PORTLAND, Ore. — Nearly 30 years ago, Oregon became the first state to legalize medical aid in dying with the "Death with Dignity Act." But even after all this time, there have been aspects of the law that rankled some physicians — and this legislative session brought changes.
In the past, patients needed to be an Oregon resident to qualify and apply for the lethal mix of medications used in the procedure. Now, anyone from any state can apply for assisted dying, as long as they meet the other requirements.
This change has been in the works for years. Back in 2021, an Oregon doctor sued the state, claiming that the residency requirement in the Death with Dignity Act was unconstitutional.
Even though both Oregon and Washington had legalized assisted suicide, Dr. Nick Gideonse at OHSU could not write end-of-life prescriptions for his Washington patients, some coming from just across the Columbia River.
Less than a year later, the lawsuit was settled.
"The settlement terms included the agreement that we would not enforce the residency requirements any longer," said Tom Jeanne, the Oregon Health Authority's deputy state health officer.
Even though it was no longer being enforced, it wasn't until the 2023 legislative session that lawmakers introduced House Bill 2279 to enshrine that part of the settlement into state law.
The bill passed both chambers, and Governor Tina Kotek signed it into law on July 13, 2023.
The OHA said that at least three people from out of state received the lethal prescriptions in 2022. But that doesn't necessarily represent a full count. While people can come to Oregon to apply for and get the medication, they do not need to die in Oregon.
"If somebody uses Oregon's law, but then actually goes back to their home state, we would actually not necessarily know, because we don't receive the death certificate from another state," Jeanne said.
It's worth noting that removing the residency requirement does not change the other necessary steps it takes to get approved.
The state says that to apply and receive the medication, the patient must be at least 18 years old, be able to understand and communicate their decisions and have six months or less to live due to a terminal illness.
How did we get here?
Long before voters went to the ballot box and approved the Death with Dignity Act, some Oregonians were fighting for a way to end their lives on their own time.
In 1990, KGW spoke to a man who was losing his daily life to Parkinson's disease and wanted to end his suffering. His daughter said that she wanted to respect her father's wishes, but she didn't want him to end his life prematurely.
"For that reason, I am almost glad there is nothing available to him at this point to end his life," she told KGW.
In 1994, the Death with Dignity Act came before Oregon voters. The outcome was close — 51% in favor to 49% against. For many, it came down to personal control over their end-of-life care.
"I have always felt in my entire adult life that people should be able to control the timing and the nature of their death," a cancer patient told KGW in 1994.
But the law didn't go into effect right away. The U.S. District Court in Eugene imposed an injunction after the group National Right to Life challenged the measure with a federal lawsuit. Religious groups, including the Catholic Archdiocese of Portland, opposed the measure. With them stood the Sisters of Providence. Other hospital systems, including Legacy, OHSU and Portland Adventists remained neutral.
"Our best medical, nursing, social and spiritual resources will be applied to counter the pain, the isolation, the loneliness that often causes the greatest suffering to dying persons," a priest said in public remarks at the time.
For three years the Death with Dignity Act hung in the balance. Then, in 1997, voters got another crack at the issue. A second initiative, Measure 51, was put before voters — this time trying to repeal the original measure. But Oregon voters rejected Measure 51, keeping the Death with Dignity Act in place.
That wasn't the end of major developments in 1997. That same year, the lawsuit that had stalled Death with Dignity in Oregon was dismissed on appeal. The law was allowed to go into effect.
But challenges to the law didn't cease there. In 2005, President George Bush's administration petitioned the U.S. Supreme Court to hear their case against the law — arguing that doctors who provided this care in Oregon could be prosecuted under federal drug laws. The following year, the Supreme Court upheld Death with Dignity in a 6-3 vote.
In 2008, Washington became the second state to approve medical aid in dying, their law closely modeled after Oregon's. It is now legal in 11 states.