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1994 Oregon Ballot Measure 16

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Measure 16 of 1994 established the U.S. state of Oregon's Death with Dignity Act (ORS 127.800–995),[1] which legalizes medical aid in dying (commonly referred to as physician-assisted suicide) 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.[citation needed]

Measure 16
November 8, 1994 (1994-11-08)
Death with Dignity Act: Allows Terminally Ill Adults to Obtain Prescription for Lethal Drugs
Results
Choice
 Votes %
Yes 627,980 51.31%
No 596,018 48.69%
Yes:     50-60%     60-70%
No:     50-60%      60-70%
Measure 51
November 4, 1997 (1997-11-04)
Would have repealed Measure 16 if successful; referred by legislature
Results
Choice
 Votes %
Yes 445,830 40.09%
No 666,275 59.91%
Yes:     50-60%
No:     50-60%      60-70%

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.[2] An injunction delayed implementation of the Act until it was lifted on October 27, 1997.[3] Measure 51, referred in the wake of the US Supreme Court's 1997 ruling in 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.[4] 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.



Measure 16 Results by County:

County Yes Votes No Votes Total
Baker 42.02 2,779 57.98 3,835 6,614
Benton 50.57 16,376 49.43 16,006 32,382
Clackamas 51.39 66,807 48.61 63,191 129,998
Clatsop 52.55 7,241 47.45 6,539 13,780
Columbia 52.29 8,454 47.71 7,714 16,168
Coos 49.99 12,270 50.01 12,273 24,543
Crook 45.66 2,932 54.34 3,489 6,421
Curry 55.81 5,107 44.19 4,044 9,151
Deschutes 51.12 19,245 48.88 18,405 37,650
Douglas 44.74 17,560 55.26 21,693 39,253
Gilliam 52.49 474 47.51 429 903
Grant 45.65 1,552 54.35 1,848 3,400
Harney 43.12 1,225 56.88 1,616 2,841
Hood River 49.73 3,356 50.27 3,393 6,749
Jackson 51.58 33,191 48.42 31,163 64,354
Jefferson 45.44 2,312 54.56 2,776 5,088
Josephine 50.04 13,672 49.96 13,648 27,320
Klamath 45.04 9,430 54.96 11,508 20,938
Lake 42.14 1,364 57.86 1,873 3,237
Lane 56.32 69,578 43.68 53,955 123,533
Lincoln 60.56 10,920 39.44 7,112 18,032
Linn 44.55 16,737 55.45 20,835 37,572
Malheur 35.75 3,032 64.25 5,448 8,480
Marion 44.80 43,284 55.20 53,330 96,614
Morrow 41.04 1,202 58.96 1,727 2,929
Multnomah 56.87 138,257 43.13 104,844 243,101
Polk 43.60 10,070 56.40 13,028 23,098
Sherman 50.52 483 49.48 473 956
Tillamook 53.20 5,298 46.80 4,660 9,958
Umatilla 42.65 7,987 57.35 10,741 18,728
Union 47.19 4,690 52.81 5,249 9,939
Wallowa 45.48 1,609 54.52 1,929 3,538
Wasco 46.70 4,281 53.30 4,887 9,168
Washington 52.25 72,268 47.75 66,047 138,315
Wheeler 39.78 290 60.22 439 729
Yamhill 44.16 12,197 55.84 15,421 27,618


Measure 51 Results by County:

County No Votes Yes Votes Total
Baker 52.82 3,232 47.18 2,887 6,119
Benton 62.61 17,039 37.39 10,174 27,213
Clackamas 59.39 70,470 40.61 48,189 118,659
Clatsop 61.55 7,826 38.45 4,888 12,714
Columbia 60.11 9,900 39.89 6,569 16,469
Coos 60.59 13,960 39.41 9,079 23,039
Crook 55.61 3,370 44.39 2,690 6,060
Curry 65.99 5,674 34.01 2,923 8,597
Deschutes 61.43 23,475 38.57 14,737 38,212
Douglas 53.88 18,598 46.12 15,920 34,518
Gilliam 58.56 496 41.44 351 847
Grant 49.74 1,554 50.26 1,570 3,124
Harney 49.92 1,301 50.08 1,305 2,606
Hood River 57.96 3,702 42.04 2,685 6,387
Jackson 58.72 34,099 41.28 23,976 58,075
Jefferson 56.98 2,834 43.02 2,140 4,974
Josephine 57.99 14,955 42.01 10,833 25,788
Klamath 55.44 10,348 44.56 8,318 18,666
Lake 51.20 1,433 48.80 1,366 2,799
Lane 63.82 67,860 36.18 29,389 106,331
Lincoln 69.58 11,936 30.42 5,219 17,155
Linn 52.26 17,080 47.74 15,604 32,684
Malheur 42.58 3,431 57.42 4,626 8,057
Marion 54.00 47,227 46.00 40,229 87,456
Morrow 50.63 1,336 49.37 1,303 2,639
Multnomah 65.56 142,197 34.44 74.687 216,884
Polk 53.74 10,783 46.26 9,281 20,064
Sherman 60.72 507 39.28 328 835
Tillamook 64.20 6,045 35.80 3,371 9,416
Umatilla 55.57 9,669 44.43 7,730 17,399
Union 58.06 5,462 41.94 3,945 9,407
Wallowa 52.64 1,742 47.36 1,567 3,309
Wasco 56.85 4,978 43.15 3,779 8,757
Washington 59.42 76,381 40.58 52,172 128,553
Wheeler 50.36 352 49.64 347 699
Yamhill 54.45 15,023 45.55 12,568 27,591

