Thursday, May 2, 2013

Oregon’s mistake

Posted on Thu, May 2, 2013 at 4:00 AM

I was disturbed by Alex Sakariassen’s article about the Montana doctor who claims to have assisted three patient suicides, euphemistically termed “aid in dying” (see “Cowardice to courage,” April 11). I am a cancer doctor with more than 40 years experience in Oregon, where physician-assisted suicide is legal. I am also a professor emeritus and former chair of the Department of Radiation Oncology at Oregon Health and Science University.

I was first exposed to the assisted-suicide issue in 1982 shortly before my first wife died of cancer. We had just visited her doctor. As we were leaving, he had suggested that she overdose herself on medication. I still remember the look of horror on her face. She said, “Ken, he wants me to kill myself.”

In Oregon, the combination of assisted suicide legalization and prioritized medical care based on prognosis has created a danger for my patients on the Oregon Health Plan (Medicaid). First, there is a financial incentive for patients to commit suicide: The plan will cover the cost. Second, the plan will not necessarily cover the cost of treatment. This is based on statistical standards. For example, cancer patients are denied treatment if they have “less than 24 months median survival with treatment” and fit other criteria. Some of these patients, if treated, however, would have many years to live, as much as five, 10 or 20 years depending on the type of cancer. The plan will cover their suicides.

In Oregon, the mere presence of legal assisted-suicide steers patients to suicide even when there is no coverage issue. One of my patients was adamant she would use the law. I convinced her to be treated instead. Twelve years later she is thrilled to be alive.

Don’t make Oregon’s mistake.

Kenneth Stevens

Sherwood, Ore.

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