Oregon Ballot Measure 16 (1994)
Encyclopedia
Measure 16 of 1994 established the U.S. state
of Oregon
's Death with Dignity Act (ORS
127.800-995), which legalizes physician-assisted dying
with certain restrictions. Passage of this initiative
made Oregon the first U.S. state and one of the first jurisdictions in the world to permit some terminally ill
patients to determine the time of their own death.
The measure was approved in the November 8, 1994 general election. 627,980 votes (51.3%) were cast in favor, 596,018 votes (48.7%) against. Measure 51, referred in the wake of Washington v. Glucksberg
by the state legislature
in November, 1997, sought to repeal the Death with Dignity act, but was rejected by 60% of voters. The act was challenged by the George W. Bush administration, but was upheld by the Supreme Court of the United States
in Gonzales v. Oregon
in 2006.
The request must be confirmed by two witnesses, at least one of whom is not related to the patient, is not entitled to any portion of the patient's estate
, is not the patient's physician, and is not employed by a health care facility caring for the patient. After the request is made, another physician must examine the patient's medical records and confirm the diagnosis. The patient must be determined to be free of a mental condition
impairing judgment. If the request is authorized, the patient must wait at least fifteen days and make a second oral request before the prescription may be written. The patient has a right to rescind the request at any time. Should either physician have concerns about the patient's ability to make an informed decision, or feel the patient's request may be motivated by depression or coercion, the patient must be referred for a psychological evaluation.
The law protects doctors from liability
for providing a lethal prescription for a terminally ill, competent adult in compliance with the statute's restrictions. Participation by physicians, pharmacists, and health care providers is voluntary. The law also specifies a patient's decision to end his or her life shall not "have an effect upon a life, health, or accident insurance or annuity policy."
). All but five of the 401 deaths involved a lethal medication of either secobarbital
or pentobarbital
; of those patients ingesting medicine received under the act, 95.1% experienced no complications.
An independent study published in the October 2007 issue of the Journal of Medical Ethics
reports there was "no evidence of heightened risk for the elderly, women, the uninsured, people with low educational status, the poor, the physically disabled or chronically ill, minors, people with psychiatric illnesses including depression, or racial or ethnic minorities, compared with background populations."
Despite the measure's passage, implementation was tied up in the courts for several years.
In 1997, the Oregon Legislative Assembly
referred Measure 51, which would have repealed the act, to the ballot.
Proponents of Measure 51 argued that the Death with Dignity Act lacked a mandatory counseling provision, a family notification provision, strong reporting requirements, or a strong residency requirement. Measure 51 opponents argued that sending the measure back to voters was disrespectful considering they had already passed Measure 16 via the initiative process. They also felt that the safeguards in the Death with Dignity Act were adequate.
Measure 51 was defeated in the November 4, 1997 special election with 445,830 votes in favor, and 666,275 votes against.
Some members of the United States Congress
, notably Senator Don Nickles
of Oklahoma
, tried to block implementation of Measure 16, but failed.
In 2002, federal judge Robert E. Jones
blocked a move by United States Attorney General
John Ashcroft
to suspend the license for prescribing drugs covered in the Controlled Substances Act
of doctors who prescribed life-ending medications under the Oregon law. The Ninth Circuit Court of Appeals affirmed the block, stating that the "Attorney General lacked Congress' requisite authorization".
In October 2005, the U.S. Supreme Court
heard arguments in the case of Gonzales v. Oregon
to determine the fate of the Death with Dignity law. Arguing on behalf of the state was Oregon Senior Assistant Attorney General Robert Atkinson. Oregon's five Democratic
members of Congress also filed a brief in support of the State's position. United States Solicitor General
Paul Clement
argued on behalf of the Bush administration, which challenged Oregon's right to regulate the practice of medicine when that practice entails prescribing federally controlled substances. On January 17, 2006, the court ruled 6–3 in favor of Oregon, upholding the law.
is a 2011 documentary film about the Oregon Death with Dignity Act, directed by Peter Richardson
. It won the Grand Jury prize for documentary film at the 27th Sundance Film Festival.
U.S. state
A U.S. state is any one of the 50 federated states of the United States of America that share sovereignty with the federal government. Because of this shared sovereignty, an American is a citizen both of the federal entity and of his or her state of domicile. Four states use the official title of...
of Oregon
Oregon
Oregon is a state in the Pacific Northwest region of the United States. It is located on the Pacific coast, with Washington to the north, California to the south, Nevada on the southeast and Idaho to the east. The Columbia and Snake rivers delineate much of Oregon's northern and eastern...
