Palliative Care for Elderly, Disabled, Worse Since Assisted Suicide Legalized

Bioethics   |   Steven Ertelt   |   Jul 28, 2004   |   9:00AM   |   WASHINGTON, DC

Palliative Care for Elderly, Disabled, Worse Since Assisted Suicide Legalized

by Paul Nowak Staff Writer
July 28, 2004

Portland, OR ( — Despite claims by assisted-suicide advocates that pain management for dying patients would improve after the practice was legalized in Oregon, a new study has found that palliative care for dying patients has gotten worse.

According to the study, conducted by Oregon Health & Science University researchers, half of the family members of dying patients surveyed between 2000 and 2002 said their loved ones’ pain was moderate or severe in the week before they died.

Before 1997, when the Supreme Court ruled against a right to assisted suicide but allowing states to pass their own laws on it, only one-third of family members surveyed rated the pain as moderate or severe.

"End of life care has not been ‘fixed,’ and there is plenty of room for improvement, particularly in the final of week of life," wrote the researchers in an article published in the Journal of Palliative Medicine.

After accounting for medical and demographic differences between the two study groups, researchers concluded that patients dying between 2000 and 2002 were twice as likely to be considered having moderate or severe pain in the final week of life.

Dr. Erik Fromme, the lead researcher in the survey, is an assistant professor of general medicine and geriatrics at OHSU and a senior scholar in its Center for Ethics in Health Care. He said the debate over assisted suicide has increased public awareness of the need for better end-of-life care.

However, the results are still surprising, especially considering that Oregon ranks high among other states in use of strong painkillers and hospice enrollment rates.

"What this study did for me was contrast our view of things versus what’s actually happening," said Dr. Fromme, who admitted the results "are not necessarily what people wanted to hear."

Dr. Robert Orr, president of the Vermont Alliance for Ethical Healthcare told that the research contradicts arguments made by groups promoting assisted suicide.

"Proponents of the legalization of physician-assisted suicide in Vermont often cite the Oregon experience, saying that the 1997 passage of such a law in that state has resulted in better end-of-life care,” said Dr. Orr. “The facts contradict this assertion.

“Indeed, Oregon was a pioneer in hospice care, leading the nation in percentage of patients dying at home with hospice care,” explained Dr. Orr.

“But this happened in the 1980s and early ’90’s — several years before legalization of physician-assisted suicide. And this study from the Journal of Palliative Medicine now shows that pain management at the end of life is no better in Oregon than in other states. In fact, this most important quality indicator of hospice care has deteriorated since 1997."

During the last legislative session, Vermont became the latest target by organizations promoting assisted suicide.

The Vermont legislative research office has been asked by 78 state legislators to investigate the impact of Oregon’s assisted suicide law, and research the arguments for and against the legalization of the practice before the next legislative session.

Opposition from state medical groups and Governor Jim Douglas (R) made legislators reluctant to take up the controversial legislation earlier this year.

Related Sites:
Vermont Alliance for Ethical Healthcare –