Oregon Offers Terminal Patients Doctor-Assisted Suicide Instead of Medical Care
PORTLAND, Ore. — Some terminally ill patients in Oregon who turned to their state for health care were denied treatment and offered doctor-assisted suicide instead, a proposal some experts have called a “chilling” corruption of medical ethics.
Since the spread of his prostate cancer, 53-year-old Randy Stroup of Dexter, Ore., has been in a fight for his life. Uninsured and unable to pay for expensive chemotherapy, he applied to Oregon’s state-run health plan for help.
Lane Individual Practice Association (LIPA), which administers the Oregon Health Plan in Lane County, responded to Stroup’s request with a letter saying the state would not cover Stroup’s pricey treatment, but would pay for the cost of physician-assisted suicide.
“It dropped my chin to the floor,” Stroup told FOX News. “[How could they] not pay for medication that would help my life, and yet offer to pay to end my life?”
The letter, which has been sent to other terminal patients throughout Oregon, follows guidelines established by the state legislature.
Oregon doesn’t cover life-prolonging treatment unless there is better than a 5 percent chance it will help the patients live for five more years — but it covers doctor-assisted suicide, defining it as a means of providing comfort, no different from hospice care or pain medication.
“It’s chilling when you think about it,” said Dr. William Toffler, a professor of family medicine at Oregon Health & Science University. “It absolutely conveys to the patient that continued living isn’t worthwhile.”
In issuing their latest Prioritized List of Health Services, state officials reported a new emphasis on preventive care and cost effectiveness. Dr. John Sattenspiel, LIPA’s senior medical director, defended the measures.
“I have had patients who would consider knowing that this is part of that range of comfort care or palliative care services that are still available to them, they would be comforted by that,” Sattenspiel said. “It really depends on the individual patient.”
Toffler called it a callous practice that went against medical convention. “It corrupts the consistent medical ethic that has been in place for 2,000 years,” he said. “It’s absolutely breathtaking.”
Oregon is the only state to legalize doctor-assisted suicide, which came into effect in 1997. Since that time, there have been 341 reported cases where doctors provided lethal doses of medicine to patients to end their lives.
Oregon voters have upheld the “Death with Dignity” law three times, and Sattenspiel says it is the state’s duty to inform patients of all their legal options.
For Stroup, however, suicide was never an option. He fought back, and the Oregon Health Plan eventually reversed its decision and is now paying for his chemotherapy, giving him hope he’ll be around a little longer for his 80-year-old mother and five grandchildren.
But I thought assisted suicide was all about empowering the rational individual to make end of life choices? This seems a lot like what those crazy pro-life lobbyists and bio-ethicists have been saying - devaluing terminally ill or disabled individuals, making subjective quality of life judgments, and starting down the road to forced euthanasia.
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Palliative care, Hospice, and doctor-assisted suicide are all offered because it has been decided by voters that relief from pain and the mitigation of the degrading conditions of terminal illness are a right…and people have a right to choose between the three choices.
If you decide that you want to try life-saving treatment in the face of medical advice, then you can pay for it yourself or another way, but my understanding is that life-saving treatments are much more expensive, and in terminal patients usually are too hard on the patients to be considered ethical…since they would do more harm than good, and cause needless additional suffering (decreasing both quantity and quality of life, at extra expense).
Asking taxpayers to pay for a treatment that is more expensive, will probably do more harm than good, and is not generally recommended by doctors seems sort of strange.
Perhaps aid for people who wish to persue life-saving treatments against standard medical recommendations is a great avenue for private charity to explore?
Teresa’s last blog post..By their fruits you shall know them.
Taxpayers voted to pay to kill people deemed by some doctor as not worthy of living? That is pretty sick, how do you reconcile that with your sudggestion that this gives them the choice?
Sam Pierce’s last blog post..MSM To BHO: Shut Up, You Had Me At Ya Know
Lets see… palliative care (in other words, care that makes their inevitable ligering death more comfortable and bearable), or doctor assisted suicide (which allows them to avoid the lingering part). Seems there is a there. You want them to have a third choice…the one where taxpayers pay more to make their inevitable death more difficult, painful, and possibly quicker.
I guess that’s a choice, but THAT’s the one that seems sick to me.
It’s not that the doctor deemed the people as “not worth living”. Usually, a doctor recommends hospice, pallitive care, etc over curative care if they believe that the curative care will be too hard on the person and hasten their death, making them miserable in the process (for instance, my grandfather died not that long ago in hospice care after palliative treatments kept him fairly comfortable). Usually, sending a person to hospice rather than giving them curative treatment is due to their illness being so advanced that curative care will not prolong their lives.
Demanding that taxpayers pay for a treatment that has no hope of cureing the person, and a fair chance of killing them quicker is not just crazy, it borders on mutilation.
However, if you don’t like it, you can do what I suggest people do who dont like Mother Theresa’s model of “care”.
