October 6, 2008

Saturday Opinion Two I-1000 PRO

By Karen Troianello

I was governor of Oregon when voters approved our state's landmark Death with Dignity Act in 1994. I endorsed that ballot measure, and another one in 1997 in which voters reaffirmed their support after the federal government tried to take the voters' original decision away. I've followed the law closely, and now, 11 years later, I still strongly support individual freedom in end-of- life decisions.

You will hear plenty of exaggerations from opponents of death with dignity. I know, because they used the same arguments in Oregon. But I can tell you that none of those worst-case scenarios ever came to pass.

When you think about supporting I-1000, Washington's death with dignity initiative, I hope you will look at the Oregon experience, and I hope that my experience can help clarify some of the facts.

My husband Frank, who died in 1993, was the longest-serving member of the Oregon legislature. In the legislature, he proved that his disability, his need for a wheelchair, did not stand in the way of the remarkable contribution he made to public policy in Oregon. He was often referred to as the "conscience of the Senate." Even before cancer put him in a wheelchair, Frank knew that as the parent of a disabled son and with 40 years of work in the disability community, I would never support a law that could harm people with disabilities.

Let me state emphatically, I would never support a law that was harmful to individuals with disabilities. The proposed Death with Dignity law is not a slippery slope. In fact, after over a decade of experience, we know that disability is irrelevant to the Death with Dignity law. Disabled people with a terminal illness are treated exactly the same as all other people with a terminal illness -- they are protected, and their decisions are respected.

There are many, many safeguards that ensure that the terminally ill patient's decision is informed and voluntary. And those are the exact same safeguards that have worked in Oregon for over 10 years.

The Death with Dignity Act has improved end-of-life care for all patients in Oregon. Patients, families and doctors are more educated about end-of-life options, and have higher expectations about end- of-life care. Oregon is rated as having the best pain management and palliative care in the nation. More people die at home than in hospitals, because doctors, families and patients can have a more informed and honest conversation about what they want.

Conversations about dying have always been a bit taboo, and fear has a way of keeping us in the dark. But when dying is discussed over dinner and in classrooms, at hair salons and barbershops, at the gym and the farmers market, then we become better educated and better prepared. We become less afraid because we have taken away the mystery and discovered the facts.

Because of the honest conversations that people have under the Death with Dignity Act, all patients have better access to better pain and palliative care. This vastly improved pain care means that patients and families get to spend more quality time with their loved ones, and less time worrying about untreated pain or wondering what will happen next.

Oregon's law has been upheld through every state and federal court challenge, including the U.S. Supreme Court. It was approved twice by a majority of voters, and used by a small number of terminally ill patients. Only 341 Oregonians chose to end their suffering under the law in the past 10 years. The patients who choose to use it are usually end-stage cancer patients, and the personal stories they and their loved ones have shared have been beautiful accounts of dignified and gentle exits, made possible by the autonomy and freedom the act provided.

An additional 546 patients chose to access the medication, but decided not to use it. The issue was choice and having an option -- and simply having that option removed some of their fear, even though they decided not to use it.

I have spoken with audiences across the nation about death and grieving, and I learned that for the terminally ill, the biggest concern is not cost or pain, but loss of control and loss of choice. The Death with Dignity Act gives terminally ill patients some control over their end-of-life care, and the right to decide how and when to ease their own suffering.

Just like in Oregon, Washington's death with dignity initiative raises the question of who should make these difficult end-of-life decisions. I hope Washingtonians will agree that terminally ill patients should have the freedom to make the decision for themselves.

Barbara Roberts was governor of Oregon from 1991-1995. Retired from politics, she remains active in community service and has held teaching positions at the John F. Kennedy School of Government and Portland State University.

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