Who decides? Physician Assisted Suicide

Woodmonkey · 10-05-2005, 14:19

I see two discussions here. The first one revolves around whether or not the state (to include the feds) should be involved in end-of-life decisions in any manner. As for the second discussion, is this a state issue or a federal issue?

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High court takes up physician-assisted suicide

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At issue: Federal authority to enforce drug laws versus the power of the states to regulate medicine.

Oregon is the only state in the nation where an individual diagnosed as terminally ill can ask a physician to prescribe a lethal dose of drugs.

Supporters of the law call the process physician-assisted death. Opponents, including former Attorney General John Ashcroft, view it as state- sanctioned killing, and say it is incompatible with a physician's role as healer.

Wednesday, after four years of litigation, the issue arrives at the US Supreme Court where the justices must decide whether Mr. Ashcroft's efforts to undermine the Oregon law were a valid exercise of federal power.

At issue is a clash between the power of the federal government to reinterpret and enforce the nation's drug laws versus the power of the states to regulate the practice of medicine in ways supported by elected state officials and twice approved by Oregon voters.

"This is a case of who gets to choose what the policy is, the federal government or the states," says Kevin Neely, spokesman for the Oregon attorney general's office, which is defending the Oregon law. "Our history has put this power squarely in the hands of the states, and that's where it should be."

The Bush administration's solicitor general, Paul Clement, disagrees. He says the issue is who decides the scope of the federal drug laws, the attorney general, seeking to enforce a uniform national standard, or each of the 50 states with 50 different views on the subject.

The dispute began in 2001 when then Attorney General Ashcroft marshaled the full force of the federal government to undercut the Oregon law. He did it by rewriting regulations to make it a crime for any doctor to prescribe federally- controlled drugs for the purpose of ending a life.

Reversal from Clinton years

In rewriting the regulations, Ashcroft reversed an earlier legal determination by the Justice Department under Attorney General Janet Reno. Ms. Reno concluded that the Oregon law did not clash with federal drug laws.

In contrast, Ashcroft concluded that "the act's clearly stated purpose is to enhance and maintain life, not end it," according to the government's brief. This conclusion is entitled to the respect and deference of judges who should not second-guess the policy decisions of federal officials, Mr. Clement says.

Oregon countered by filing suit in federal court charging that Ashcroft was abusing his power as attorney general at the expense of the sovereign authority of the state. Oregon won - twice.

The case which began as Oregon v. Ashcroft has since become Gonzales v. Oregon, adopting the name of the new attorney general, Alberto Gonzales.

Some supporters of Ashcroft's position see the case as an opportunity for the high court to address the right to life. Matthew Staver, of the Florida-based group Liberty Counsel, says that by relying on federally-controlled drugs to carry out physician-assisted suicides Oregon is forcing the federal government to participate in ending a person's life.

"When a state undertakes efforts to undermine the right to life I think the federal government has the right to assert the preference for life," Mr. Staver says.

Supporters of the Oregon law say the central issue in the case is the balance of federal-state power. Federalism and states' rights is usually a priority of conservatives. The practice of medicine has traditionally been an area of state control.

But in this case the Bush administration is pushing to nationalize medical regulations at the expense of state regulations, they say.

An intrusion?

Such intrusion into state authority should not be permitted unless Congress made clear at the time it wrote the federal drug laws that state regulations would be preempted, supporters say.

"It is painfully ironic that such a conservative administration and conservative attorney general would be using an agency rule to dramatically expand the power of the [federal government] over the states," says Eli Stutsman, a Portland appellate lawyer who represents two Oregon physicians in the case.

Mr. Stutsman says the attorney general's job under the federal Controlled Substances Act has always been to battle drug trafficking, not to rewrite the law to undermine the lawful practice of medicine under state regulations. He says Ashcroft changed the law to reflect his own personal policy preferences rather than remaining faithful to the drug laws as written by Congress.

"He is not the FDA [Food and Drug Administration], he is the DEA [Drug Enforcement Administration], and his law enforcement role doesn't allow him to regulate medicine," Stutsman says.

Supporters of Ashcroft's approach say such efforts are important to prevent opening a Pandora's box of end-of-life issues. "Once you open the medical industry up to saying we are going to use medical ways of making people die, there is no way to stop that," says Mailee Smith of the Chicago-based group, Americans United for Life. "What the Oregon law says to people is that their life isn't worth anything once they get past a degree of illness," she adds.

Stutsman has a different perspective.

"There is nothing more thoughtful and profound than having the conversation that the Oregon Death With Dignity Act brings up," he says. "It is not anything that is done quickly, cheaply, or without thought. It is just the opposite."

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Why Oregon is at the forefront of change on end-of-life care

Woodmonkey · 10-06-2005, 00:22

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Who Chooses Physician-Assisted Suicide?

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PORTLAND, Ore. — Since 1997, more than 230 terminally ill Oregonians have ended their lives with lethal but legally prescribed doses of medication. The rate of "assisted suicides" has risen since the Oregon Death With Dignity Act (search) went into effect, hitting a high of 42 in 2003.

A common argument against legal assisted suicide has been that the poor, black, or uneducated would be more vulnerable to abuse. But in Oregon, those who have opted for it have tended to be college educated, white, single and suffering from cancer, AIDS or Lou Gehrig's disease.

Most have reported the reason they chose to commit suicide was out of fear they would eventually be unable to care for themselves, rather than out of fear of pain or becoming a financial burden to their families.

Click in the video box to the above right to view a report by FOX News' Dan Springer.

According to health department reports, most patients died within a few hours of taking a lethal amount of barbiturates.

