Physician-assisted suicide: Reflections on Oregon's first case

The authors analyze Oregon's first reported assisted suicide of Mrs. A as a real life application of the Oregon Death with Dignity Act. They critique the effectiveness of the Act's safeguards as illustrated by the case of Mrs . A. They point out that the Act does not require that physicians be adequa tely trained in palliative care in order to participate in assisted suicide . Most physicians do not have such training. Without it, they are not able to effectively present alternatives to patients requesting assisted suicide . Most physicians also lack the expertise to assess patients' decision-maki ng capacity. Nor does the Act ensure that physicians will be in a position to assess coercion of patients' decisions. The Act requires physicians to r eport only minimal information about their cases, and there are no enforcem ent provisions to see that even this is done. Under the Act, a good faith s tandard rather than the more usual negligence standard immunizes physicians from civil or criminal liability even when they act negligently. The autho rs demonstrate that the Act protects physicians more than patients, and enc ourages secrecy. The authors conclude that secrecy will need to be replaced by openness to permit the kind of examination the practice of assisted sui cide warrants.