海角大神

It was inevitable that the debate over end-of-life issues and healthcare reform would turn to Oregon -- the only state that allows doctors to help people take their own lives.

It鈥檚 a profound and politically-charged issue. Depending on one鈥檚 point of view, it鈥檚 either 鈥渄eath with dignity,鈥� to use the phrase describing the law Oregonians approved in two ballot measures in the 1990s. Or it conjures up images of involuntary euthanasia.

The strictly prohibits "lethal injection, mercy killing, or active euthanasia." But it allows mentally competent adults who declare their intentions in writing, and have been diagnosed as terminally ill, to take a doctor-prescribed lethal drug themselves, orally, after a waiting period.

Since the law went into effect in 1998, about 40 people a year have taken their own life this way. , 60 individuals did so (out of 88 who received the prescriptions).

Over the years, there have been no reported violations under the law -- no evidence that individuals have been pressured by doctors or family members. And Oregon has become noted for the quality of end-of-life care, especially the use of hospices.

But the law has always had its strong critics.

The Bush administration tried unsuccessfully to stop the practice using the federal Controlled Substances Act, a move the US Supreme Court rejected. Some medical professionals say helping a patient take his or her own life violates the Hippocratic Oath. Efforts to enact similar laws in California, Washington, and other states have failed. Conservative religious groups have fought it just as hard as they do abortion.

These days, Oregon鈥檚 law has become part of the over whether healthcare reform should include a provision that Medicare pay for voluntary counseling sessions to plan for end-of-life medical care. some Oregonians have been denied medical care that could have successfully treated their illness.

The , known for its opposition to abortion, has been particularly vocal on the subject, insisting that 鈥渢here is no such thing as a life not worth living.鈥�

Supporters of Oregon鈥檚 law are pushing back.

(D) of Oregon says claims that legislative proposals for advance care planning consultations include euthanasia and are mandatory every five years 鈥渁re blatantly false.鈥� He鈥檚 set up a page on his website.

Other supporters of end-of-life counseling point to a new study in the Journal of the American Medical Association (JAMA) which found that patients and their families benefit from having such counseling.

鈥淭his study confirms the benefits of end-of-life counseling, as have other studies. It鈥檚 shameful that opponents suggest that such counseling is harmful,鈥� says Barbara Coombs Lee, president of , a Denver-based advocacy organization that provides patient counseling.

鈥淩ecently, an idea took hold that it鈥檚 highly dangerous and tyrannical to encourage doctors to talk with patients about what kind of treatments they would want if they were terminally ill and unable to speak for themselves,鈥� says Coombs Lee. 鈥淭his notion is false. Talking about death won鈥檛 kill you, but not talking about it may increase unnecessary suffering.鈥�
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