Oregon's guidelines for physician-assisted suicide: A legal and ethical analysis

Oregon's Death With Dignity Act was first passed by a ballot initiative in 1994, but numerous judicial challenges delayed implementation of the Act. I n November of 1997, following the United States Supreme Court decisions in Vacco v. Quill and Washington v. Glucksberg, which left the states' power t o regulate physician-assisted suicide undisturbed, the Oregon voters upheld their law. Oregon remains the only state in the nation to authorize physic ian-assisted suicide. The Task Force to Improve the Care of Terminally Ill Oregonians published a Guidebook for health care providers on the Oregon Ac t, and the New England Journal of Medicine recently issued a special report on the first year's experience under the Act. This paper analyzes the lega l context of the Oregon Death With Dignity Act, discusses the efficacy of t he tenets in the Guidebook, and explores ethical issues underlying the guid elines, particularly those pertaining to the meaning of a patient's request for assisted suicide and processes supporting informed consent.