1994 Oregon Ballot Measure 16
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Measure 16 of 1994 established the
U.S. state In the United States, a state is a constituent political entity, of which there are 50. Bound together in a political union, each state holds governmental jurisdiction over a separate and defined geographic territory where it shares its sove ...
of
Oregon Oregon () is a state in the Pacific Northwest region of the Western United States. The Columbia River delineates much of Oregon's northern boundary with Washington, while the Snake River delineates much of its eastern boundary with Idaho. T ...
's Death with Dignity Act ( ORS 127.800–995), which legalizes medical aid in dying (commonly referred to as
physician-assisted suicide Assisted suicide is suicide undertaken with the aid of another person. The term usually refers to physician-assisted suicide (PAS), which is suicide that is assisted by a physician or other healthcare provider. Once it is determined that the p ...
) with certain restrictions. Passage of this
initiative In political science, an initiative (also known as a popular initiative or citizens' initiative) is a means by which a petition signed by a certain number of registered voters can force a government to choose either to enact a law or hold a ...
made Oregon the first U.S. state and one of the first jurisdictions in the world to permit some
terminally ill Terminal illness or end-stage disease is a disease that cannot be cured or adequately treated and is expected to result in the death of the patient. This term is more commonly used for progressive diseases such as cancer, dementia or advanced h ...
patients to determine the time of their own death. The measure was approved in the November 8, 1994, general election. 627,980 votes (51.3%) were cast in favor, 596,018 votes (48.7%) against. An injunction delayed implementation of the Act until it was lifted on October 27, 1997. Measure 51, referred in the wake of the
US Supreme Court The Supreme Court of the United States (SCOTUS) is the highest court in the federal judiciary of the United States. It has ultimate appellate jurisdiction over all U.S. federal court cases, and over state court cases that involve a point of ...
's 1997 ruling in '' Washington v. Glucksberg'' by the state legislature in November 1997, sought to repeal the Death with Dignity Act, but was rejected by 60% of voters. The act was challenged by the
George W. Bush administration George W. Bush's tenure as the 43rd president of the United States began with his first inauguration on January 20, 2001, and ended on January 20, 2009. Bush, a Republican from Texas, took office following a narrow victory over Democratic ...
, but was upheld by the Supreme Court of the United States in '' Gonzales v. Oregon'' in 2006.


The law

Under the law, a competent adult Oregon resident who has been diagnosed, by a physician, with a terminal illness that will kill the patient within six months may request in writing, from his or her physician, a prescription for a lethal dose of medication for the purpose of ending the patient's life. Exercise of the option under this law is voluntary and the patient must initiate the request. Any physician, pharmacist, or other healthcare provider who has moral objections has the right to refuse to participate. The request must be confirmed by two witnesses, at least one of whom is not related to the patient, is not entitled to any portion of the patient's estate, is not the patient's physician, and is not employed by a health care facility caring for the patient. After the request is made, another physician must examine the patient's medical records and confirm the diagnosis. The patient must be determined to be free of a mental condition impairing judgment. If the request is authorized, the patient must wait at least fifteen days and make a second oral request before the prescription may be written. The patient has a right to rescind the request at any time. Should either physician have concerns about the patient's ability to make an informed decision, or feel the patient's request may be motivated by depression or coercion, the patient must be referred for a psychological evaluation. The law protects doctors from liability for providing a lethal prescription for a terminally ill, competent adult in compliance with the statute's restrictions. Participation by physicians, pharmacists, and health care providers is voluntary. The law also specifies a patient's decision to end his or her life shall not "have an effect upon a life, health, or accident insurance or
annuity In investment, an annuity is a series of payments made at equal intervals.Kellison, Stephen G. (1970). ''The Theory of Interest''. Homewood, Illinois: Richard D. Irwin, Inc. p. 45 Examples of annuities are regular deposits to a savings account, ...
policy."


