Having become, in 1997, the first state to legalize physician-assisted suicide, Oregon, out of further compassion, has decided to provide this service to 270,000 low-income residents without charge. Death does not discriminate -- why should Oregon?
As of Dec. 1, the Oregon health plan provides state funds for diagnostic and counseling sessions to verify the desire for suicide. And, of course, the lethal drugs to fulfill that desire will be free.
State funds for this act of extreme compassion will be segregated from federal Medicaid money because Congress has not yet permitted death to be subsidized under Medicaid.
As Richard Doerflinger reported in "Life At Risk" (a newsletter published by the National Conference of Catholic Bishops), there were angry dissenting voices at a November hearing on this dividend for the economically challenged.
Ric Burger -- a diabetic, a wheelchair user and a spokesman for disabled citizens in the state -- noted: "The fact that the state of Oregon will not properly fund our personal attendant services, yet will pay for us to die, amounts to nothing less than cultural genocide."
Another group, Physicians for Compassionate Care, charged that "bureaucratic barriers have already been placed in the way of providing state funding for state-of-the-art antidepressant medication and even pain medicines, while full funding of assisted suicide for this same vulnerable population is being promoted."
Last year, the Economist praised Oregon's Democratic Gov. John Kitzhaber for rationing health care in the face of limited resources and observed that Oregon no longer pays for such treatments as "efforts to fight the final stages of AIDS." But now, AIDS patients can be lawfully assisted to kill themselves -- thereby saving the state even more money.
Despite the recent defeat in Michigan of an assisted-suicide proposal, other states are likely eventually to allow doctors to provide patients the means to dispose of themselves.
Polls indicate much popular support for state-aided "death with dignity." Many doctors agree. Some are neutral, like the Oregon Medical Association.
Yet in 1994 the New York State Task Force on Life and Law issued a report -- "When Death is Sought: Assisted Suicide and Euthanasia in the Medical Context" -- that warned doctors and patients of the dangers in the state's hastening of death.
This group, created by then-Gov. Mario Cuomo, consists of lawyers, physicians and an ecumenical roster of religious leaders. The task force pointed out that "in light of the pervasive failure of our health care system to treat pain and diagnose and treat depression, legalizing assisted suicide and euthanasia would be profoundly dangerous for many individuals who are ill and vulnerable. The risks would be most severe for those who are elderly, poor, socially disadvantaged, or without access to good medical care."
The task force also noted that "racism, ageism, bigotry against disabled people, and issues of class and economic status would materially affect killing decisions."
The Supreme Court refused on June 6, 1997, to declare physician-assisted suicide a constitutional right, but in the decision for a unanimous court, Chief Justice William Rehnquist encouraged the states to explore ways of dealing with this rising issue.
Rehnquist emphasized that "the lives of the terminally ill, disabled and elderly people must be no less valued than the lives of the young and healthy." Otherwise, he said, they would become victims of "abuse" by compassionate expediters.
And Justice David Souter, in a concurring opinion, stated his concern that assisted suicide could slip into euthanasia: "Whether acting from compassion or under some other influence, a physician who would provide a drug for a patient to administer might well go the further step of administering the drug himself, so the barrier between assisted suicide and euthanasia could become porous as well as the line between voluntary [and involuntary] euthanasia."
Souter also recognized "the financial incentives" in this new era of managed care.
In the sweepingly compassionate new world ahead, I would not be surprised if Oregon became the first state to legalize the right of physicians to directly kill a patient. At no cost to the departed, of course.