Rogue state

This past February, Oregon resident David Prueitt awoke from a coma and asked, "Why am I not dead?" The terminally ill 42-year-old had self-administered a supposed lethal dose of barbiturates three days earlier in accordance with state law, under which doctors can legally prescribe suicidal amounts of drugs to qualifying patients. Mr. Prueitt lived for two more weeks before dying naturally of lung cancer, telling his wife that God had rejected his premature death and that doctor-assisted suicide is wrong.

Oregon is the only state with a law on its books saying otherwise. Oregon voters first passed the Death with Dignity Act as a citizen's initiative in 1994: It allows fully conscious patients projected to die within six months to end their lives prematurely via doctor-prescribed lethal overdoses. The Oregon Medical Association voted by a 122-1 margin in 1997 to oppose the Act, but 60 percent of Oregon voters that year rejected a measure to repeal it.

The law raises different issues than those in the case of Terri Schiavo. Qualifying Oregon residents must be able to swallow and cannot receive aid in administering the drugs. They must choose physician-assisted suicide for themselves. Oregon's Department of Human Services reports that 208 people had made such a grave decision through the end of 2004. The DHS report, however, makes no mention of any prior cases similar to that of Mr. Prueitt.

Opponents of the Death with Dignity Act believe such cases are intentionally left unreported, part of an effort to present a rosy picture of euthanasia to other states. "It's like asking Kevorkian, 'How did it go?'" said Dr. William Toffler, a professor of family medicine at the Oregon Health and Science University in Portland. Dr. Toffler is a co-founding member of the Physicians for Compassionate Care Educational Foundation (PCCEF), a group of doctors committed to exposing the underbelly and preventing the spread of what he labels "a culture of death."

Legislative committees in Vermont and California will vote soon on whether to follow Oregon's lead. PCCEF co-founder Dr. Kenneth Stevens testified against California's proposed bill in early February one day before helping to shoot down a similar bill in Hawaii. The 65-year-old oncologist and father of 12 argues that a physician's function is antithetical to euthanasia: "As a doctor, my role is to help people live and to relieve their discomfort, not to cause their death. Causing a person's death is not medicine."

This fall, the U.S. Supreme Court will consider whether the Oregon law violates federal drug policy, a challenge wrought by former attorney general John Ashcroft and maintained by his replacement Alberto Gonzales. An affirmative ruling would prevent doctors from prescribing lethal quantities of federally controlled substances. Dr. Stevens says the ruling matters little as doctors could still legally prescribe lethal doses of other drugs.

Euthanasia proponents are optimistic that the practice will remain legal in Oregon and become increasingly accepted throughout the country. George Eighmey, executive director of Compassion in Dying of Oregon, an organization that expedites physician-assisted suicides, said his organization has worked with more than 700 patients and 500 doctors in seven years. He states that most patients prescribed lethal drugs never go through with their suicide but experience a calming effect at feeling in control.

But Mr. Prueitt, a client of Compassion in Dying, was anything but in control when he awoke from his coma. However rare such failed suicides may be, Dr. Toffler says incorrect projections over how much longer someone has to live are extremely common: "We don't have a crystal ball. Everyone has stories where someone they knew was given three months to live and 17 years later Grandpa's doing just fine."

Dr. Toffler also worries that Oregon's Death with Dignity Act represents only a first step toward devaluing human life. He suggests the philosophical line between legalized suicide and the extermination of severely handicapped people is slippery and sloping.