Impact

From the beginning of 1999 through the end of 2015, a total of 1,545 people have had prescriptions written and 991 patients have died from ingesting medications prescribed under the act. The median age of the 991 patients who died from ingesting medication was 71; 77.1 percent of patients had malignant neoplasms (
cancer Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. These contrast with benign tumors, which do not spread. Possible signs and symptoms include a lump, abnormal b ...
). Of the 991, 51.4% were male (48.6% female); 45.5% had a Baccalaureate degree or higher; 45.3% were married; primary end of life concerns were loss of autonomy (91.6%), inability to make life enjoyable (89.7%), and loss of dignity (78.7%). An independent study published in the October 2007 issue of the ''
Journal of Medical Ethics The ''Journal of Medical Ethics'' is a monthly peer-reviewed academic journal covering the field of bioethics that was established in 1975. According to the ''Journal Citation Reports'', the journal has a 2019 impact factor of 2.021, ranking it fou ...
'' reports there was "no evidence of heightened risk for the elderly, women, the uninsured, people with low educational status, the poor, the physically disabled or chronically ill, minors, people with psychiatric illnesses including depression, or racial or ethnic minorities, compared with background populations." The Death with Dignity Act was the basis of the
Washington Death with Dignity Act Initiative 1000 (I-1000) of 2008 established the U.S. state of Washington's Death with Dignity Act ( RCW 70.245), which legalizes medical aid in dying with certain restrictions. Passage of this initiative made Washington the second U.S. state to ...
in 2008. In 2011 the documentary film ''
How to Die in Oregon ''How to Die in Oregon'' is a 2011 American documentary film produced and directed by Peter Richardson. It is set in the U.S. state of Oregon and covers the state's Death with Dignity Act that allows terminally ill patients to self-administer b ...
'' was released. It won the Grand Jury prize for documentary film at the
27th Sundance Film Festival The 27th annual Sundance Film Festival took place from January 20, 2011 until January 30, 2011 in Park City, Utah, with screenings in Salt Lake City, Utah, Ogden, Utah, and Sundance, Utah. The festival opened with five screenings, one from each c ...
. According to
Dignity in Dying Dignity in Dying (originally The Voluntary Euthanasia Legalisation Society) is a United Kingdom nationwide campaigning organisation. It is funded by voluntary contributions from members of the public, and as of December 2010, it claimed to hav ...
, Lord Falconer's Assisted Dying Bill, first tabled in the
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in June 2014, "draws on the experience" of the Death with Dignity Act.


Attempts to repeal

In addition to arguments against physician-assisted dying, opponents feared that terminally ill people throughout the nation would flock to Oregon to take advantage of the law. This fear has not been realized, largely because drafters of the law limited its use to Oregon residents. Despite the measure's passage, implementation was tied up in the courts for several years. In 1997, the Oregon Legislative Assembly referred Measure 51, which would have repealed the act, to the ballot. Proponents of Measure 51 argued that the Death with Dignity Act lacked a mandatory counseling provision, a family notification provision, strong reporting requirements, or a strong residency requirement. Measure 51 opponents argued that sending the measure back to voters was disrespectful considering they had already passed Measure 16 via the initiative process. They also felt that the safeguards in the Death with Dignity Act were adequate. Measure 51 was defeated in the November 4, 1997,
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with 445,830 votes in favor, and 666,275 votes against. Some members of the
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, notably Senator
Don Nickles Donald Lee Nickles (born December 6, 1948) is an American politician and lobbyist who was a Republican United States Senator from Oklahoma from 1981 to 2005. He was considered both a fiscal and social conservative. After retiring from the Senat ...
of Oklahoma, tried to block implementation of Measure 16, but failed. In 2002, federal judge Robert E. Jones blocked a move by
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to suspend the license for prescribing drugs covered in the Controlled Substances Act of doctors who prescribed life-ending medications under the Oregon law. The
Ninth Circuit Court of Appeals The United States Court of Appeals for the Ninth Circuit (in case citations, 9th Cir.) is the U.S. federal court of appeals that has appellate jurisdiction over the U.S. district courts in the following federal judicial districts: * District ...
affirmed the block, stating that the "Attorney General lacked Congress' requisite authorization". In October 2005, the
U.S. Supreme Court The Supreme Court of the United States (SCOTUS) is the highest court in the federal judiciary of the United States. It has ultimate appellate jurisdiction over all U.S. federal court cases, and over state court cases that involve a point o ...
heard arguments in the case of '' Gonzales v. Oregon'' to determine the fate of the Death with Dignity law. Arguing on behalf of the state was Oregon Senior Assistant Attorney General Robert Atkinson. Oregon's five Democratic members of Congress also filed a brief in support of the State's position.
United States Solicitor General The solicitor general of the United States is the fourth-highest-ranking official in the United States Department of Justice. Elizabeth Prelogar has been serving in the role since October 28, 2021. The United States solicitor general represent ...
Paul Clement argued on behalf of the Bush administration, which challenged Oregon's right to regulate the practice of medicine when that practice entails prescribing federally controlled substances. On January 17, 2006, the court ruled 6–3 in favor of Oregon, upholding the law.


