A new study on America's oldest physician aided suicide programme shows that numbers of those being euthanised have been steadily increasing, and reveals that some are opting to end their lives because they cannot afford chemotherapy.
The study, published in JAMA Oncology, is one of the first detailed analyses of the Death with Dignity Act, which passed in the state of Oregon 18 years ago. It shows a 12 percent yearly increase in lethal prescriptions from 1998 to 2013, with an unexplained jump of nearly 30 percent in 2015.
Although the lead author of the study, Dr. Charles Blanke, an Oregon Health & Science University oncologist, who has himself issued about 65 lethal prescriptions, said the data "indicates the law is working as intended to give dying people a choice of how they want to die", there were some worrying findings.
Inadequate pain control
It was found that in 25.2% of cases, inadequate pain control was given as a reason for desiring euthanasia. Dr Blanke called that a tragedy, saying scientists must make sure patients aren't killing themselves because they're not getting help managing their pain.
Cost of chemo
Shockingly, it was also reported that 3% of patients used the law because the cost of chemotherapy was too high. "What's worse than that - literally nothing," Dr Blanke said. There are known examples of this happening - both Barbara Wager and Randy Stroup were told that their medical insurance would not pay for cancer treatment, but would cover assisted suicide.
Depression
Concerns have also been raised about the mental competency of those choosing euthanasia. Brian Johnson, a consultant for the California-based group, Seniors Against Suicide, and a former California commissioner on ageing, said the study shows that patients were deeply depressed. "This is a cry for help," he said. "Suicide is the number one indicator of depression."
Dr Blanke admitted that this might be a problem, saying research has shown that as many as three in four terminal patients are depressed. "Either we're missing depression," Dr Blanke said, "or it's possible that physicians agree that depression is not enough to make a person incompetent to make such an important decision."
The Oregon Catholic Conference called on physicians to improve pain care for end-of-life patients, and said: "Assisted suicide laws make suicide socially acceptable. As a result, Oregon's overall suicide rate is 41 percent higher than the national rate. Assisted suicide, like other forms of suicide, has negative effects on victims and families."
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