Thaddeus Mason Pope is the director of the Health Law Institute at Hamline University, and a frequent legal commentator and blogger on end-of-life medical issues.

Since the Oregon Death with Dignity Act was enacted in 1997, more than 1,100 people have obtained life-ending prescriptions, and about 750 used them. Most were dying of cancer. And most feared a loss of autonomy, dignity and decreasing ability to participate in activities that made life enjoyable.

Safeguards ensure that patients who are terminally ill make voluntary, informed decisions. There is no evidence of exploitation.

These and other statistics on Oregon’s experience are available, because of neutral data collection and reporting. This has permitted legislatures and courts around the world to assess Oregon’s experience. Overwhelmingly, they have found it worthwhile.

In significant part, this is due to many safeguards in Oregon’s law, which only allows participation by defined categories of patients. Patients must be mentally healthy residents of Oregon, 18 or older, who have had two physicians determine that they have no more than six months to live.

The safeguards also ensure that patients are making a voluntary and informed decision. A physician must educate the patient about all options, including palliative care, pain management and hospice. The patient must make three separate requests (two oral and one written). The oral requests must be separated by at least 15 days, and the written request must be independently witnessed by two people. The patient can rescind these requests at any time. Finally, to further ensure that patients remain in full control of the process, they must administer the medication themselves.

These safeguards work. There is no evidence of an inordinate impact on vulnerable populations. Indeed, over 97 percent of the patients who died from ingesting a lethal dose of medication were white. Over 98 percent had health insurance, over 90 percent were enrolled in hospice and over 72 percent had gone to college. Nor does available research show any negative impact on the availability of palliative care or on the physician-patient relationship. Today Oregon is a universally recognized leader in end-of-life care across the entire continuum of options. In short, the Oregon law has been a success.

It is no surprise that many other states and countries have looked to Oregon as a model. Notable among these are Washington in 2008, British Columbia in 2012, Vermont in 2013 and Quebec this year.

In short, while once widely rejected, assisted suicide is receiving — and surely will continue to receive — increased recognition as an appropriate response to the suffering of patients at the end of life. This is due in large part to Oregon’s proven safe and effective implementation.

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