MEASURE NO. 51

ARGUMENT IN FAVOR

A MESSAGE TO THE PEOPLE OF OREGON
FROM THE OREGON MEDICAL ASSOCIATION
BALLOT MEASURE 51

In the next three months you will hear a great deal about Measure 51 which, if passed, will repeal Measure 16, Oregon's "Death With Dignity Act" which permits physician-assisted suicide for terminally ill patients.

The Oregon Medical Association (OMA) wants the voters of Oregon to know exactly where we stand on physician-assisted suicide, without interpretation by political coalitions who support or oppose Measure 51.

When the Death With Dignity Act passed in 1994, the OMA chose to stay neutral because our 5,500 physician members were narrowly divided on physician-assisted suicide, as were all Oregonians. Oregon physicians have had three years to study the law and we believe it has serious medical deficiencies that will negatively affect the care we provide to seriously ill patients.

While it is clear there continues to be a deep division of opinion on physician-assisted suicide, that won't be the issue when we vote in November.

The question is whether this law is a good one or not.

We don't think it is.

OMA urges you to vote Yes on Measure 51 in November to repeal Oregon's flawed physician-assisted suicide law.

(This information furnished by J.T. Hoggard, MD, President Elect, Oregon Medical Association.)


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ARGUMENT IN FAVOR

Oregon Association
of Hospitals and Health Systems

Position Statement on:

Ballot Measure 51

Oregon Association of Hospitals and Health Systems supports the repeal of Oregon's "Death With Dignity Act" and therefore supports a "YES" vote on ballot Measure 51. We are opposed to Oregon's Death With Dignity Act for the following reasons:

We do not believe the concept of "death with dignity" requires the use of physician-assisted
suicide as called for in Oregon's "Death With Dignity Act." We support more appropriate alternatives for terminally ill patients, including:

There are fundamental problems with the provisions of the Act including:

The Oregon Association of Hospitals and Health Systems urges voters to vote Yes on Measure 51 to repeal Oregon's flawed and unneeded physician-assisted suicide law.

(This information furnished by Ken Rutledge, Oregon Association of Hospitals and Health Systems.)


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ARGUMENT IN FAVOR

The Oregon electorate should vote on November 4, 1997 to repeal the so-called "Death with Dignity" or "doctor assisted suicide" act they previously approved in 1996 by a narrow margin. Humanitarian as well as religious grounds strongly endorse such action. Fortunately, court actions have hitherto hindered this measure from going into effect, postponing at least our state from becoming the death capital of the world, the first political entity to officially allow physicians to cross the line between curing and killing. It would be tragic, if Oregon, so famous for pioneering many things, were to gain the reputation of pioneering this disgrace! And if the electorate does not stop physician assisted suicide, who knows what methods might be enacted next?

With good reason Roman Catholics and most Protestants view suicide in any form as one of the worst possible sins, partly because it would be impossible for a perpetrator to repent of the act.

Life and death rightfully should be left in the hands of God. St. Paul declared, "In Him we live and move and have our being" (Acts 16:28). The divine decree in Ecclesiastes 8:8 thunders, "no one has power over the day of his death" (NIV).

Four different individuals in the Bible sought assisted suicides from God, namely Job, Moses, Elijah, and Jonah. They all prayed for God to kill them. God never answered such prayers, nor will he. To do so would violate his own principle that the human body is the "temple of the Holy Ghost" (I Corinthians 6:19).

The Netherlands is to date the only nation in the world where doctor assisted suicide and euthanasia widely prevails. Yet both practices remain illegal there. Usually the authorities just look the other way. But investigators lament that the practices there are really "no Dutch treat"! Cases surface where by their own initiative some physicians administer death without the decision of the patients.

Oregonians would do well to vote yes on measure 51.

(This information furnished by Raymond Cox, Th.D.)


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ARGUMENT IN FAVOR

Doctor/Patient Trust Essential

I have been a medical doctor in Oregon for most of 40 years. This great state has been good to me and my family. I am appalled at the prospect of Oregon becoming the main facilitator of an evil culture of disrespect and incivility at best, and violence and death at worst, all because of a very vocal few who have, I believe, a misguided concept of compassion.

As a physician, I was honored to attend, and not extend, the dying of many wonderful men and women. With God's help, I was never unable to help them to end their lives more easily and contentedly, mainly just through simply caring about them, being there, and meeting their medical needs.

Are we physicians now expected to ignore and deny our oath and ethical code of Hippocrates--"The regimen I adopt shall be for the benefit of my patients according to my ability and judgment, and not for their hurt or for any wrong. I will give no deadly drug to any, though it be asked of me, nor will I counsel such, and especially I will not aid a woman to procure abortion".

Can we really afford to ignore our pledge of allegiance "to one nation under God" and deny His dominion over us by again usurping His power of life and death? It continues to be our ultimate human arrogance to take what we cannot replace.

