The NZMA position is currently presented as reflecting the views of doctors, not some doctors, and it is a powerful factor in some people’s minds in deciding not to support legislative change.

by Jude on January 22, 2016
Jude

Andrew, in fairness, I was quoting that summary ("States that legalized PAS were characterized by higher rates of nonassisted suicide"), but I agree that it ain't worth putting much stock in that without seeing the full analysis.

On capacity: I guess I gravitate towards the opposite side. I do see a distinction, and I respect the views of healthcare professionals and their representative bodies to that effect. I accept that dissenting doctors can be accommodated in a PAS regime by creating scope for opt-out (as in Oregon), but for me that doesn't do enough to address the fact that at that point Parliament would have already lowered society's ethical bar. It would be broadly analogous if Parliament lowered the drinking age (as it did in 1999) on the logic that it would reduce underage drinking. 

As to the NZ Code of Health and Disability Services Consumers' Rights, I don't think those examples you cite are not exhaustive in terms of what amounts to "diminished capacity" under Right 7(3) of the Code. For example, Canterbury District Health Board sets a lower threshold on diminished capacity under Right 7(3), stating that (para 7)

"For consent to be valid it must be voluntary, knowing or informed, and competently given. Medication, intellectual disability, mental illness, inebriation, or physical injuries all may affect the informed consent process."

Graham, some responses to a couple of your points:

1) NZMA is still a representative body that is democratically elected and accountable. Its governance board is subject to elections every two years, which is pretty frequent for any governance body. A core part of NZMA's role is tackling ethics for the profession and administering the Code of Ethics. Putting this together, if the "vast majority" of practitioners thought NZMA was out of line on such a key ethical issue, surely this would have seen some change in the composition of NZMA's governance body; even just a moderate shift in how it expressed its views on euthanasia? And yet, in the 10 years since NZMA put out its categorically anti-PAS position statement, nothing has materially changed.

2) Even if we put NZMA to this side (which I'm not), that doesn't account for the identical views of other bodies like the World Medical Association and the Australia and New Zealand Society of Palliative Medicine to name a couple. Are all of these bodies out of touch with their constituencies?

by Jude on January 22, 2016
Jude

*Andrew, sorry - the starting bit of the first sentence in para 3 of my response above should be: "I don't think those examples you cite are exhaustive...". 

by Graham Adams on January 23, 2016
Graham Adams

Jude, you might ask the same about assisted dying and the general electorate. Is it plausible to believe that an issue which gets 65-75 per cent support in polls reliably over 20 years is not reflected in the policies of the major parties who are elected every three years? It sounds preposterous, but, unfortunately, that is the case, which is why we’re having this voluntary euthanasia debate currently. I still think that if those organisations you cited (including the World Medical Association and the Australia and New Zealand Society of Palliative Medicine) polled their members and publicised the results we’d all be better informed about the level of opposition to changing the legislation. Assisted dying is not a deal-breaker for most people when it comes to voting. I wouldn’t be at all surprised if all, or some, of these bodies were out of touch with their constituencies on this topic. 

 

by Andrew Geddis on January 25, 2016
Andrew Geddis

I accept that dissenting doctors can be accommodated in a PAS regime by creating scope for opt-out (as in Oregon), but for me that doesn't do enough to address the fact that at that point Parliament would have already lowered society's ethical bar.

While for me, introducing aid in dying raises society's ethical bar as it recognises the individual as an autonomous being who is capable of making informed choices about all aspects of their lives (including how this will end). The denial of aid in dying is the ultimate form of paternalism - a demand that a person literally live/die according to others' view of what is "proper" - that cannot be justified without good reason. And I don't think the evidence is there to back up the alleged reasons for imposing that limit on choice.

But I think I've argued this enough for now. Thanks for a cordial and useful exchange of views.

by Tim Watkin on January 26, 2016
Tim Watkin

Thanks for the fascinating discussion. To raise a new point, however, I've got questions about those Oregon stats that start Matthew's post. First, Oregon is a very white state with a population around 90% white anyway... Next, I'd note that fewer than half of those who took the option were university educated (ie most weren't well-educated, contrary to the argument). It's fair to note though (despite no mention of this in the post) it does skew to those more educated, as around 30% of people in Oregon are university educated.

As for 60% having private medical insurance, well, the last time I looked something like 55-60% of Americans have private health insurance, so that hardly suggests a skew to the rich. So I'm dubious of the conclusions about who's using the law. Am I missing something Matthew?

by Charlie on January 26, 2016
Charlie

Regardless of the legal niceties, I will check out when I think the time is right. (If fate doesn't catch up with me first!)

I think the law needs to change to support AS, merely to reflect the reality of what people will do anyway.

 

 

 

 

 

by MikeKirk on February 16, 2016
MikeKirk

Assisted dying is not allowed in NZ. This means that in hospices, people expected to die within a week are made as 'comfortable' as possible, until the process of dying has finished. This is totally ludicrous. The family is forced to watch the process, during which the person is NOT pain free, as pain is not always controllable. When a person has been assessed by two Doctors as terminally ill and expected to die within 2 weeks, for the sake of argument, what objection is there to ending that person's life, with the consent of family?

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