Oregon's assisted suicide vote: the silver lining

Article Abstract:

The passage in Oregon of the physician-assisted suicide initiative may have resulted in spurring health care professionals to improve care for the dying. The Oregon assisted suicide measure passed narrowly in the 1994 general election, and was interpreted more as the voters' rejection of current medical care of the dying than as approval of physician-assisted suicide. The measure has not been implemented because it was ruled unconstitutional. Many health care professionals who opposed the measure may now be taking the lead in reforming end-of-life care. A new awareness of hospices has resulted. Patient and physician reimbursement for hospice care have increased. Medical students and physicians are receiving better education about care of the dying.

Ethical aspects

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Care of the dying: clinical and financial lessons from the Oregon experience

Article Abstract:

Oregon's experience shows that better palliative care for all Americans might reduce the need for physician-assisted suicide. Physician-assisted suicide was legalized in Oregon in 1994. The state also developed a form to ensure that dying patients' wishes are followed, which is not always the case. Placement into hospice programs increased and fewer Oregonians die in a hospital than in any other state. The state also covers terminal care for many uninsured residents. The money spent to defeat the law would have paid for three years of hospice care for every dying Oregonian.

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Oregon's Low In-Hospital Death Rates: What Determines Where People Die and Satisfaction with Decisions on Place of Death?

Article Abstract:

Avoiding hospital admission and deciding to limit the extent of medical care may substantially reduce the risk of dying in the hospital. Researchers reviewed patient attitudes in Oregon, where only 31% of deaths occur in the hospital -- the lowest in the US. Avoiding hospitalization was more common than choosing to be discharged, and deciding against treatment was almost four times as common as choosing to stop treatment. Do-not-resuscitate orders and living wills are very common in Oregon, and only 2.4% of families of patients who died felt they were undertreated.

Oregon, Patient outcomes, Mortality, Hospital patients, Advance directives (Medicine)

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