Do we really want to not be able to consistently trust our caregivers with our health and lives?

Are our individual rights more important than our responsibilities to each other and society as a whole?

Is not reverence for life from God the basis for all ethics, morality, civility, peace, and love---and disrespect for life the basis for their destruction?

Chesterton said, "Before you take down a wall, be sure you understand why it was put there in the first place". The Netherlands and the Nazi doctors are tragic examples.

I know I need not remind Oregonians that the worth of a nation (or state) is measured by how well it cares for its more vulnerable.

Please vote yes on Measure 51.

Joseph H. Eusterman, MD

(This information furnished by Joseph H. Eusterman, M.D.)


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ARGUMENT IN FAVOR

STATEMENT IN SUPPORT OF REPEAL OF THE
PHYSICIAN-ASSISTED SUICIDE LAW IN OREGON

Providence Health System is honored to serve people throughout Oregon with a wide range of physician, hospital, home care and hospice services. It is from our deep experience in caring for persons with life-threatening illness and their families that we find the following reasons to support repeal of the physician-assisted suicide law in Oregon:

  1. By legalizing the ability of physicians to hasten death through assisted suicide, the law will adversely change the nature of the physician-patient relationship. Physicians, health plans, and health systems risk the loss of patients' trust that their doctors will always provide or advocate for appropriate treatment, relief of their pain and symptoms, and facilitation of a compassionate and peaceful death.
  1. Health care providers need more time to show that pain management, hospice care, and other forms of support for dying persons do work. With recent legislation on advance directives and end-of-life treatment, advancements in pain and symptom management, and the widespread availability of hospice care, the needs of dying persons and their families can effectively be met. And more is being done: organizations across the country are working to continue improving the health system and building community-based systems of care for persons who are dying and their families. We should allow these efforts to demonstrate their ability to improve the quality of our living and dying.
  1. The law reinforces the view that dying people are an unnecessary burden. Because the law's provisions on mental health counseling and family notification are not mandatory, people diagnosed with a terminal illness may request suicide in the absence of other needed support. This law will reinforce the view that dying people are an undue burden to society, and provide a legitimate way of turning away from people during this critical period of their lives.

Please vote YES on Ballot Measure 51.

(This information furnished by John P. Lee, Providence Health System.)


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ARGUMENT IN FAVOR

OHSU Medical Students Support Measure 51

Under Measure 16 the consistent ethics to which our profession has ascribed for the past 2400 years are in danger of being discarded. These include the promises to "First do no harm" and "I will not give a deadly drug to anyone even if asked for it."

As future physicians, we see serious flaws in Measure 16. We know that doctors cannot accurately predict an individual's quality and quantity of remaining life. None of us will be able to accurately diagnose a 6-month life expectancy by the time our training is completed.

Two groups in the medical profession most ardently opposed to physician-assisted suicide are hospice workers and advocates for persons with disabilities. Their opposition sends us the message that the easy way to treat suffering is not the best way. These professionals understand that we need training in palliative care and advances in pain management and not in how to write prescriptions for lethal medications. We do not have to end life in order to end suffering. Quality end-of-life care must continue to be a fundamental part of our medical education.

Traditionally, doctors have been taught to view a suicidal tendency as a call for help. We maintain that the appropriate treatment for a person seeking an end to life is to employ methods that eliminate the reason for the despair rather than the person in despair.

We are training to save lives, not terminate them. We urge the people of Oregon to keep compassion in medicine by repealing Measure 16 today.

Nicole Alexander Heather Marshall
Eric Anderson Stephen Morgan
Jonathan Anderson Lawrence Neville
Peter Bessas James Obester Jr.
Anatoly Brodsky Sara Philip
Michael Dixon Sean Ponce
Jeff Douglass Karie Praszek
James French Kerry Rasmussen
Erik Gilbert Krysta Schlis
Thomas Gilberts Daniel Toweill
Amy Grimsrud Christopher Zoolkoski
Andrea Grout

(This information furnished by Christopher Zoolkoski & Peter Bessas, OHSU Medical Students for Measure 51.)


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ARGUMENT IN FAVOR

The effort to repeal Oregon's Measure 16, is not as much about assisted suicide as it is about a flawed law - a fatally flawed law. That is why doctors, nurses, hospice workers - people across the state of Oregon - support Measure 51.

PRESIDENT BILL CLINTON
"I believe it (assisted suicide) is wrong and I have always believed it to be wrong. The risks and consequences of physician-assisted are simply too great." (Official Statement 6/26/97)

"The Oregon Hospice Association is concerned that Oregon's assisted suicide law is not a good law, regardless of what an individual's position may be on physician-assisted suicide. But we are most concerned that Oregonians do not vote to keep Oregon's assisted suicide law because they believe their only choice is to suffer."
ANN JACKSON, OREGON HOSPICE ASSOCIATION

SENATOR MARK O. HATFIELD
"During the 46 years I was honored to represent Oregonians in public office, I confronted many difficult and complex issues. I found that the greatest challenge was to stand firm when confronted with flawed solutions to very real human problems, and to reject the tempting, but simplistic answer. Though now retired from office, I still feel a great sense of commitment to stay true to this conviction. That is why I am asking you to join me in supporting Measure 51."