Might I point out that the “care” recieved by most people who have passed through the doors of the Sisters Of Mercy has been palliative/hospice…even though many of them COULD have been cured by reletively cheap treatments…but they don’t get that sort of treatment…they are merely given a comfortable place to die, because it allows the Sisters of Mercy to “care” for more people if they give minimal treatment to those in their care.
Criticism of their care model has been called a hate crime against Catholics… and it is many times more selective as the “sick” care that you chastize Oregon for.
But Mother Theresa is the hero of the world, and the government is evil…whatever.
I scoff at the people who criticize Mother Theresa’s ministry, ’cause at least the Sistes Of Mercy are helping some people die with some amount of dignity and comfort. What are their critics doing? Criticising.
If you don’t like the care (without treatment)that Mother Theresa’s charity gives, then create your own charity that cures people, rather than just giving them comfort and clean surroundings while they die.
If you don’t like the treatment the government gives people, then create a charity that gives them the treatment you want them to have if they so choose…if they can find a doctor to administer it.
Otherwise, why the bellyaching?
Teresa’s last blog post..Im a winner!
Teresa, I think you’re missing the point here. Did you even read the story?
In other words, the Oregon state government has decided for individuals that their lives are only worthwhile if they last 5 more years, rather than 1, 2, 3, or 4. When did God die and give power to Oregon to decide that one year of life is worth less than five?
My main point in posting this is that pro-euthanasia activists have stridently declared that they want individuals to have CHOICES (hello Derek Humphrey?) in end of life care - be it assisted suicide, palliative care, or treatment. The facts in Oregon prove that their movement is far more sinister than the public has been led to believe. It is not about end of life choices, it is about weeding out the weak and the defenseless based on personal quality of life evaluations that have no medical value.
Teike Rae,
Yes, I read the story.
I did read the story. I think that “5% chance of surviving more than five years” means something different to me than it means to you.
Perhaps it is due to my experience in watching numerous friends and relatives deal with cancer.
Teresa’s last blog post..Copy-Cat Creep
Teresa,
I’m thinking we don’t even need doctors. Just people to help us kill ourselves if we become ill. Not terminally ill, mind you, just ill. /sarc
Newsflash: Everyone’s death in inevitable. I’m sorry that you’ve had to watch so many loved ones die of cancer. However, that does not give you the absolute moral authority card to decide the values of others, and their desire to live on this earth as long as possible.
Sunflower Desert’s last blog post..Bighorn Sheep in the Canyon
“Oregon doesn’t cover life-prolonging treatment unless there is better than a 5 percent chance it will help the patients live for five more years.”
Let’s rephrase that: Oregon WILL cover life-prolonging treatments if there is a 6% chance that the patient will live for another three days. Oregon will no longer fund “Hail Mary Medicine”.
I have seen taxpayer-funded triple bypass surgery done on a semi-comatose nonegenarian (that’s a person in their 90s) with emphysema, pneumonia, and failing kidneys …taken from the ICU to surgery and back to ICU, where she lingered for another couple of weeks. Where is the medical reason for that?
Your desire to live as long as possibleis just that - your DESIRE, not a taxpayer-funded right.
What’s so objectionable about saying that the government will only pay if there’s a greater than 5% chance of an additional 5 years of life? Sure, it does put a price on people’s lives, but that’s true in so many other ways. In fact, if the government were to pay for life for any life extending measures, that would simply put a higher price on the lives of the terminally ill at the expense of everyone else. What about a kid who suffers a complicated bone fracture that leaves him effectively crippled for life because the government doesn’t have money left to pay for the required surgery? How many X-ray machines could we do without to give some people a hope of living a little while longer? Or conversely, how much physical therapy could you pay for with the money it’d take to keep a terminally ill cancer patient alive for a few more weeks or months?
Whichever way you look at it, it’s always going to be a cynical equation when health care resources are limited and compromises must be made. The best the health care system can do is be honest about it, at that seems to be the case here.
That said, I do see that an unusual level of tact is required when telling someone, “Sorry, we’re not going to pay to give you a chance for extended life, but what we CAN pay for is a quick and painless death…”
There’s a difference between choosing to live, and asking the taxpayers of Oregon to foot the bill for your life. The taxpayers have decided the cost-benefit isn’t worth their dollars.
Is it worth yours? Then pay the freight. Life is a privilege. No one has the right to be kept alive at all costs. It’s hard, yes, but I don’t see the problem. Regardless, it has nothing to do with the state of Oregon. If god wants to keep this man alive, then he/she knows what to do …
Oh, and I’ve dealt with a family death from cancer. Sometimes there is such a thing as “too much.”
Sunflower Deasert,
“I’m thinking we don’t even need doctors. Just people to help us kill ourselves if we become ill. Not terminally ill, mind you, just ill.” /sarc
NOW you are talking about the “Mother Theresa” health care system…which must be so much better because it is religious.
My point is not that people should be denied the right to live as long as possible. My POINT is that given the prognosis, care would not likely prolong the person’s life.
If the person believed that eating a concoction of oregano oil and garlic would prolong their life, would you demand that taxpayers fund it, despite the unliklyhodd it would work?
No.
