Last week an amendment to Oregon's 'Death with Dignity Act' (DWDA) was proposed in the State Legislature. The Act as it stands allows lethal drugs to be prescribed for people who request them and who are thought to meet certain conditions, one of which is that they are 'capable' - meaning that they are able to make and communicate decisions. The recipient of such a prescription may collect the drugs or defer their collection to a later date. If they are collected, they must be self-administered. In other words, the DWDA allows physician-assisted suicide but not physician administered euthanasia.
The proposed amendment would allow someone who has received a prescription for lethal drugs to execute an advance directive enabling a named individual to collect those drugs and to administer them to the person concerned in the event that that person should have lost decision-making capacity. This raises a number of important questions. First, who is to judge whether the person for whom the drugs had been prescribed has lost capacity? Is there to be a re-assessment of the case by the doctor who prescribed the drugs? Or is it be left to someone else - for example, a relative - to make that judgement? Second, is it envisaged that there should have been a request by the person whose life is on the line? And, if it is so envisaged, what assurance can there be that a request from someone who has lost capacity is truly voluntary?
Then there is that all-important word 'administer'. What is being proposed seems to be that, if an intended recipient of lethal drugs should lose capacity before collecting them, someone else should be able to collect them and feed them to the person concerned. If this interpretation is correct (and it is difficult to think of any other) and if the proposed amendment is accepted by the State Legislature, it would open the door from assisted suicide into euthanasia. That would be a major step.
This matter was drawn to the attention of the House of Lords yesterday by Baroness Howe and Lord Alton in the course of a one-hour debate, at the request of Baroness Jay (a campaigner for legalisation of physician-assisted suicide), on whether such legislation in North America provided an appropriate template for Britain. "What price now", commented Lord Alton, "all those reassurances we have received from the 'assisted dying' lobby here that there is no pressure to extend Oregon's law!".
The fundamental problem with 'assisted dying' laws is that they replace a natural legal boundary with an artificial one. As former President of the Family Division of the High Court Baroness Butless-Sloss has written:
"Laws are like nation states. They are more secure when their boundaries rest on natural frontiers. The law that we have rests on just such a frontier. It rests on the principle that we do not involve ourselves in bringing about other people's deaths. Once exceptions are introduced, based on arbitrary criteria like terminal illness, that frontier is blurred. It becomes no more than a line in the sand, easily crossed and hard to defend".
We will have to wait and see whether the Oregon State Legislature accepts this far-reaching amendment. But there can little doubt that the pressures to extending Oregon's law are building. This not the first attempt that has been made.