"AS ONE OF THE STATE'S LARGEST ADVOCACY GROUPS FOR SENIORS, WE ARE DEEPLY CONCERNED ABOUT OREGON'S ASSISTED SUICIDE LAW, AND THE THREAT THIS DANGEROUS LAW POSES TO OREGON'S SENIORS. THAT IS WHY THE OREGON STATE COUNCIL OF SENIOR CITIZENS ENDORSES THE PASSAGE OF MEASURE 51."
OREGON STATE COUNCIL OF SENIOR CITIZENS

If we are going to repeal Oregon's fatally flawed assisted suicide law, we cannot make this stand alone. It will take all of us. Please vote yes on Measure 51.

(This information furnished by Trish Conrad, Yes on 51 Committee.)


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ARGUMENT IN FAVOR

Most people know of someone diagnosed with a life-threatening illness, such as cancer, who overcame the odds and lived. As amazing as it may seem, this happens frequently. If a doctor did, by some chance, make a mistake and a patient really wasn't terminal, wouldn't that be a cause for celebration? Not with Oregon's seriously flawed assisted suicide law. Under this poorly written law, the misdiagnosed patient may die anyway.

The law allows physicians, who are quite capable of making mistakes, to write prescriptions for lethal pills to end the lives of patients diagnosed with less than six months to live. And the prescription could actually be requested over the telephone, not in person. The physician does not even need to be present at the time of the suicide attempt.

The fact is that 50% of Oregon's doctors say they cannot accurately predict when someone will die. According to an editorial by two prominent pathologists, autopsies show pre-death diagnoses were wrong in 10-15% of all hospital cases where deaths occur.

No matter how well intentioned doctors may be, and no matter how authoritative their research and tests may appear, they can, and do, make mistakes. Oregon's assisted suicide law will turn these mistakes into deaths for patients who might otherwise have survived their illnesses and gone on to live healthy, happy and productive lives. This is a risk I am not willing to take.

No wonder the Oregon Medical Association recently declared that it "...urges you to vote Yes on Measure 51 in November to repeal Oregon's flawed physician-assisted suicide law." (Oregonian, 8/17/97). Please join them, and me, in voting YES ON MEASURE 51!

Benneth Husted, M.D.

(This information furnished by Benneth Husted, DO.)


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ARGUMENT IN FAVOR

A PERSONAL MESSAGE FROM SENATOR MARK O. HATFIELD

During the 46 years I was honored to represent Oregonians in public office, I confronted many difficult and complex issues. I found that the greatest challenge was to stand firm when confronted with flawed solutions to very real human problems, and to reject the tempting, but simplistic answer. Though now retired from office, I still feel a great sense of commitment to stay true to this conviction. That is why I am asking you to join me in supporting Measure 51.

When the American Medical Association addressed Congress last year, they stressed the need to more aptly and compassionately care for the terminally ill. "The movement for legally sanctioning physician-assisted suicide is a sign of society's failure to address the complex issues raised at the end of life....Our response should be a better informed medical profession and public, working together to preserve fundamental human values at the end of life."1 I could not agree more.

After careful consideration, I have found that the numerous flaws in Oregon's assisted suicide law outweigh any potential relief for our terminally ill.

While you may even support the concept of assisted suicide, I am sure you would not want a dangerously flawed law. Oregon deserves better.

Please join me. Vote yes on Measure 51.


1 AMA Statement, House Judiciary Subcommittee, 4/29/96.

(This information furnished by Trish Conrad, Yes on 51 Committee.)


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ARGUMENT IN FAVOR

An important message from the Oregon State Council of Senior Citizens

As one of this state's largest advocacy groups for seniors, we are deeply concerned about Oregon's assisted suicide law, and the threat this dangerous law poses to the well being of Oregon's seniors. That is why the Oregon State Council of Senior Citizens endorses the passage Measure 51.

Senior citizens coping with their own terminal illness should not have to face this traumatic situation alone. Certainly, no senior citizen should have to make the decision of ending their own life without the support of loved ones. But, this law does not require family notification of the decision to commit assisted suicide. A senior citizen could take their own life in complete isolation, and in terrible fear. Not even the patient's physician need be present.

This law also victimizes seniors suffering from the emotional devastation that often accompanies a diagnosis of terminal illness. Without a requirement for mental health counseling, or a waiting period that allows sufficient time to make an emotional adjustment to the diagnosis, a patient could resort to assisted suicide without truly considering or comprehending the consequences of this very final decision.

