1. LIBERTY FOR CONTROL: END OF LIFE ISSUES
Running head: Liberty for Control
Liberty for Control
Mary Jo Cameron
Robert Morris University
2. LIBERTY FOR CONTROL: END OF LIFE ISSUES
The Death with Dignity Act has allowed 341 people to take their lives in the state of
Oregon due to terminal illnesses (Aungst, 2008). Hospice, palliative care, and medications are
used in Illinois to deal with terminal patients to make them comfortable for their passing. But in
Oregon, the extra option of Physician-Assistant Suicide has led to a new option for control.
Physician Assisted Suicide through the Death with Dignity Act was passed fourteen years ago
after a long fight with the legal and ethical issues, and informative considerations scoped out.
On October 27, 1997, the state of Oregon enacted the Death with Dignity law to allow
terminal patients a voluntary way to end their lives through a self-administered lethal medication
(Aungst, 2008). Seventeen years ago, the state of Oregon became the one and only state to allow
Physician Assisted Suicide (PAS). Though the process wasn’t easy, terminally ill patients now
have another option for their end of life care plan. Oregon started fighting for this law in 1980
after the Supreme Court decided to “leave it to the individual states to grapple with the question
of the lawfulness of the practice” (Mathes, 2006). Oregon passed the law in 1994 due to a
different way of approach. The state decided to let the people decide what they feel is right rather
than the legislature (Mathes, 2006). This provided the society a chance to weigh the legal and
ethical points, and make their own democratic decision, leading to a 60 percent result for
enacting the law. With such a controversial law, many people thought it was unconstitutional by
providing a way out of life, unethically. The law was appealed after controversy with the
Controlled Substance Law in which states that a controlled substance can only be administered
for a legitimate medical purpose (Mathes, 2006). The court overruled the appeal because of the
situation. The history of the Death with Dignity Law goes back to the ancient times, but Oregon
made a society altering decision for the law to allow death to terminally ill patients.
3. LIBERTY FOR CONTROL: END OF LIFE ISSUES
When creating the Death with Dignity Law, they needed to have limitations so it does not
become abused. A patient has to qualify for the Law through multiple different steps. First, the
patient has to be 18 or older and also have the capacity to make an informed decision regarding
their health care. They also need to be a terminally ill patient that has a prognosis of no more
than six months. After these qualifications are met, the patient has to make an oral request to the
doctor for medication. After fifteen days, the patient is required to write a letter of intent with
two witnesses, other than the physician. When the doctor is informed that this may be an option
for this patient, he/she is obligated to discuss other options such as hospice and palliative care. In
addition, the doctor must describe the risks of the medication, and the probable result of death
(Mathes, 2006). With this medication, the patient needs to understand that the medication has to
be self-administered with no help drinking the fluid. Many specifications are listed to make sure
the medication is not being abused and the patient is readily informed of the consequences.
Cody Curtis, 54, chose to participate in the documentary, How to Die in Oregon, to show
the benefits in her life for the new option in end of life care. Cody struggled with liver cancer at a
very young age. She chose to get the legal medication through her doctor so if she ever felt like it
was time, she would have the medication. She fought every minute of the fight and lived far
beyond her prognosis. But when the cancer started to metastasize, she could barely walk,
breathe, or communicate with her family. Cody decided to go to the doctor and let her know it
was time, and her physician decided to be involved with the lethal medication administration.
Cody thought it was right for her because she wanted to leave in peace, with her family nearby.
This is the story that provokes ethical consideration for the Death with Dignity Law. The
organization, Compassion and Choices, is an organization rooted in Oregon, that helps
terminally ill patients navigate the complex legal requirements for the act (Miller, 2004). This
4. LIBERTY FOR CONTROL: END OF LIFE ISSUES
organization also supports the patients through counseling so they can make the most informed
decision. After speaking with a representative from Compassion and Choices, they told me about
how the advocates are volunteers. The volunteers become their companion until the last day,
when the advocate becomes responsible for preparing the medication. In the movie, How to Die
in Oregon, the we see the real life stories of people suffering from terminal illnesses and that’s
when we have to choose between the ethical or legal considerations that are controlling
Physician Assisted Suicide within other states.
Though the Death with Dignity Law has benefited many people in the state of Oregon,
there are other considerations that need to be thought about. In an evaluation of the law, the
concept of respect versus liberty created a controversial point of view. Doctors are mandated to
respect their career by providing treatments and care to “cure” the body of its disease. This
means that within the limitations of a doctor’s ethical stances, The Death with Dignity Law
violates their job description. Though, in our pledge of allegiance we have, “Justice and Liberty
for all.” According to the dictionary, Liberty is defined as, “The state of being free within society
from oppressive restrictions imposed by authority by ones way of life, behavior, and political
stances.” This means we as United States citizens, we should have the right to freely choose our
way of life without outside pressure (Durante, 2009). This especially is linked to political views
being imposed on the decider as a way of liberty. So, though patients can decide freely, once
they have decided, the doctor cannot help them based of the limitations. Another consideration to
be made is the fragility of terminally ill patients (Durante, 2009). If there was a box that said,
Fragile—handle with care, would it be ripped it apart? In relation to the Death with Dignity Act,
assisting in the death of a terminal ill patient is not handling them with care. With our extensive
5. LIBERTY FOR CONTROL: END OF LIFE ISSUES
hospice, palliative care, and many resources, people should be able to die without a lethal
medication killing them within minutes.
Cody Curtis was a young woman that ended her life early due to a terminal illness using
the Death with Dignity Act. The history of the act was on high radar through the ethical and legal
considerations. After a long debate in the Supreme Court, the act is now being enforced in one of
the fifty states of the United States of America. The choice laid in the hands of Oregon’s citizens
and not the government. As we all deserve liberty for our choices, some choices are meant to be
made, in the end of life care treatment plans with the Death with Dignity Act.
6. LIBERTY FOR CONTROL: END OF LIFE ISSUES
Aungst, H. (2008). 'Death with dignity'. Geriatrics, 63(12), 20-22.
Durante, C. (2009). Life, Liberty, and the Pursuit of Palliation: Re-Evaluating Ronald Lindsay's
Evaluation of the Oregon Death with Dignity Act. American Journal Of Bioethics, 9(3), 28-29.
How To Die in Oregon, Peter Ricardson, 2011.
Mathes, M. (2006). Gonzales v. Oregon and the Legitimate Purposes of Medicine: Who Gets to
Decide?. MEDSURG Nursing, 15(3), 178-181.
Miller, L. L., Harvath, T. A., Ganzini, L., Goy, E. R., Delorit, M. A., & Jackson, A. (2004).
Attitudes and experiences of Oregon hospice nurses and social workers regarding assisted
suicide. Palliative Medicine, 18(8), 685-691.