Legislators are thinking of expanding the way people can take their lives under Oregon’s Death With Dignity law: They want patients to be able to use an automatic syringe.
Currently, the law allows only medications that dying patients can take orally. That means a patient has to pick up the prescription themselves and be able to swallow it. Authors of the Death With Dignity law thought that restriction would help ensure no one could harm a patient against their will.
But some doctors say many patients are so sick they can’t actually pick up the medicine or they're too ill to swallow it, effectively blocking them from using the law.
Oregon Health and Science University end-of-life scientist Dr. Charles Blanke wrote 15% of Oregon’s death with dignity prescriptions last year — more than any other doctor in the state. He said many of his patients have difficulties with swallowing and are very afraid they won’t be able to ingest the medications when the time comes.
“They are terrified they’ll only be able to force down a partial, non-fatal dose and that they will then wake-up, or worse, remain in a permanent coma,” he said. “I’m convinced some take their lives too early because they’re afraid their swallowing will only get worse.”
Blanke and others are supporting House Bill 2217 because it permits patients to use other ways of getting lethal medications into their bodies. Those methods could include using a pump syringe to inject the medications automatically at the push of a button.
The bill goes on to prohibit anyone other than a patient from administering medication to end their life. But there is significant opposition.
For example, some doctors say automatic injection pumps are expensive and tricky to operate. One can cost $2,900, and it has to inject three drugs sequentially. Critics warn that if it doesn’t work properly, a patient could wake up during injection of the paralytic, for example, and experience seizures as they struggle to breathe.
Dr. Brick Lantz doesn’t want to see the law changed.
“We’re taking the physician away from being a healer to simply being a technician. And that’s not how we practice medicine, and I think it’s wrong,” said Lantz.
The change is unnecessary, he said, because medicines have vastly improved over the 25 years since voters approved the Death With Dignity law. Lantz said care at the end of life can be done compassionately, with dignity and with comfort, under the current law.
Other people worry that setting up an IV, which a pump syringe needs to function, increases a physician’s participation beyond the point where a patient can truly be said to be taking their own life. But Sen. Elizabeth Steiner Hayward, D-Beaverton, a practicing physician, said there’s no difference between the kind of feeding tube people already use to take the medication and an IV.
“I could see why some people might say, from a layperson’s perspective, that somehow a feeding tube is different to an IV. But from a medical perspective, both require an intervention,” she said. “In fact, it’s medically easier and safer to put in an IV than to put in a feeding tube.”
House Bill 2217 passed the Oregon House but on a party-line vote, with Democrats supporting it and Republican against.
It’s now waiting for action from the Senate Judiciary Committee.