Under this assisted suicide law, the "right to die" could become the "duty to die" for many of Oregon's seniors. Rising health care costs coupled with dwindling resources could pressure seniors to end their lives rather than become an economic burden on their family. It would be tragic if money became the controlling factor in a senior's decision to end their life, but this could certainly be the case if we retain this fatally flawed assisted suicide law.

Oregon's assisted suicide law targets some of the most vulnerable people in our society. That is why the Oregon State Council of Senior Citizens urges you to join them in repealing this dangerously flawed law ­ VOTE YES ON MEASURE 51!

(This information furnished by James A. Davis, D.Ed., Oregon State Council of Senior Citizens.)


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ARGUMENT IN FAVOR

ASSISTED SUICIDE LAW LACKS SAFEGUARDS

There is no more final decision than a terminally ill person choosing assisted suicide. It is a serious decision that cannot be taken lightly. Any law that permits assisted suicide must include safeguards that ensure this decision is not made recklessly.

Unfortunately, Oregon's assisted suicide law does not. The current law lacks adequate safeguards.

There is no requirement for mental health counseling. The decision to refer a patient for consultation is solely at the doctor's discretion, who often lacks the training necessary to detect depression or mental illness. Under this law, a patient diagnosed with terminal illness could suffer depression and choose suicide without truly considering the consequences of such a drastic step.

The waiting period is too short. Fifteen days does not give a person receiving the emotionally devastating diagnosis of terminal illness sufficient time to mentally adjust and consider the options clearly. This recovery could take up to five weeks.

There is no real residency requirement. Since "resident of Oregon" is not specifically defined, people from out-of-state, like California or Washington, could come to Oregon just to commit suicide. This would make Oregon the "death capital" of the nation and taxpayer money might be needed for the burial of the victims.

It lacks strong reporting requirements. There is no enforceable mandate for doctors to report their assisted suicides and doctors are not allowed to indicate assisted suicides on death certificates. Only a "sample" of records needs to be reviewed by the proper authorities and these records are barred from public examination. Tracking abuses under the current law will be nearly impossible. If the death is an assisted suicide, why not record it as death by assisted suicide?

As a hospice nurse, I believe the terminally ill, and all Oregonians, deserve an assisted suicide law that includes adequate protections. This law does not. It should be repealed. Please vote Yes on Measure 51!

David A. Abbott, R.N.

(This information furnished by David A. Abbott R.N.)


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ARGUMENT IN FAVOR

Oregon Pharmacist Opposes Assisted Suicide Law

As a licensed pharmacist in the state of Oregon, I must speak up concerning this vague and badly-written assisted suicide law which changes the role of all pharmacists dramatically.

For many years the pharmacy profession has been regarded as highly respected by all, because your life, health and well-being has been highly respected by your pharmacist.

Unlike the physicians, the pharmacists may not have the use of the "freedom of conscience" clause, which would permit them to refuse to participate in assisted suicides. The law provides no specific legal protections for the pharmacist when a prescription for a lethal drug is filled.

There could be an enormous increase in malpractice suits in the state, as a result of this badly-written law. There is a 25% possibility that the patient will live after swallowing the prescribed pills, perhaps suffering a painful reaction to the drugs and possibly being worse off than before.

This lack of legal protection means pharmacists could find themselves hard-pressed to obtain malpractice coverage if they dispense lethal drugs.

Oregon's assisted suicide law threatens the integrity of my profession, and endangers my ability to perform my work. Please vote to repeal it by voting Yes on 51.

John Gabaldon R. Ph.

(This information furnished by John Gabaldon R. Ph.)


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ARGUMENT IN FAVOR

OREGON PHYSICIANS FAVOR MEASURE 51

In 1994, many physicians in Oregon were unaware of significant issues and risks associated with Measure 16. In the three years since the narrow passage of Measure 16, physicians in Oregon have seriously studied, evaluated and are now responding to Measure 16.

The more we have learned, the more we realize the significant harm and danger of Measure 16. It will be harmful to patients and to physicians. Measure 16 represents a reversal from the proper role of physician as healer, comforter, consoler; to an improper role of helping patients commit suicide, where physicians provide the means and the instructions. Physician-assisted suicide is really "physician-directed suicide" because it uses the physician's prescription, which is a written "order or direction" to the patient. How can physicians now order and direct the death of patients?

We should not be misled by the faulty evidence and reasoning that has been used to promote Measure 16. Physicians must use and continue to improve their knowledge and skills in order to comfort and care for patients, not to encourage and assist in their death. We do not want to learn how to kill patients. Those of us who are teaching physicians do not want to teach medical students, interns, or residents how to perform physician-assisted suicide.

Measure 16 will have a devastating effect on the practice of medicine in Oregon. It will have a devastating effect on patients and their ability to trust their physicians.

