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The Oregon Death with Dignity Act is a citizen's initiative that makes physician-assisted suicide a legal option for terminally ill, eligible state residents. The act mandates that the Oregon Health Division develop a reporting system to monitor adherence to specific statutory requirements of the act, and to issue to the public an annual statistical report, while maintaining the confidentiality of those who participate. The act does not authorize the Oregon Health Division, as Foley and Hendin suggest, to investigate how physicians determine their patients' diagnoses and prognoses, nor does it give us the mandate to conduct "psychological autopsies" of participating patients. The reporting system for the act relies on information provided by the physicians who write prescriptions and sign the death certificates. During the first year we also interviewed participating physicians to gain additional information regarding the circumstances surrounding the patients' deaths. We carefully considered how much additional intrusion into the lives of patients and their families was acceptable. Given the intense media scrutiny of physician-assisted suicide in Oregon in 1998, we were especially concerned about an inadvertent breach of confidentiality that might result from a more invasive approach involving interviews with other health care providers or family members. We believe that our decision to conduct additional in-depth interviews only with the prescribing physicians best balanced the need for immediate information with the need to respect the privacy and confidentiality of those involved. The authors of the article incorrectly state that the Oregon Health Division has been conducting a "public relations campaign and that "those sanctioned by the government to analyze its operation have become its advocates." This is not true. The reality is that the Oregon Health Division's role is to provide accurate data to the public regarding participation in the act, which is exactly what we have done. Because this is such a hotly debated topic, with intense media attention, we broadly and openly disseminated the first year's data to as wide an audience as possible. This included issuing a press release and holding a briefing at the National Press Club. We also, at the governor's request, held a briefing for congressional staffers on both sides of the aisle, with varying positions on the act. In these briefings, we presented the data; we didn't argue either for or against the law. For example, we presented data on the time of ingestion to death. Although the median duration was 26 minutes, we pointed out that one patient lived for 11.5 hours after taking the medications. This information can be interpreted in either a positive (most patients died quickly) or negative (the time until death is not always rapid or predictable) manner. Our job is to present the data; it is up to others to decide whether or not the data |
