Oregon has long been ground zero for radical, end-of-life ideology and legislation. It was the first state to legalize physician-assisted suicide (PAS) two decades ago, and since that time the practice has grown both in social acceptance and legislative momentum. Currently, more than 20 states have PAS bills on the legislative docket, and three jurisdictions have legalized the practice over the past two years. The practice itself has seen a groundswell of support in part due to well-produced documentaries, emotional anecdotes and a grassroots effort that has been overwhelmingly efficient.
Sensing a movement toward a more universal acceptance of PAS, and building on the success of the “right to die” movement, advocates are now setting their sights on the as-of-now prohibited practice of euthanasia. Not content with simply allowing doctors to write prescriptions for lethal medications, advocates are working to expand the practice of PAS to allow for euthanasia in cases where the patient is unable to self-administer the lethal medication.
To this end, legislators in Oregon have introduced Senate Bill 893, a bill that would allow for an,
expressly identified agent, pursuant to lawfully executed advance directive and in accordance with Oregon Death with Dignity Act, to collect and administer prescribed medication for the purpose of ending patient’s life in humane and dignified manner if patient ceases to be capable after having received prescription for life-ending medication.
To be clear, Oregon’s Death with Dignity Act currently requires that patients receiving a prescription for life-ending medications be able to administer the medications to themselves. This bill would, in certain situations, remove that requirement so that someone else would be able to administer the lethal medication to the patient. This would effectively legalize euthanasia in the state of Oregon.
The relevant portion of the bill, Section 3, reads as follows:
An expressly identified agent may collect medications dispensed under [Oregon’s Death with Dignity Act] and administer the medications to the patient in the manner prescribed by the attending physician if:
1. The patient lawfully executed an advance directive in the manner provided by [Oregon’s Death with Dignity Act]
2. The patient’s advance directive designates the expressly identified agent as the person who is authorized to perform the actions described in this section;
3. The patient’s advance directive includes an instruction that, if the patient ceases to be capable after medication has been prescribed pursuant to [Oregon’s Death with Dignity Act], the expressly identified agent is authorized to collect and to administer to the patient the prescribed medication;
4. The medication was prescribed pursuant to ORS [Oregon’s Death with Dignity Act; and
5. The patient ceases to be capable.
This is not a surprising development. It was only a matter of time before there would be a case in which a patient could not self-administer his or her own life-ending medications. Since the “right to die” has already been established, it would be unconstitutional to disallow someone from claiming this right based on personal ability. While it was easy to see this coming, the bill as it is currently written does leave some unanswered questions, specifically around the word “capable.”
What does it mean to say that a person ceases to be capable of self-administering life-ending medications? Ceases to be capable physically? Ceases to be capable mentally? Is capability left up to the discretion of the “expressly identified agent”? Who gets to decide whether the patient is capable or not? What happens if the “expressly identified agent” deems the patient incapable but the patient believes otherwise?
Until these questions are answered definitively and legally, this bill does an extremely poor job of protecting those who are vulnerable to abuse of it. It does not take much work to imagine an elderly patient being force-fed the medications before he or she is ready. This already happens. If the “expressly identified agent” claims that the patient was incapable and that the agent was merely acting in good faith pursuant to Oregon’s Death with Dignity Act, would anyone be able to challenge that assertion?
The notion that this law could be so easily abused should give a person chills, especially considering the already-high prevalence of elder abuse. Further, while many cringe at the very thought of the slippery slope argument, it’s clear that in places where euthanasia has been legalized for some time, an increasing number of persons are euthanized in the absence of consent. Some clarification of the word “capable” is in order here.
However, it seems doubtful that legislators in Oregon are concerned with creating unambiguous end-of-life statutes. They have also introduced Senate Bill 494, a bill that one writer calls “intentionally ambiguous” and subtly savage. This bill would, among other things, obscure the language contained within Oregon’s end-of-life statutes and open the door to increasingly sinister interpretations of those statutes. The bill takes aim at vulnerable populations, making it easier to withhold food and water and increasing the amount of leeway doctors are given to make judgment calls regarding the wellbeing of patients in their care.
The bill also allows for the creation of an Advanced Directive Rules Adoption Committee. This committee would be appointed by the governor and would be charged with the task of creating the sole advanced directive form to be used by persons within the state of Oregon. This would take the task out of the hands of elected legislators and put it into the hands of unelected bureaucrats who are accountable neither to constituents nor anyone else. This is a quick way to expand the power of government to control end-of-life decisions and to indirectly rob individuals of their input in this matter.
These two bills show the future of the euthanasia movement in the United States. While it’s no surprise that the state of Oregon is again acting as the trailblazer in pursuit of a society that universally permits the practice of euthanasia, the audacity of these two bills should serve as a wake-up call to those fighting against the devaluation of life in its end stages. For those who thought euthanasia would never rear its ugly, loathsome head in the United States, it’s here and it’s knocking on the door.
Euthanasia is a dangerous proposition for marginalized populations, for the medical field, and for society as a whole. In fighting against this dangerous proposition, it’s good to be mindful of the deleterious effects that progressive end-of-life legislation has on a society. As Wesley Smith suggests in his book Forced Exit, “…in light of the consequences that could flow from the legalization of legitimization of euthanasia, we should all think deeply about what [succumbing to] the values of the death culture would really mean for our country and for our world.”
It’s clear that those who oppose the values espoused by a death culture should be mounting a stalwart defense against this detestable practice. This defense should begin with encouraging legislators in Oregon and across the United States to reject these radical end-of-life measures. It should begin with increasing awareness of the dangers contained within the various pieces of legislation. It is only through an honest examination and discussion of these dangers that society can come to an informed understanding of the issue of euthanasia and the implications of its legalization.