The Oregon Medical Association has carefully and thoroughly evaluated Measure 16, and overwhelmingly "opposes Measure 16 as seriously flawed". (Oregonian, August 17, 1997)

It is critical for Oregonians to reject Measure 16 by voting Yes on Measure 51.

Lynne Bissonnette MD PhD
Richard L. DeKlotz MD
John W. Kendall MD
Naima S. Panow MD
William M. Petty MD
Thomas M. Pitre MD
Donald Schroeder MD
William L. Toffler MD
Fran Yuhas MD

(This information furnished by W. L. Toffler, MD.)


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ARGUMENT IN FAVOR

'Right to Die' Becomes 'Duty to Die'

Doctors serve the sick by curing disease when possible and/or providing 'comfort care' to relieve suffering. In Holland for two decades, laws have allowed doctors to kill informed and rational terminally-ill patients at their request, using pills (assisted suicide) and/or lethal injection (euthanasia). Oregon's Measure 16 identifies such a patient group.

Despite written safeguards (stronger than those in Measure 16), Dutch doctors have expanded assisted suicide and euthanasia to include other patients. At least 21-30% of all patients receiving assisted suicide or euthanasia are killed without their consent, often as a convenience for doctors and/or families. Consequently, Dutch comfort care is underdeveloped. Many patients there must choose to be killed to get pain relief.

Holland provides free health care for all its people, so money issues do not impact their patients, families and doctors. By contrast, American health care is heavily money-driven. Many patients have no insurance, being poor or have become poor paying for expensive health care. Many others are treated under capitation payment systems imposed by medical and government bureaucracies, having doctors pay for their patient's care. Doctors, CEOs and stockholders thus profit from earlier deaths of 'expensive' patients. Patients often feel guilty for being a burden to their families. For them, the 'right to die' becomes the 'duty to die'.

WJ Smith put it bluntly in 'Forced Exit: The Slippery Slope from Assisted Suicide to Legalized Murder ', 1997, page 14: "The day doctors are legally allowed to kill patients, Wall Street investors in for-profit HMOs will be dancing in the streets." We must restructure our health care system and improve pain management, not do the easiest and cheapest thing by killing patients.

Please vote YES on Measure 51 to prevent implementation of Measure 16.

Miles Edwards, M.D.
Lung Specialist (retired),
Portland.
Rob Boone, M.D.
Cancer Specialist,
Bend.
James Chesnutt, M.D.
Family Practice,
Portland

(This information furnished by Miles J. Edwards, M.D.)


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ARGUMENT IN FAVOR

Deceit is no basis for sound public policy in Oregon or anywhere else. Yet, deceit was used to mislead voters into supporting Oregon's assisted suicide law in 1994.

A chief spokeswoman for assisted suicide appeared in television commercials telling Oregonians how her dying daughter had slipped away peacefully after taking a lethal dose of pills. However, that was not the whole story.

In reality, her mother later admitted what the pills caused was so gruesome, her son was tempted to suffocate the girl with a pillow. "In the end, Rosen, a registered nurse, said she 'hit a vein,' suggesting she had to use an injection to end her daughter's life." (Mark O'Keefe, Oregonian 6/29/97).

The voters were not told that the key flaw in Oregon's assisted suicide law was clearly represented in that case ­ pills don't work. They have a failure rate as high as 25%, a figure admitted to by one of assisted suicide's strongest supporters, "right to die" advocate and Hemlock Society President, Derek Humphrey.

In addition to this potential for failure, the law's lethal pills can have dreadful, unintended side effects. After swallowing the suggested dose of 60-100 pills, many people suffer vomiting, convulsions and brain damage. Victims may suffer in agony for days.

Since this fatally flawed law does not allow for lethal injection to end the drug-induced trauma, the ghastly option of suffocating the suffering patient by placing a plastic bag over their head may be the only other available option to "complete" this clearly less than dignified suicide.

Had Oregonians been told in 1994 that the assisted suicide law's sole method (lethal pills) was ineffective and unreliable, leaving only suffocation as a sure way to "finish the job," would they still have voted the same way?

Now that we know the rest of the story, I urge you to repeal Oregon's fatally flawed assisted suicide law.

VOTE YES ON MEASURE 51!

Dr. N. Gregory Hamilton

(This information furnished by Dr. N. Gregory Hamilton.)


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ARGUMENT IN FAVOR

MEASURE 16 DESTROYS TRUST BETWEEN PATIENT AND PHYSICIAN

In addition to 30 years experience as a physician treating over 8000 cancer patients in Oregon, I have personal experience regarding the harmful effects of physician-assisted suicide on trust in the relationship between patient and physician.

