Inside Dr. Peter Rasmussen's office in Salem, Ore., something happens that most anywhere else would be a crime. The cancer specialist prepares his patient, Patricia Lundin, for a prescription he will write that will intentionally end his patient’s life.
Lundin asks, "And what do you do? Just go to sleep?" And Dr. Rasmussen replies, "Yes. You just drink it down and it gets absorbed through the lining of the stomach very quickly and so you get sleepy really quickly."
Oregon is the only state in the nation that allows physician assisted suicide. Patricia Lundin has lung cancer and has been given less than six months to live.
Patients must be terminally ill, diagnosed with less than six months to live to ask for the deadly prescription. After years of court battles and two state-wide votes in favor, what’s called the Death with Dignity act became law in Oregon in 1997.
But now Attorney General Ashcroft is threatening to use federal drug laws to punish any Oregon doctor who helps a patient die. Aschcroft would take away the doctor’s license to write prescriptions.
Says Dr. Rasmussen, “I couldn’t prescribe federally controlled drugs. As an oncologist and palliative care specialist, if I can’t prescribe narcotics, I can’t practice.”
The State government has gone to court to defend the Death with Dignity Act and the state’s right to regulate medical care. The case will go before a federal judge in Portland on Friday.
Kristen Granger is with the Oregon Attorney General’s office. She says, "Oregonians are not anymore arguing about whether it is-- it is appropriate to have physician assisted suicide as a-- Oregon state law. We have adopted it. So now it's a matter of protecting that law and-- and ensuring those rights for Oregonians who wish to access those rights.”
The Death with Dignity Act has not brought a rash of assisted suicide to Oregon. Last year, only 21 terminally ill patients chose to end their lives early. A total of 23 others actually asked their doctors to write lethal prescriptions but then didn't use them. Proponents of the law say for the dying, simply knowing the choice is there is a comfort.
Eight months ago, Jim Romney was diagnosed with Lou Gehrig’s disease, ALS. He says, "When I learned I could control the end of my life to how I would die, it brought me great joy, great liberation. I can only say that, for me, dying with dignity is very important and with ALS, my disease, it's very difficult to die with dignity, because one becomes pretty much vegetative. You go through a-- through a-- through a total paralysis your body. You can't speak. You can't breathe. You lose control of your bowels and your bladder. You're on feeding tubes. You'd be a tremendous burden to your family. And I see no dignity in that.”
At home in Portland with his wife and their son, Eric, Jim Romney is determined to enjoy every day that he can, but still wants to know he can take that lethal prescription if he chooses.
Says his wife, "Of course, I don't want that to happen, and neither one of us do. And if that day ever comes, it's gonna probably be the, you know, worst day of my life."
Says son Eric, "He's going to die either way. The fact that he has the option, if pain or whatever gets too bad to, you know, to take any more, he has that option. I think that gives him a peace of mind. And I think it gives us peace of mind too. I don't wanna see my father suffer."
And Romney himself adds, "We all want to live forever. None of us want to die. And if I can maintain diginity in my life until my death, I will do so."
Marilyn Thompson knows what its like to watch someone with ALS die slowly. As her husband Troy declined, they chose his grave site together.
"What can you do?" says Marilyn. "What are you supposed to do to get ready for death, for dying?"
Troy was just 34 when he was diagnosed. Within months, he was in a wheelchair and then confined to bed. But he opposed physician-assisted suicide and as he was dying, he fought to repeal the law.
"Our life is a gift, but how we live it is our choice and how long we live it should belong to someone who is much bigger and a much greater being who can see the future," says Marilyn. "I am thankful the suffering is over, but I wouldn’t trade one minute of his life."
As Troy Thompson saw it, the Death with Dignity Act declared that the lives of those who were dying were less important than the lives of others.
Says Marilyn, "He had such an impact with every day of his life. If he had gone, when the doctors said that he had less than six months to live, he would've missed out on 2 1/2 years of his life."
Why is this law in Oregon?
"We are a state where people like to make choices," explains Marilyn. "They like to have control over their lives. But does it really give us control over our lives? Or does it put control into the doctors' hands?"
Psychiatrist Dr. Gregory Hamilton has been a consistent opponent of physician-assisted suicide.
"What this law does," he says, "is it gives doctors and the HMOs for which they work the right to give lethal overdoses to those people whose care is expensive, and who may be in despair... You don't respond to somebody being afraid that they may need help or...may need their family to assist them, you don't respond to that by saying, 'Yes, your life is no longer valuable, here, take this overdose.' No, you respond to them by taking care of them, by telling them that you value them, by-- by helping them find hope and meaning in the end of life like all of us have to find hope and meaning throughout our lives."
The law says patients must be mentally capable.
"But we know the vast majority of the people with any interest in assisted suicide are depressed," says the psychiatrist.
But Dr. Rasmussen says, "Yeah, and you know, I was taught that when I went to medical school and I believed it for many years I think there are people who are perfectly sane, who know what their future holds for them, and then don’t want that. Those are the ones who want the death with dignity."
Leza Washington knows her options well. She’s a doctor as well as a patient. She’s 36 years old, losing a long fight with cancer. She says: "When I thought about dying, that's the way I want it. I want it to be in the company of friends, and I want it to let things go, just about the way I think they should without -- added—aides"
She understands those who choose to end their lives, but her wish is to die naturally. "It's iffy," she explains. "And I go back and forth. I really do. I think of the ease of taking medication that I know will do one thing. But that's not what I would like.”
The terminally ill in Oregon could lose their right to physician-assisted suicide within days or weeks if Attorney General Ashcroft prevails in court on Friday.
At the offices of cancer specialist Dr. Peter Rasmussen, some patients have decided they may want the prescription in hand while its still legal.
NARR: Like most people in Oregon who ask about the lethal prescription Patricia Lundin isn’t sure she’ll take it. But in the independent-minded state, many have found their final days easier knowing they can choose.
For more information:
Compassion in Dying
Physicians for Compassionate Care
Information about ALS (Lou Gehrig's disease) and ALS research
Oregon State Attorney General's office
U.S. Attorney General's office