's Death with Dignity Act (ORS
Oregon Revised Statutes
The Oregon Revised Statutes is the codified body of statutory law governing the U.S. state of Oregon, as enacted by the Oregon Legislative Assembly, and occasionally by citizen initiative...
127.800-995), which legalizes physician-assisted dying
Assisted suicide
Assisted suicide is the common term for actions by which an individual helps another person voluntarily bring about his or her own death. "Assistance" may mean providing one with the means to end one's own life, but may extend to other actions. It differs to euthanasia where another person ends...
with certain restrictions. Passage of this initiative
Initiative
In political science, an initiative is a means by which a petition signed by a certain minimum number of registered voters can force a public vote...
made Oregon the first U.S. state and one of the first jurisdictions in the world to permit some terminally ill
Terminal illness
Terminal illness is a medical term popularized in the 20th century to describe a disease that cannot be cured or adequately treated and that is reasonably expected to result in the death of the patient within a short period of time. This term is more commonly used for progressive diseases such as...
patients to determine the time of their own death.
The measure was approved in the November 8, 1994 general election. 627,980 votes (51.3%) were cast in favor, 596,018 votes (48.7%) against. Measure 51, referred in the wake of Washington v. Glucksberg
Washington v. Glucksberg
Washington v. Glucksberg, 521 U.S. 702 , was a case in which the Supreme Court of the United States unanimously held that a right to assistance in committing suicide was not protected by the Due Process Clause.-Facts:Dr...
by the state legislature
Oregon Legislative Assembly
The Oregon Legislative Assembly is the state legislature for the U.S. state of Oregon. The Legislative Assembly is bicameral, consisting of an upper and lower house: the Senate, whose 30 members are elected to serve four-year terms; and the House of Representatives, with 60 members elected to...
in November, 1997, sought to repeal the Death with Dignity act, but was rejected by 60% of voters. The act was challenged by the George W. Bush administration, but was upheld by the Supreme Court of the United States
Supreme Court of the United States
The Supreme Court of the United States is the highest court in the United States. It has ultimate appellate jurisdiction over all state and federal courts, and original jurisdiction over a small range of cases...
in Gonzales v. Oregon
Gonzales v. Oregon
Gonzales v. Oregon, 546 U.S. 243 , was a decision by the United States Supreme Court, which ruled that the United States Attorney General could not enforce the federal Controlled Substances Act against physicians who prescribed drugs, in compliance with Oregon state law, for the assisted suicide of...
in 2006.
The law
Under the law, a capable adult Oregon resident who has been diagnosed, by a physician, with a terminal illness that will kill the patient within six months may request in writing, from his or her physician, a prescription for a lethal dose of medication for the purpose of ending the patient's life. Exercise of the option under this law is voluntary and the patient must initiate the request. Any physician, pharmacist or healthcare provider who has moral objections may refuse to participate.The request must be confirmed by two witnesses, at least one of whom is not related to the patient, is not entitled to any portion of the patient's estate
Estate (law)
An estate is the net worth of a person at any point in time. It is the sum of a person's assets - legal rights, interests and entitlements to property of any kind - less all liabilities at that time. The issue is of special legal significance on a question of bankruptcy and death of the person...
, is not the patient's physician, and is not employed by a health care facility caring for the patient. After the request is made, another physician must examine the patient's medical records and confirm the diagnosis. The patient must be determined to be free of a mental condition
Mental illness
A mental disorder or mental illness is a psychological or behavioral pattern generally associated with subjective distress or disability that occurs in an individual, and which is not a part of normal development or culture. Such a disorder may consist of a combination of affective, behavioural,...
impairing judgment. If the request is authorized, the patient must wait at least fifteen days and make a second oral request before the prescription may be written. The patient has a right to rescind the request at any time. Should either physician have concerns about the patient's ability to make an informed decision, or feel the patient's request may be motivated by depression or coercion, the patient must be referred for a psychological evaluation.
The law protects doctors from liability
Legal liability
Legal liability is the legal bound obligation to pay debts.* In law a person is said to be legally liable when they are financially and legally responsible for something. Legal liability concerns both civil law and criminal law. See Strict liability. Under English law, with the passing of the Theft...
for providing a lethal prescription for a terminally ill, competent adult in compliance with the statute's restrictions. Participation by physicians, pharmacists, and health care providers is voluntary. The law also specifies a patient's decision to end his or her life shall not "have an effect upon a life, health, or accident insurance or annuity policy."