We had been married for 18 years and had 6 children. For three years my wife had been suffering from advancing malignant lymphoma. It had spread from the lymph nodes to her brain, to her spinal cord and to her bones. She had received extensive chemotherapy and radiation treatments. She required considerable pain medication, antidepressants and other supportive measures. In late May, 1982, we met again with her physician to review what more could be done. It was obvious that there was no further treatment which would halt the cancer's progressive nature.

As we were about to leave his office, her physician said, "Well, I could write a prescription for an 'extra large' amount of pain medication for you." He did not say it was for her to hasten her death, but she and I both felt his intended message. We knew that was the intent of his words. We declined the prescription.

As I helped her to our car, she said, "He wants me to kill myself." She and I were devastated. How could her trusted physician subtly suggest to her that she take her own life with lethal drugs? We had felt much discouragement during the prior three years, but not the deep despair that we felt at that time when her physician, her trusted physician, subtly suggested that suicide should be considered. His subtle message to her was, "Your life is no longer of value, you are better off dead."

Six days later she died peacefully, naturally, with dignity and at ease in her bed, without the suggested lethal drugs.

MEASURE 16 DESTROYS TRUST BETWEEN PATIENT AND PHYSICIAN

VOTE YES ON 51

Kenneth R. Stevens, Jr., M.D.

(This information furnished by Kenneth R. Stevens, Jr., MD.)


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ARGUMENT IN FAVOR

"The OMA specifically opposes Oregon's Death With Dignity Act as seriously flawed." (Oregonian, 8/17/97). In doing so, they have joined physicians across the nation calling for the repeal Oregon's dangerously flawed assisted suicide law.

While many of these flaws are evident to even the most casual observer, my overriding concern is the way this law compromises the integrity of the medical profession, and my ability to treat patients in a humane and dignified fashion.

As a physician who treats cancer patients on a daily basis, I understand the need for uncompromising care at the end of life. Oregon's assisted suicide law does nothing to address that need.

The OMA is right to call for the repeal of Oregon's flawed assisted suicide law. Any physician committed to compassionate care of the dying will agree.

VOTE YES ON MEASURE 51!

Dr. Gary L. Lee
Oncology Associates of Oregon

(This information furnished by Gary L. Lee, M.D.)


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ARGUMENT IN FAVOR

Undignified Death After Suicide Attempt

In my earlier career as an ICU physician, I saw many people die. The case that stands out to me as the most tragic was that of a young man in his early 20s who had attempted suicide (after break-up with his girl friend). The evening before I first met him, he had swallowed over 60 Seconal tablets (the same medication and dose recommended by proponents of assisted suicide). He then became unconscious and then vomited his full stomach contents into his lungs (a common consequence of this scenario).

By the time he arrived in our ICU, he was regaining consciousness (the Seconal 'wearing off') and was coughing up much very smelly sputum (like that of a watery diarrhea). We diagnosed this condition as aspiration pneumonia with 'putrid' lung abscesses. The bacterial organisms causing such a pneumonia are bowel bacteria similar to those in diarrhea. I performed a bronchoscopy and observed very burned appearing, inflamed airway membranes with copious foul brownish fluid coming from extensive areas of the lungs.

This young man suffered not only the physical discomfort of tasting this putrid sputum but was very embarrassed by realizing he smelled so bad to others. The room reeked with the smell. He greatly regretted his suicide attempt and wanted to live. Unfortunately, despite our giving him massive doses of antibiotics, he died of this pneumonia two days later. It stands out as the most undignified death I ever witnessed in 35 years of medical practice.

The Dutch experience tells us that about 20-25% of assisted suicide attempts 'fail', patients don't die immediately as planned. One of the leading complications of this approach is aspiration pneumonia as with this unfortunate young man, a scenario which will be particularly likely in already nauseated cancer patients.

Please vote YES on Measure 51 to prevent implementation of Measure 16.

(This information furnished by Miles J. Edwards, M.D.)


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ARGUMENT IN FAVOR

ORAL MEDICATIONS DON'T WORK

People attempting suicide with medications fail to kill themselves from 20% to 88% of the time. The only method of suicide specified in Measure 16 is by ingestion, which means taking medicine by mouth.

The most effective medicines to cause death are the old fashioned sleeping pills, the barbiturates. They are bitter and cause nausea and vomiting. They must be swallowed rapidly and kept down in large amounts to cause death.

Most terminally ill people have difficulty eating rapidly or keeping food and medicines down. Cancer patients lose their appetites and vomit easily. Patients with heart failure or pulmonary failure have difficulty breathing and so eat slowly. People with neurological disorders often eat slowly.

So the target population for physician assisted suicide, the terminally ill, will not be able to commit suicide under Measure 16.

MEASURE 16 IS NOT DEATH WITH DIGNITY. VOTE YES ON MEASURE 51 TO REPEAL MEASURE 16.

William M. Petty, M.D.,
Gynecologic Oncology

(This information furnished by William M. Petty, MD, Oncologist.)


