Legal physician-assisted suicide in Oregon and The Netherlands: evidence concerning the impact on patients in vulnerable groups--another perspective on Oregon's data

J Med Ethics. 2011 Mar;37(3):171-4. doi: 10.1136/jme.2010.037044. Epub 2010 Nov 11.


Battin et al examined data on deaths from physician-assisted suicide (PAS) in Oregon and on PAS and voluntary euthanasia (VE) in The Netherlands. This paper reviews the methodology used in their examination and questions the conclusions drawn from it-namely, that there is for the most part 'no evidence of heightened risk' to vulnerable people from the legalisation of PAS or VE. This critique focuses on the evidence about PAS in Oregon. It suggests that vulnerability to PAS cannot be categorised simply by reference to race, gender or other socioeconomic status and that the impetus to seek PAS derives from factors, including emotional state, reactions to loss, personality type and situation and possibly to PAS contagion, all factors that apply across the social spectrum. It also argues, on the basis of official reports from the Oregon Health Department on the working of the Oregon Death with Dignity Act since 2008, that, contrary to the conclusions drawn by Battin et al, the highest resort to PAS in Oregon is among the elderly and, on the basis of research published since Battin et al reported, that there is reason to believe that some terminally ill patients in Oregon are taking their own lives with lethal drugs supplied by doctors despite having had depression at the time when they were assessed and cleared for PAS.

Publication types

  • Comment

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Attitude of Health Personnel*
  • Attitude to Death
  • Data Collection
  • Female
  • Humans
  • Male
  • Middle Aged
  • Netherlands
  • Oregon
  • Practice Patterns, Physicians' / ethics*
  • Practice Patterns, Physicians' / legislation & jurisprudence
  • Right to Die / ethics*
  • Right to Die / legislation & jurisprudence
  • Suicide, Assisted / ethics*
  • Suicide, Assisted / legislation & jurisprudence
  • Terminal Care / legislation & jurisprudence
  • Terminal Care / standards
  • Terminally Ill / psychology
  • Vulnerable Populations* / legislation & jurisprudence