Analysis of impact
From the act's passage to 2008, 401 patients used the act, representing an estimated 19.4 deaths per 10,000 total deaths in the same time period. The average patient age was 70, with 81.8 percent of patients suffering from malignant neoplasms (cancerCancer
Cancer , known medically as a malignant neoplasm, is a large group of different diseases, all involving unregulated cell growth. In cancer, cells divide and grow uncontrollably, forming malignant tumors, and invade nearby parts of the body. The cancer may also spread to more distant parts of the...
). All but five of the 401 deaths involved a lethal medication of either secobarbital
Secobarbital
Secobarbital sodium is a barbiturate derivative drug that was first synthesized in 1928 in Germany. It possesses anaesthetic, anticonvulsant, sedative and hypnotic properties...
or pentobarbital
Pentobarbital
Pentobarbital is a short-acting barbiturate that was first synthesized in 1928. Pentobarbital is available as both a free acid and a sodium salt, the former of which is only slightly soluble in water and ethanol....
; of those patients ingesting medicine received under the act, 95.1% experienced no complications.
An independent study published in the October 2007 issue of the Journal of Medical Ethics
Journal of Medical Ethics
The Journal of Medical Ethics is a peer-reviewed academic journal in the field of bioethics established in 1975. , its editors are Søren Holm and John Harris ....
reports there was "no evidence of heightened risk for the elderly, women, the uninsured, people with low educational status, the poor, the physically disabled or chronically ill, minors, people with psychiatric illnesses including depression, or racial or ethnic minorities, compared with background populations."
Attempts to repeal
In addition to the standard arguments against physician-assisted dying, opponents feared that terminally ill people throughout the nation would flock to Oregon to take advantage of the law. This fear has not been realized, largely because drafters of the law limited its use to Oregon residents.Despite the measure's passage, implementation was tied up in the courts for several years.
In 1997, the Oregon Legislative Assembly
Oregon Legislative Assembly
The Oregon Legislative Assembly is the state legislature for the U.S. state of Oregon. The Legislative Assembly is bicameral, consisting of an upper and lower house: the Senate, whose 30 members are elected to serve four-year terms; and the House of Representatives, with 60 members elected to...
referred Measure 51, which would have repealed the act, to the ballot.
Proponents of Measure 51 argued that the Death with Dignity Act lacked a mandatory counseling provision, a family notification provision, strong reporting requirements, or a strong residency requirement. Measure 51 opponents argued that sending the measure back to voters was disrespectful considering they had already passed Measure 16 via the initiative process. They also felt that the safeguards in the Death with Dignity Act were adequate.
Measure 51 was defeated in the November 4, 1997 special election with 445,830 votes in favor, and 666,275 votes against.
Some members of the United States Congress
United States Congress
The United States Congress is the bicameral legislature of the federal government of the United States, consisting of the Senate and the House of Representatives. The Congress meets in the United States Capitol in Washington, D.C....
, notably Senator Don Nickles
Don Nickles
Donald Lee Nickles is an American businessman and politician who was a Republican United States Senator from Oklahoma from 1981 until 2005. He was a fiscal and social conservative.-Early life:...
of Oklahoma
Oklahoma
Oklahoma is a state located in the South Central region of the United States of America. With an estimated 3,751,351 residents as of the 2010 census and a land area of 68,667 square miles , Oklahoma is the 28th most populous and 20th-largest state...
, tried to block implementation of Measure 16, but failed.
In 2002, federal judge Robert E. Jones
Robert E. Jones (judge)
Robert Edward Jones is an American politician and judge in Oregon. He is currently a senior judge for the United States District Court for the District of Oregon in the Portland...
blocked a move by United States Attorney General
United States Attorney General
The United States Attorney General is the head of the United States Department of Justice concerned with legal affairs and is the chief law enforcement officer of the United States government. The attorney general is considered to be the chief lawyer of the U.S. government...
John Ashcroft
John Ashcroft
John David Ashcroft is a United States politician who served as the 79th United States Attorney General, from 2001 until 2005, appointed by President George W. Bush. Ashcroft previously served as the 50th Governor of Missouri and a U.S...
to suspend the license for prescribing drugs covered in the Controlled Substances Act
Controlled Substances Act
The Controlled Substances Act was enacted into law by the Congress of the United States as Title II of the Comprehensive Drug Abuse Prevention and Control Act of 1970. The CSA is the federal U.S. drug policy under which the manufacture, importation, possession, use and distribution of certain...
of doctors who prescribed life-ending medications under the Oregon law. The Ninth Circuit Court of Appeals affirmed the block, stating that the "Attorney General lacked Congress' requisite authorization".