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ARGUMENT IN FAVOR

WHY WE PHYSICIANS FAVOR MEASURE 51

Measure 16 is Harmful to Patients.

Measure 16 is Harmful to Physicians

Measure 16 is Harmful to Society

As caring physicians we urge your support for Measure 51 and the repeal of Measure 16.

VOTE YES ON MEASURE 51

Gerald B. Ahmann MD Leon Harrington MD
Joseph P. Amato MD Mark O'Hollaren MD
William M. Bennett MD Donald Orwick MD
William E. Connor MD William M. Petty MD
Pam Edwards MD Jana M. Reddoch MD
Jerry Flaming MD Neal Rendleman MD
Milton D. Hyman MD Paul C. Tseng MD
Selma Hyman MD Thomas Van Veen MD
John W. Kendall MD Earl Van Volkinburg MD
Laura A. Miller MD

This information furnished by William M. Petty, MD, Oncologist.)


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ARGUMENT IN FAVOR

MEASURE 16 DISCOUNTS THE DISABLED

Being disabled, I know the discrimination and abuse that is directed toward anyone in our society perceived as "different" or outside the mainstream. Many challenge the contributions that disabled people make to our society, considering them "burdens," or as not making positive contributions.

This image is slowly changing. Recent years have seen progress in recognizing the rights of the disabled. Passage of the landmark Americans with Disabilities Act (ADA) in 1990 is a prime example.

However, I, and many other disabled people, fear that Oregon's dangerously flawed assisted suicide law will reverse this progress and be a step backward to the days when the disabled were seen as "expendable."

This faulty law discriminates against those disabled by terminal illness, withholding from them the same protections from premature termination of life that others enjoy. This law deems the life of a person suffering a terminal illness less worthy of the state's protection than the life of a healthy, able-bodied person.

Oregon's law poses additional dangers to the disabled. By defining "terminal illness" vaguely, countless disabling conditions could qualify as "terminal." A new spinal cord injury is one example. The law allows individuals with certain disabilities to die within fifteen days of the first request, before gaining access to available therapies and rehabilitation.

Members of vulnerable groups are destined to become the chief victims of assisted suicide. A disabled person could see the "right to die" become the "duty to die," as subtle pressure for assisted suicide surfaces due to financial considerations, fears of being a burden on the family or a lack of independent living opportunities.

Let's not reverse the progress society has made in recognizing and responding to the rights and needs of the disabled. Please vote Yes on Measure 51.

Ellie Jenny
Founder, Not Dead Yet - Oregon

(This information furnished by Ellie Jenny, Not Dead Yet.)


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ARGUMENT IN FAVOR

Statement of Endorsement

Measure 51

We stand united in opposition to any legislation promoting assisted suicide.

Optimal management of end-of-life issues can be achieved.

We urge all voters to understand the distinction between active termination and compassionate treatment.

Barbara A. Zavanelli-Morgan, MD
Endocrinologist

Stuart Morgan, MD
Internist

(This information furnished by Barbara A. Zavanelli-Morgan, MD.)


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ARGUMENT IN FAVOR

MEASURE 16 SUPPORTERS OPEN DOOR TO DEATH MACHINES

In 1994, Measure 16 supporters told the citizens of Oregon that Measure 16 was for lethal drugs to be swallowed by the patients. Yet, one of the many flaws in Measure 16 is that pills cannot always be swallowed and don't always work.

The supporters of Measure 16 told us in 1994 and told the legislature in 1997 that Measure 16 did not permit Kervorkian-style suicide machines.

Now they say the opposite!

In the Oregon Health Law Manual, published in August, 1997, Coombs Lee, Stutsman and Hagan write that the "route of administration" of lethal drugs "is also discretionary". They now suggest that Kervorkian-style inhalation of lethal gas and intravenous infusions (allowing lethal drugs to flow through IV tubing by gravity) "may be used" by the patient, depending on judicial interpretation.

This is not what the voters of Oregon understood in 1994.

Have the voters of Oregon been tricked into legalizing being gassed, having lethal drugs flowing into their IV tubing and calling it something other than lethal injection or death machines?

Measure 16 supporters have said that no one wanted "infusion pumps" or Kervorkian-style death-machines. Yet they now say that those same devices may be permitted under the scope of Measure 16.

VOTE YES ON MEASURE 51

REPEAL MEASURE 16

Robert W. DuPriest MD
N. Gregory Hamilton MD
Mark A. Kallgren MD
Mark A. Kummer MD
R. Eugene Lienert MD
Leonard W. Ritzmann MD
Kenneth R. Stevens MD
William L. Toffler MD

(This information furnished by N. Gregory Hamilton, MD.)


