Elderly patients at risk of forced starvation in Oregon

Oregon pro-lifers are fighting a bill in their state’s Senate that could allow the starvation or dehydration of patients with dementia or mental illness—without their prior written consent.

S.B. 494, introduced by a judiciary committee, appears at first simply to update the state’s advance directive laws. But it allows a patient’s representative to remove undefined “life-sustaining procedures” if the patient has “a progressive illness,” has stopped talking, and cannot recognize family members.

The bill would allow an authorized guardian, spouse, a majority of their children, their parents, a friend, or if none is available, an attending physician to order the withdrawal of “life-sustaining procedures” that could include food and water, even if the advance directive did not give explicit permission or if the patient had no advance directive at all.

A spokeswoman for the Senate committee said about 50 people worked on the legislation for the last two years. Authors of the bill did not respond to questions about its content.

“S.B. 494 has as its goal to give surrogates the ability to withdraw food and fluids from Alzheimer’s patients, dementia patients, and mentally ill patients,” Gayle Atteberry, director of Oregon Right to Life, told me. “It does it in very sneaky and crafty ways, but it does it.”

Atteberry said lawmakers kept the bill’s wording intentionally vague in order “to make everything very unclear and subject to whatever the people surrounding the patient want to do.”

The bill removes the definitions of tube feeding, life support, and dementia, along with all references to power of attorney from current Oregon advance directive law. But it leaves the definitions of tube feeding and life support in the advance directive form patients would fill out.

“You can say, ‘I don’t want tube feeding,’ but unless tube feeding is defined in the statute, it’s just words,” Atteberry said.

The bill also leaves room to stop spoon-feeding patients who can and still want to eat, Atteberry said. Last year, Oregon courts considered the case of a man who wanted nursing home workers to stop spoon-feeding his wife, Nora Harris, who had Alzheimer’s. He argued her advance directive against life support included spoon-feeding. A judge disagreed, ruling Oregon law requires nursing home workers to provide assistance with eating, including offering food on utensils.

Alex Schadenberg, director of the Euthanasia Prevention Coalition, said the bill would not force people to choose death by dehydration, “but it’s so highly suggestive it’s ridiculous.”

Most advance directive forms allow people to choose death by dehydration, he said, but he’s never seen an advance directive bill so focused on withdrawing food and water.

“This is dressed up as a normal advance directive bill, but for some reason, someone has a fetish for dehydration,” he said. ”It’s the priority of this bill to get people to say, ‘yes’ to dehydration. I will tell you that that is the gateway to euthanasia.”

Since death by dehydration, even softened by morphine, is a death prolonged over roughly nine days, he said people will begin “clamoring for death by euthanasia,” which is faster and appears more compassionate: “Who wants to watch Mom dehydrating to death? No one.”

Oregon Right to Life members are working to inform legislators, both Republicans and Democrats, of every facet of the bill. Pro-life senators, Atteberry said, oppose the bill, while even pro-choice senators act surprised at its contents.

“We are hopeful,” Atteberry said. “We are praying. The only one who can really stop this bill is God.”