In October 2005, the U.S. Supreme Court
Supreme Court of the United States
The Supreme Court of the United States is the highest court in the United States. It has ultimate appellate jurisdiction over all state and federal courts, and original jurisdiction over a small range of cases...
heard arguments in the case of Gonzales v. Oregon
Gonzales v. Oregon
Gonzales v. Oregon, 546 U.S. 243 , was a decision by the United States Supreme Court, which ruled that the United States Attorney General could not enforce the federal Controlled Substances Act against physicians who prescribed drugs, in compliance with Oregon state law, for the assisted suicide of...
to determine the fate of the Death with Dignity law. Arguing on behalf of the state was Oregon Senior Assistant Attorney General Robert Atkinson. Oregon's five Democratic
Democratic Party (United States)
The Democratic Party is one of two major contemporary political parties in the United States, along with the Republican Party. The party's socially liberal and progressive platform is largely considered center-left in the U.S. political spectrum. The party has the lengthiest record of continuous...
members of Congress also filed a brief in support of the State's position. United States Solicitor General
United States Solicitor General
The United States Solicitor General is the person appointed to represent the federal government of the United States before the Supreme Court of the United States. The current Solicitor General, Donald B. Verrilli, Jr. was confirmed by the United States Senate on June 6, 2011 and sworn in on June...
Paul Clement
Paul Clement
Paul Drew Clement is a former United States Solicitor General and current Georgetown University legal professor. He is also an adjunct professor at New York University School of Law. He was nominated by President George W...
argued on behalf of the Bush administration, which challenged Oregon's right to regulate the practice of medicine when that practice entails prescribing federally controlled substances. On January 17, 2006, the court ruled 6–3 in favor of Oregon, upholding the law.
Documentary film
How to Die in OregonHow to Die in Oregon
How to Die in Oregon is a 2011 documentary film produced and directed by Peter Richardson. The film is set in the state of Oregon and covers the state's Death with Dignity Act that allows terminally ill patients to end their own life with medication prescribed by their physician .- Synopsis...
is a 2011 documentary film about the Oregon Death with Dignity Act, directed by Peter Richardson
Peter Richardson
Peter Richardson is an English actor, comedian, director, and writer, best known for The Comic Strip Presents... television series. He is also a long time comedy partner with Nigel Planer.-Early career:...
. It won the Grand Jury prize for documentary film at the 27th Sundance Film Festival.
See also
- List of Oregon ballot measures
- Washington Death with Dignity Act, a similar measure passed in November 2008 in the state of Washington
- Compassion & Choices of OregonCompassion & Choices of OregonCompassion & Choices of Oregon is a US nonprofit organization launched in 1998 as a provider of services for persons eligible for the Oregon Death with Dignity Act, and their physicians and pharmacists. The organization recruits and trains volunteers to provide legal and medical consultation and...
, providing medical consultation and direct service for persons eligible for the Oregon Death with Dignity law. - Baxter v. MontanaBaxter v. MontanaBaxter v. Montana, was a Montana Supreme Court case, argued on September 2, 2009, and decided on December 31, 2009, that addressed the question of whether the state's constitution guaranteed terminally ill patients a right to lethal prescription medication from their physicians.-Background of the...
, a court decision legalizing aid in dying in Montana - Death with Dignity National CenterDeath with Dignity National CenterDeath with Dignity National Center is a nonprofit organization located in Portland, Oregon which has led the defense of and education about Death with Dignity laws throughout the US...
, an organization founded to pass and support the law. - Gonzales v. OregonGonzales v. OregonGonzales v. Oregon, 546 U.S. 243 , was a decision by the United States Supreme Court, which ruled that the United States Attorney General could not enforce the federal Controlled Substances Act against physicians who prescribed drugs, in compliance with Oregon state law, for the assisted suicide of...
- Washington v. GlucksbergWashington v. GlucksbergWashington v. Glucksberg, 521 U.S. 702 , was a case in which the Supreme Court of the United States unanimously held that a right to assistance in committing suicide was not protected by the Due Process Clause.-Facts:Dr...
External links
- Text of the law
- State government website about law
- Web site in favor of law
- Briefs filed by the state of Oregon in the Oregon v. Gonzales case
- Is the Oregon Death with Dignity Act a good law? Website with pros and cons
- Oregon Voter's Guide page on Measure 51--includes the full text of the measure, and arguments for and against
- The New Atlantis: Ten Years of "Death with Dignity"