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ARGUMENT IN FAVOR

MEASURE 16 IS "FATALLY FLAWED"
VOTE YES ON 51 FOR ITS REPEAL

Recently, the Oregon Medical Association publicly urged a YES vote on Measure 51 to repeal Oregon's assisted suicide law. The physicians of Oregon noted that Measure 16 is "fatally flawed" and should be repealed. What is meant by the term "fatally flawed"?

The answer resides in the drugs that would be used. In particular, physician assisted suicide relies on the use of alcohol and an old-fashioned class of drugs called barbiturates, both drugs administered orally, rather than injected into a vein. Administered orally, alcohol and barbiturates merely induce a deep sleep. They do not stop the heart and only rarely do they stop breathing. However, they can cause a lack of oxygen sufficient to cause permanent and irreversible brain damage. To "complete" the suicide, one places a pillow or plastic bag over the victim's head and waits for the person to die by suffocation.

To effectively cause death, euthanasia must utilize injected drugs that stop the heart and stop breathing (for example, intravenous potassium chloride and curare). In such instance, death invariably follows (as in lethal injections for criminal executions). Potassium and curare, however, must be given by injection (they are not effective when taken by mouth) and the victim must be watched by a physician and family until he/she is dead. Is this what Oregon voters really want? I think not!

The evidence is clear that orally administered alcohol and barbiturates are ineffective, and that lethal injection is the only reliable method to bring about death. Proposition 16, however, appears to forbid such action. Measure 16 may be a first step (approval of a "fatally flawed," ineffective method) as a prelude to euthanasia by lethal injection.

Please vote YES on Measure 51 to repeal Oregon's fatally flawed physician-assisted suicide law and stop the move towards euthanasia by lethal injection.

Robert M. Julien, M.D., Ph.D.
Physician, author and pharmacologist
Portland, Oregon

(This information furnished by Robert M. Julien, M.D., Ph.D., Physician, author, and pharmacologist.)


(This space purchased for $300 in accordance with ORS 251.255)

The printing of this argument does not constitute and endorsement by the State of Oregon, nor does the state warrant the accuracy or truth of any statement made in the argument.

ARGUMENT IN FAVOR

PATIENTS IN PAIN FEAR MEASURE 16

One of the chief arguments used to justify Measure 16, is that it would provide and "out" for
terminally-ill individuals having pain.

Yet, cancer patients with pain regard physician-assisted suicide (Measure 16) as a threat to their receiving proper medical care.

The public, and even some physicians, are not aware of the new information regarding the fear of physician-assisted suicide and euthanasia by cancer patients and by AIDS patients with experience with pain.

Medical research has shown the following:

References:

PROTECT PATIENTS WITH PAIN
PROTECT THE VULNERABLE ELDERLY
VOTE YES ON MEASURE 51

Ward Buckingham MD
Thomas Comerford MD
Carl Jenson MD
Kenneth Stevens MD
John Vetto MD

(This information furnished by Kenneth R. Stevens, Jr., MD.)


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The printing of this argument does not constitute and endorsement by the State of Oregon, nor does the state warrant the accuracy or truth of any statement made in the argument.

ARGUMENT IN FAVOR

Measure 16 poses a striking danger to residents of Oregon and its quality of life. As residents of Eastern Oregon we are alarmed by the following serious concerns:

Oregon voters were misled by pro-Measure 16 forces in 1994. The most glaring example was the chief spokesperson for the Measure 16 media campaign claiming that her daughter had "slipped peacefully away" after she was given lethal pills. She now admits the pills didn't work so she gave her daughter a lethal injection. (Oregonian 11-4-94)

Up to 100 pills must be taken, often causing difficulties leading to an agonizing lengthy death.

Measure 16 doesn't require counseling nor family notification before a loved one is put to death.

Measure 16 doesn't define who is a resident of Oregon. Quite likely people will flock to Oregon from other states to commit suicide, leaving Oregonians to pay for the burial of the bodies. There is no provision for anyone to verify the patient's actual place of residence. Oregon should be known as a great place to live, not a great place to die!

Measure 16 goes against medical traditions of western civilization. It is a violation of the Hippocratic Oath, "I will give no deadly medicine to any if asked, nor suggest any such counsel." The OMA recently declared that they urge Oregonians to vote yes for the repeal of "Oregon's flawed physician-assisted suicide law." (Oregonian 8-17-97)

Presently suicide is one of the leading causes of death among teenagers. We fear Measure 16 will accelerate this trend by giving youth the message that society wholeheartedly supports
suicide!

This summer in a rare unanimous decision the United States Supreme Court justices were of one mind that there is no constitutional "right to die". (Oregonian 8-7-97)

A fully informed Oregon electorate has the opportunity to repeal this seriously flawed assisted-suicide law.

VOTE YES ON MEASURE 51.

(This information furnished by David Lodzinski, Friends of Malheur and Harney Counties.)


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Measure 51

Explanatory Statement

Legislative Argument

Arguments in Opposition

Online Voters' Guide Contents Page