The legalisation of assisted suicide in Oregon was a “mistake”, a senior doctor in the US State has declared.
The 20-year law is lauded as a model of best practice by assisted suicide campaigners in the UK who hope that the House of Commons will approve a Bill “closely based” on it next month.
But Prof William Toffler, one of the most senior doctors in Oregon, has declared that the law has been a disaster in his home state.
He said that “assisted suicide has been detrimental to patients, degraded the quality of medical care, and compromised the integrity of the medical profession”.
“The sick and ageing deserve better than Oregon’s mistake,” said Dr Toffler, the Professor of Family Medicine at Oregon Health and Science University in Portland and a licenced GP for 35 years.
“Since the voters of Oregon narrowly legalised physician-assisted suicide 20 years ago, there has been a profound shift in attitude toward medical care—new fear and secrecy, and a fixation on death. Well over 850 people have taken their lives by ingesting massive overdoses of barbiturates prescribed under the law. Proponents claim the system is working well with no problems. This is not true.”
He continued: “I have seen first-hand how the law has changed the relationship between doctors and patients, some of whom now fear that they are being steered toward assisted suicide.
“In one case a patient with bladder cancer contacted me. She was concerned that an oncologist treating her might be one of the ‘death doctors’, and she questioned his motives. This was particularly worrying to her after she obtained a second opinion from another oncologist who was more positive about her prognosis and treatment options. Whichever of the consultants was correct, such fears were never an issue before.”
Under Oregon’s law, a patient can request lethal drugs only if he has a terminal illness and less than six months to live.
But Prof Toffler said it is nearly impossible “to predict the course of an illness six months out, and many patients given such prognoses live full, rewarding lives long past six months”.
Studies, including one published in the British Medical Journal in 2008, have showed that in many cases patients requesting assisted suicide has mental health problems, he said, yet few of them are referred for psychological examinations before they are prescribed a cocktail of lethal drugs.
This is because “some doctors see suicide as a solution to suffering and depression as rational given patients’ circumstances,” Prof Toffler said in an article in the Wall Street Journal.
He said that Oregon was now using assisted suicide as a means of saving money, with cover for the practice included in medical insurance while important services and medications are omitted.
“Supporters claim physician-assisted suicide gives patients choice, but what sort of a choice is it when life is expensive but death is free?” he asked.
He added: “As a society we should continue to reject the legalisation of physician-assisted suicide as a solution to suffering. Instead we must work to increase access to hospice and palliative care to better support those suffering from terminal illness.”
The remarks of Prof Toffler echo those of Prof Theo Boer, the Dutch euthanasia regulator who last year denounced the practice after previously supporting it, with a warning to Westminster: “Don’t go there.”
They come just a fortnight before MPs vote on an assisted suicide Private Member’s Bill introduced by Rob Marris, Labour MP for Wolverhampton South West.
The comments were welcomed by Fiona Bruce, the Conservative MP for Congleton and chair of the All Party Parliamentary Pro-Life Group.
“This profoundly disturbing report on the detrimental impact of assisted suicide being legalised in Oregon, both on the doctor-patient relationship and the quality of end-of-life care, coming as it does from a doctor with extensive first-hand experience of this issue, deserves to be treated as a clear warning bell to the UK not to replicate the Oregon legislation,” she said.
“These observations simply cannot be ignored or batted away as naive or ill-informed – they clearly are not – indeed it is those who propose similar legislation for the UK who would be naive and ill-informed if they fail to heed such warnings.”
The Marris Bill has been drafted by the campaign group Dignity in Dying and would create “suicide courts” in Britain for the first time.
It is nearly identical to that introduced by the Labour peer Lord Falconer last year except that it includes a requirement for a High Court judge to process an application for assisted suicide within a fortnight.
The Bill, which will receive its Second Reading in the Commons on September 11, represents the sixth attempt in 12 years to push an assisted suicide law through Parliament, but the first chance for MPs to vote for a change in the law since 1997, when a Bill was overwhelmingly defeated.
Although recent polling has indicated public support for a change in the law both Welsh and Scottish assemblies have dismissed similar moves after the facts about assisted suicide were made clear to elected representatives.
David Cameron has granted Tory MPs a free vote on the issue but has made his opposition to the Bill clear in a statement in the Commons.
Downing Street has indicated that time will not be given for the Bill to progress although this position has been contradicted by the Government, which says it considers the Bill a matter for Parliament.
Supporters of the Marris Bill insist that the experience of assisted suicide in Oregon shows that such a law can work with proper safeguards and that it will be immune from incremental abuses seen in Holland and Belgium, where last year euthanasia was extended to “emancipated children”.
Sarah Wootton, the chief executive of Dignity in Dying, formerly the Voluntary Euthanasia Society, said that the Oregon law has worked “safely” for years and was a better option than the UK ban on the assisted suicide, which can carry a maximum prison sentence of 14 years.
But figures from Oregon have showed that deaths by assisted suicide in Oregon have soared by a huge 44 per cent in the past year alone and are now running at a record high.
The figures also show a drop in the proportion of suicides involving cancer patients from 80 to 68 per cent, corresponding with a rise in suicides in those with such non-terminal illnesses as diabetes, multiple sclerosis and Parkinson’s disease.
Oregon also witnessed the first attempt to amend the law this year so that more people can qualify for prescriptions of lethal drugs.