The law

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Under the law, any competent adult[5] 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 other healthcare provider who has moral objections has the right to 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, 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."

Impact

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From the beginning of 1999 through the end of 2015, a total of 1,545 people have had prescriptions written and 991 patients have died from ingesting medications prescribed under the act.[6]

The median age of the 991 patients who died from ingesting medication was 71; 77.1 percent of patients had malignant neoplasms (cancer). Of the 991, 51.4% were male (48.6% female); 45.5% had a Baccalaureate degree or higher; 45.3% were married; primary end of life concerns were loss of autonomy (91.6%), inability to make life enjoyable (89.7%), and loss of dignity (78.7%).[6]

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."[7]

The Death with Dignity Act was the basis of the Washington Death with Dignity Act in 2008. In 2011 the documentary film How to Die in Oregon was released. It won the Grand Jury prize for documentary film at the 27th Sundance Film Festival.

According to Dignity in Dying, Lord Falconer's Assisted Dying Bill, first tabled in the House of Lords in June 2014, "draws on the experience" of the Death with Dignity Act.[8]

Attempts to repeal

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In addition to 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.[9] 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.[10] 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.[11]

Some members of the United States Congress, notably Senator Don Nickles of Oklahoma, tried to block implementation of Measure 16, but failed.[12][13]

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.[14] The Ninth Circuit Court of Appeals affirmed the block, stating that the "Attorney General lacked Congress' requisite authorization".[15]

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.[16] 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.[17]

See also

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References

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  1. ^ "Chapter 127.800–995 The Oregon Death with Dignity Act". Oregon State Legislature.
  2. ^ "Initiative, Referendum and Recall: 1988–1995" (PDF). Oregon Blue Book.
  3. ^ "Oregon's Death with Dignity Act". Oregon.gov.
  4. ^ "Initiative, Referendum and Recall: 1996–1999" (PDF). Oregon Blue Book.
  5. ^ "Oregon Health Authority : Frequently Asked Questions : Death with Dignity Act : State of Oregon". www.oregon.gov. Retrieved 19 February 2023. As of March 2022, the Oregon Health Authority is no longer enforcing the DWDA's residency requirement.
  6. ^ a b "Oregon Death with Dignity Act: 2015 Data Summary" (PDF). Oregon Public Health Division. State of Oregon. 2016-02-04. Retrieved 2016-04-04.
  7. ^ Legal physician-assisted dying in Oregon and the Netherlands: evidence concerning the impact on patients in "vulnerable" groups. Battin, P. et al. Journal of Medical Ethics 2007;33:591–597
  8. ^ "Lord Falconer's Assisted Dying Bill". Dignity in Dying. Retrieved 2015-06-27.
  9. ^ Howell, Joseph (2006). "Death With Dignity Act 2006 Annual Report". State of Oregon. Retrieved 2007-04-11.
  10. ^ Voters' Pamphlet Special Election 1997 – Measure 51 Legislative Argument in Support
  11. ^ Measure 51 election results from Oregon Secretary of State
  12. ^ Wentz, Patty. "Dignified suicide". Willamette Week. Archived from the original on 2010-01-13. Retrieved 2010-07-07.
  13. ^ "Senate Bill To Nullify Death With Dignity Act Also Threatens Pain Care Nationwide". Compassion in Dying. Body Health Resources Corporation. Spring 2000. Retrieved 2007-04-17.
  14. ^ Johnson, Kevin (2002-04-18). "Federal judge backs Oregon suicide law". USA Today. Retrieved 2007-03-18.
  15. ^ "Oregon V Ashcroft May 26, 2004". 2003. p. 1118.
  16. ^ Daly, Matthew (2005-07-21). "Assisted suicide defended". The Columbian. Associated Press.
  17. ^ Christie, Tim (2006-01-18). "Assisted suicide upheld". The Register-Guard.
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