Resident of Oregon, Jeanette Hall voted in favour of assisted suicide in 1997 and faced the prospect of it when she was diagnosed with inoperable colon cancer in 2000 at the age of 55 and given a year or less to live [1]. Jeanette did not wish to undergo chemotherapy or radiation, and her refusal of treatment worsened her prognosis to less than six months, thereby allowing her to access assisted suicide through Oregon’s Death with Dignity law [2].
According to Jeanette herself: “My hope turned into despair, and I prepared to die before the suffering got worse, since I was determined not to have chemo or radiation” [3].
However, Jeanette was convinced by her oncologist, Dr Kenneth Stevens, not to seek assisted suicide. According to Jeanette, he “battled me to think of living instead of dying and brought me back to reality with the question, ‘Don’t you want to see your son get married?’ He did not know that at that given time, I thought I would only become a burden to my son and my thought was that he would be o.k. without seeing me suffer” [4].
Writing to the Boston Globe in 2011, Jeanette reported that “I am so happy to be alive! It is now 11 years later […] If my doctor had believed in assisted suicide, I would be dead. I thank him and all my doctors for helping me to choose ‘life with dignity’” [5].
Fifteen years later, Jeanette is now free from cancer and celebrated her 70th birthday with her son [6]. She has further commented that “It’s great to be alive to have one more day and be able to encourage others to not give up when there seems to be no hope when given a terminal illness […] I say “NO” to assisted suicide” [7].
Dr Stevens opposes assisted suicide and has stated that “I didn’t go into medicine to kill people […] When a doctor writes a prescription, a prescription is a written order. If he’s writing a prescription for lethal drugs, he’s writing a prescription to kill the person” [8].
In respect of Jeanette’s case, he warned that “Doctors make misdiagnosis […] Jeanette Hall had a correct diagnosis—her cancer was inoperable meaning it [could not be] treated with surgery, but it is a cancer that’s treated with chemotherapy and radiation” [9].
Oregon legalised physician assisted suicide in 1997 following the passage of the Death with Dignity Act in 1994. This has legalised the prescription of lethal drugs for self-administration to mentally competent Oregon residents above the age of 18 who are suffering terminal illness and likely to die within six months [10]. The latest report for 2020 showed around 28% increase in the number of DWDA deaths from 2019, which is fifteen times more than the number of deaths in its first year of 1998 [11]. Concern about being or becoming a burden on family, friends, and caregivers ranked significantly higher (47.5%) than inadequate pain control, or concern about inadequate pain control (27.4%) [12].
Subsequent to inquiries in 2017, the Oregon Health Authority freely admitted that ‘incurable’ illness can include illnesses for which life-sustaining treatment exists, and that the definition of ‘terminal’ illness is based on the likelihood of death within six months if such life-sustaining treatment is stopped [13]. This can allow patients with chronic conditions, such as diabetes, to transform their condition into a terminal version by refusing appropriate treatment, such as insulin, and thus legally apply for assisted suicide. The 2020 DWDA report for Oregon found that ‘terminal’ conditions had included arthritis, arteritis, and complications from a fall [14].