But last year, there were three reported incidence of complications. The patients vomited after taking the pills, and while they all eventually died, one took 31 hours to do so.

This year, Oregon saw its first reported case of failure. Lung-cancer patient David Prueitt went into a coma that lasted for three days. After he woke up, he lived for two more weeks. The ordeal reinforced his brother's opposition to assisted suicide.

"It just seems like we are dabbling in an area that is really not ours. We are taking control in an area that ... God gives life, he's also the taker of it," said brother Steve Prueitt.

But one cancer patient said that knowing that a physician-supervised suicide is an option has given her great peace.

"All I want is the option. The amount of peace I have had, knowing from the beginning when I was given my diagnosis, that this option was available to me is beyond describing," said Lovell Svart.

Oregon voters have largely agreed that Svart and others like her ought to be given a choice. Sixty-one percent of voters backed the law in 1997, and while initial polls showed doctors overwhelmingly against it, acceptance is growing.

The medical profession is still deeply divided over the issue. Doctors who participate argue assisted suicide is compassionate, but many of their colleagues say the practice is a violation of the oath to do no harm.

Click here for the source
of this article

Woodmonkey · 10-06-2005, 00:28

Quote:

Who Chooses Physician-Assisted Suicide?

Quote:

PORTLAND, Ore. — Since 1997, more than 230 terminally ill Oregonians have ended their lives with lethal but legally prescribed doses of medication. The rate of "assisted suicides" has risen since the Oregon Death With Dignity Act (search) went into effect, hitting a high of 42 in 2003.

A common argument against legal assisted suicide has been that the poor, black, or uneducated would be more vulnerable to abuse. But in Oregon, those who have opted for it have tended to be college educated, white, single and suffering from cancer, AIDS or Lou Gehrig's disease.

Most have reported the reason they chose to commit suicide was out of fear they would eventually be unable to care for themselves, rather than out of fear of pain or becoming a financial burden to their families.

Click in the video box to the above right to view a report by FOX News' Dan Springer.

According to health department reports, most patients died within a few hours of taking a lethal amount of barbiturates.

But last year, there were three reported incidence of complications. The patients vomited after taking the pills, and while they all eventually died, one took 31 hours to do so.

This year, Oregon saw its first reported case of failure. Lung-cancer patient David Prueitt went into a coma that lasted for three days. After he woke up, he lived for two more weeks. The ordeal reinforced his brother's opposition to assisted suicide.

"It just seems like we are dabbling in an area that is really not ours. We are taking control in an area that ... God gives life, he's also the taker of it," said brother Steve Prueitt.

But one cancer patient said that knowing that a physician-supervised suicide is an option has given her great peace.

"All I want is the option. The amount of peace I have had, knowing from the beginning when I was given my diagnosis, that this option was available to me is beyond describing," said Lovell Svart.

Oregon voters have largely agreed that Svart and others like her ought to be given a choice. Sixty-one percent of voters backed the law in 1997, and while initial polls showed doctors overwhelmingly against it, acceptance is growing.

The medical profession is still deeply divided over the issue. Doctors who participate argue assisted suicide is compassionate, but many of their colleagues say the practice is a violation of the oath to do no harm.

Click here for the source
of this article

SherryGrace · 10-06-2005, 22:39

Physician assisted suicide is as old as the very first physician.

Malpractice law suits, insurance dictating your choice of family doctor, more and more hospitals vs small town doctor's offices are some of the reasons that physician assisted suicide has slowed down...if not all but stopped.

Back in the day, when a single doctor delivered generations of the same family, as well as most of the people in town, period...assisted suicide was a part of the job. Mercy killings, as well. It was a part of the doctor's job to treat the "whole" person and the "whole" family. The family doctor was considered a dear friend and healer...a confidante...there was more between a person and their doctor than just a copay and insurance check. Doctors did what was best for their patients and their families.

Many death certificates were fudged...to avoid family scandals and such. Many new borns were whisked away with falsified birth certificates...to protect young mothers, or again, to avoid scandals (incest, etc.).

So. I believe in physician assisted suicide. Yes yes...it has to have its rules. Before, doctors let their good judgement set the rules. We now acknowledge that there is a good deal of people in this world, with degrees of all kinds, that do not possess good judgement.

Anyone else?

Oh yeah...should it be governed by state or federal? Beats me.

Woodmonkey · 10-06-2005, 23:40

Quote:

Originally Posted by SherryGrace

Physician assisted suicide is as old as the very first physician.

Malpractice law suits, insurance dictating your choice of family doctor, more and more hospitals vs small town doctor's offices are some of the reasons that physician assisted suicide has slowed down...if not all but stopped.

Back in the day, when a single doctor delivered generations of the same family, as well as most of the people in town, period...assisted suicide was a part of the job. Mercy killings, as well. It was a part of the doctor's job to treat the "whole" person and the "whole" family. The family doctor was considered a dear friend and healer...a confidante...there was more between a person and their doctor than just a copay and insurance check. Doctors did what was best for their patients and their families.

Many death certificates were fudged...to avoid family scandals and such. Many new borns were whisked away with falsified birth certificates...to protect young mothers, or again, to avoid scandals (incest, etc.).

So. I believe in physician assisted suicide. Yes yes...it has to have its rules. Before, doctors let their good judgement set the rules. We now acknowledge that there is a good deal of people in this world, with degrees of all kinds, that do not possess good judgement.

Anyone else?

Oh yeah...should it be governed by state or federal? Beats me.

This case is about whether or not the federal government can interfere with the states' perogatives. I don't believe in it, but think the federal government should stay out of this. It is a state issue, IMO.