See also

*
Act 39 Act 39 of 2013 established the U.S. state of Vermont's Patient Choice and Control at End of Life Act ( Vermont Statutes Annotated Sec. 1. 18 V.S.A. chapter 113), which legalizes medical aid in dying (commonly referred to as physician-assisted suici ...
in
Vermont Vermont () is a state in the northeast New England region of the United States. Vermont is bordered by the states of Massachusetts to the south, New Hampshire to the east, and New York to the west, and the Canadian province of Quebec to ...
, the first state to pass a death with dignity law by legislative action * Assisted suicide in the United States *
List of Oregon ballot measures The list of Oregon ballot measures lists all statewide ballot measures to the present. In Oregon, the initiative and referendum process dates back to 1902, when the efforts of the Direct Legislation League prompted amending the Oregon Constit ...
*
California End of Life Option Act California End of Life Option Act is a law enacted in June 2016 by the California State Legislature which allows terminally ill adult residents in the state of California to access medical aid in dying by self-administering lethal drugs, provided ...
* Compassion & Choices of Oregon, providing medical consultation and direct service for persons eligible for the Oregon Death with Dignity law. * Death with Dignity National Center, an organization founded to pass and support the law. * Massachusetts Death with Dignity Initiative *
Washington Death with Dignity Act Initiative 1000 (I-1000) of 2008 established the U.S. state of Washington's Death with Dignity Act ( RCW 70.245), which legalizes medical aid in dying with certain restrictions. Passage of this initiative made Washington the second U.S. state to ...
, a similar measure passed in November 2008 in the state of
Washington Washington commonly refers to: * Washington (state), United States * Washington, D.C., the capital of the United States ** A metonym for the federal government of the United States ** Washington metropolitan area, the metropolitan area centered o ...
* '' Baxter v. Montana'', a court decision legalizing aid in dying in Montana * '' Gonzales v. Oregon'' * '' Washington v. Glucksberg'' * Euthanasia in Australia *
Voluntary Assisted Dying Act 2017 (Victoria) {{use Australian English, date=December 2017 {{Use dmy dates, date=August 2017 {{Infobox legislation , short_title = Voluntary Assisted Dying , legislature = Parliament of Victoria , image = , imagesize = , ...


References


External links


Official Oregon Health Authority page on the DWDA
with Annual Reports
Web site in favor of law


* ttp://www.euthanasiaprocon.org/dwdagoodbadlaw.html Is the Oregon Death with Dignity Act a good law?Website with pros and cons
Oregon Voter's Pamphlet Special Election November 1997 – Measure 51
ncludes the full text of the measure, and arguments for and against
The New Atlantis: Ten Years of "Death with Dignity"
{{Authority control 1994 Oregon ballot measures 1997 Oregon ballot measures Death in Oregon Initiatives in the United States Assisted suicide in the United States