A detailed analysis of the experience of the first year with the law on assisted suicide Oregon doctor suggests that the worst fears some opponents of the law was not supported outside. the terminally ill patients who choose to end their lives under the law were more concerned about losing their autonomy as suffering unbearable pain or financially ruin their families, according to the analysis, which was published in this week New England Journal of Medicine .
In October 1997, Oregon became the first and only US state to legalize physician-assisted suicide for terminally ill people. At the time, critics have warned the so-called "Death with Dignity Act" would cause a disproportionate number of poor people or patients with fear of extreme pain to commit suicide, while those who could afford good care or had less fear would stay alive longer. To minimize these risks, a number of safeguards were built into law: The patient, not the doctor had administered the fatal dose; two doctors to agree to prescribe the lethal dose of barbiturates; the patient had to ask three times the requirement of 15 days; and the patient should be informed of the hospice and other care options.
One year after the law took effect, epidemiologist Gene Chin and colleagues at the Health Division of the Oregon (agency of the State Public Health) from 15 people who took lethal doses with 43 deaths similar terminal illnesses, to find out why some people choose to end their life and others do not. Detailed questionnaires completed by physicians of patients revealed that both groups were similar in many respects; people who opted for suicide are less educated disproportionately underinsured, on Medicaid, or fear of pain, said Chin. But suicide group had worried addition to being bedridden and incontinent: 80% of them, against 40% of control patients were told their doctors they feared losing control over their lives. "What has been driving this was a strong need for autonomy," says Chin.
But some experts disagree. "This conclusion is not justified by the data," says psychiatrist Herbert Hendin, medical director of the American Foundation for suicide prevention, which maintains that the information provided by doctors could be misleading because patients may not reveal their true motivation. But the pathologist Cyril Wecht of Pittsburgh Duquesne University calls the study "valid and credible." "It highlights several misconceptions," he said.
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