My “moral authority” or lack thereof has nothing to do with the fact that someone who is that sick is unlikely to be helped or have their life prolonged by curative treatment. Indeed, as in some cases I have observed, they died more quickly due to the treatment.
(for instance, chemo shut down my grandmother’s kidneys and liver…she died four months sooner than her prognosis without treatment. Chemo also gave my grandfather kidney failure, and he survived about as long as he was likely to without treatment. Also, my Mother-in-law has terminated her treatment as the chemo she was on caused seizures that almost killed her on two seperate occasions.)
Teresa’s last blog post..Copy-Cat Creep
It is convenient for people to pretend that public health isn’t ALWAYS a numbers game…for instance, it is considerred rediculous to ban Alar from fruit growers because it ONLY caused 50 cancers per million.
Whats to say that those 50 people’s lives (probaly not all of them died, but most likely, their lives were SHORTENED) less valuable than the benefit of increased attractivness in fruit?/sarc
The EPA assesses air quality requirements based on a cost/benefit analysis of the number of pre-mature deaths a certain level of pollutants is likely to cause.
http://www.oag.state.ny.us/press/2006/dec/dec18b_06.html
Many people are OK with passing a law that would make it illegal for a woman to have an abortion if pregnancy will shorten her life, but her life is not in immediate danger. They casually weigh the value of her shortened life-span against her child’s life without a second thought.
Or the airplane industry that decides that a set of safety upgrades cost too much to save x number of lives every year.
People and institutions make these assessments and judgements all of the time.
Consistancy on this issue could end up being quite demanding.
Teresa’s last blog post..Copy-Cat Creep
Teresa,
As nice as all your Mother Theresa / Sisters of Mercy references are, I could honestly care less. They are a private charity that individuals can chose to go to or not.
As far as I’m concerned, the government ought not to be in the business of paying for physicians to kill patients and they sure as hell ought not to be willing to pay for death but not for life - no matter how short and painful it may or may not be. And yes, if a person qualifies for state health care for whatever reason, the state has an obligation to pay for medical care. I thought Democrats were in favor of universal health care? Apparently not so much.
Who are you people making moral quality of life decisions about who should live and who should die based on how much pain they may or may not be in or exactly how much time they may have?
The truth is in the facts. Be it in palliative care or treatment for the specific illness, the medical technology of pain management has advanced to the point where 98-99% of all pain is manageable. So, if you have experienced loved ones dying in extreme pain, I am sorry that you had to go through it but it wasn’t necessary and it doesn’t justify just killing more people.
If someone wants to or has to stop treatment for whatever illness they are fighting and be satisfied with palliative care, that is absolutely their prerogative. There is never a cause or justification to kill a person because they are elderly or physically/mentally ill or disabled. And if you continue to deny the fact that there is a slippery slope of devaluing life with death is on the table in light of this particular story, you should readjust your blinders.
Teiki Rea,
I think it is convenient for you to misunderstand what I’m saying. Talk about blinders.
You keep saying that I am makeing judgements about who lives or dies.
I am not doing any such thing. Cancer is killing this man. He believes that a certain kind of treament (curative treatment) will extend his life. That is extremely unlikely.
According to what was said by the official, Palliative treament is an option. Hospice is an option, and Doctor-assisted suicide is an option. He has a right to choose to have taxpayers pay for any one (or more…palliative until it no longer works, hospice until he dies or until it becomes unbearable for whatver reason, dr.-ass suicide if he decides he doesn’t want to wait)
He even has a right to choose the curative option if he finds a private way to pay for it, and is strong enough to have it not kill him faster (as happened with reletives of mine).
You say that I was objecting to reletives dying in pain. The pain was unfortunate, but that is not what I was talking about. I was talking about curative treaments killing them more quickly or as quickly as if they had not been treated at all, and how palliative treatments are a much better option for terminal patients because they are less harsh on the body, but delay the cancer and allow for quality of life and don’t kill you quicker.
I am not using those anecdotes to justify killing people. I am saying that palliative treatment is more appropriate for terminal patients than curative treaments which are likely to do more harm than good.
Besically, I’m saying that it seems you are arguing for the right of patients to be “killed with the cure”.
And furthermore, you are saying that if I don’t think it’s a good idea, I’m responsible for people dying. Which is just weird.
Teresa’s last blog post..Copy-Cat Creep
I’m from the UK and we currently have had a series of similar issues; while Dr assisted suicide is not an option there have been many public outcries over the availability of certain drugs on the National Health Service (NHS).
The problem is that at some point in some way the decision has to be made that “sorry we can’t afford to cure you”. The job of any public health service is then to draw these lines in such a way that the maximum number of people benefit.
The thing that isn’t mentioned in the story are the relative costs of each treatment; additionally a “life-prolonging treatment unless there is better than a 5 percent chance” are pretty slim odds thats 1:20 chance of the treatment having a worth while affect.
The Dr assisted suicide is purely another option.
I see only one thing wrong with this which is the phrasing of the letter which was pretty poor. Health care for all is a wonderful idea but it has limited funds.