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How to die in Oregon – and maybe in Massachusetts

Posted by John McDonough  September 29, 2012 07:32 AM

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Seems surprising how little electricity has been generated over Question 2 on the November 6th Massachusetts ballot: "Prescribing Medication to End Life." Not too often that a ballot question has such direct life or death consequences.

As the most helpful summary in Secretary of State Bill Galvin's voter guide explains, the proposed law would:

"allow a physician licensed in Massachusetts to prescribe medication, at a terminally ill patient's request, to end that patient's life. To qualify, a patient would have to be an adult resident who (1) is medically determined to be mentally capable of making and communicating health care decisions; (2) has been diagnosed by attending and consulting physicians as having an incurable, irreversible disease that will, within reasonable medical judgment, cause death within six months; and (3) voluntarily expresses a wish to die and has made an informed decision. The proposed law states that the patient would ingest the medicine in order to cause death in a humane and dignified manner." 

Yes, there are groups deeply energized by this proposal. On the "for" side are Dignity 2012 which launched the campaign, the American Civil Liberties Union of Massachusetts, and notable individuals such as Dr. Marcia Angell, former editor of the New England Journal of Medicine. On the "against" side are the Committee Against Physician Assisted Suicide, the Massachusetts Citizens for Life, the Massachusetts Medical Society, disability rights groups and more -- 32 health and disability related organizations listed on the anti-campaign's website.

I had assumed this would be a highly engaged and combative campaign on both sides, particularly from the opponents. Most people I raise it with are unaware it's even on the ballot -- no kidding. Preliminary polling showed a relatively high base of support for this proposal by Massachusetts voters, and a low-key campaign is surely an advantage for them. This high base of support is surely a key reason why Massachusetts was targeted by national Dignity advocates to be the third state to adopt this policy, following Oregon and Washington.

Back in the 1980s and '90s when I was in the Legislature, it was understood that Massachusetts was always one of the last states to adopt policies such as this. For example, Massachusetts was among the last states to permit individuals to create their own advance medical care directives to state their wishes regarding medical treatment if unable to do so in the future.  Why so slow?  We understood it to be the hefty influence of the Catholic Church and the Mass. Catholic Conference.  Not any more -- not since the Church's child abuse scandal irrevocably diminished their influence on matters such as this.

A couple of weeks ago, I rented from Netflix an HBO documentary called "How to Die in Oregon," which follows the compelling real life stories of a few of the 400-500 Oregonians who have exercised their rights under their similar law, approved in 1994, to obtain and use life-ending medication. It also follows the experience of Washington State in 2010 as they became the second state to approve this policy. Though the documentary is shown from an avowedly pro position -- it's a compelling film for folks on either side of this issue who may appreciate an on-the-ground view from Oregon.

I'll be awaiting many results on the evening of November 6th, and this will surely be one of them.

This blog is not written or edited by or the Boston Globe.
The author is solely responsible for the content.

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About the author

John E. McDonough is a professor of practice at the Harvard School of Public Health. He is the author of the book “Inside National Health Reform”, published in 2011 by More »


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