Correlation in not causality. Just because A comes before B doesn’t necessarily mean AB caused, even though many people predicted it would. But sometimes it cannot be ruled out. This could be the case with Oregon’s decade-long Medical Suicide Act (PAS) and recent efforts to deny life-saving care to COVID-19 patients with disabilities.
National Public Radio recently released a story indicating that some Oregon hospitals and doctors may refuse health care to COVID-19 patients with significant disabilities.
According to NPR investigative reporter Joseph Shapiro, Sarah McSweeney, a woman with multiple disabilities, entered a hospital in suburban Portland with COVID-19. The doctor wanted to put her on a ventilator. She didn’t get one, although Oregon had a surplus at the time and was loaning its fans to other states. She died.
In the story, Jake Cornett of Disability Rights Oregon cites similar cases of denial of care to COVID-19 patients with disabilities. “So that several cases like this occur again and again in a single state, the alarm bell should be triggered. It should convince people that this is a real problem that we need to address quickly at the state and federal levels, ”Cornett says in the story.
NPR investigated a dozen cases in Oregon. State Senator Sara Gelser, who has dealt with allegations of denial of care for people with disabilities, told NPR that people believe these are “dystopian stories that would never happen, but they do and they have and them will”.
The story goes that some Oregon health care providers have found that certain people with severe disabilities lack a threshold for quality of life so treatment is neither worth the effort nor the cost.
When Oregon voters approved a medical-assisted suicide policy in 1994, it was the first state to do so. Many people have expressed concerns that this could lead to degradation in life, especially for certain groups of the population – the very young, the very old, and the severely disabled.
Over the years, the Clinton and George W. Bush administrations, as well as congressmen and senators, religious and patient rights groups, made several attempts to question the law precisely because of the deadly threat it posed to certain populations.
But the state has been persistent in asserting its right to help certain terminal patients end their lives with dignity. The US Supreme Court agreed twice (1997 and again in 2006), essentially concluding that under a federal system, the federal government has limited capabilities and states have the right to pass such laws.
(Note: At the time of the Oregon debate, I was invited by medical ethicists to contribute a chapter to a book – “Doctors’ Suicide: Expanding the Debate” – that addresses the question of whether doctor suicide would save the health system which was one of the arguments for it. I did it and it didn’t.)
The number of medical assisted suicides in Oregon has risen almost every year since then. From 2013 onwards, there has been a remarkable increase that continues to this day.
Death with Dignity, an advocacy group, writes: “In 2019, 112 doctors in Oregon wrote 290 prescriptions to dying Oregonians who qualified for the law. 188 people died with the drugs required by law. “Some people ask for the recipe, but decide against it.
Since Oregon passed its law, eight other states have passed similar laws, most of which were passed in the past five years – probably too early to notice any real change in attitudes toward people with severe disabilities.
And while medical assisted suicide raises concerns, the public broadly supports this option. According to Gallup, 72 percent of Americans support a terminal patient’s right to end their life with the help of a doctor. That is understandable. I think most of us would like this option to be available even if we are extremely unlikely to use it.
Younger people, Democrats, Liberals, and those who rarely or never attend church are the strongest supporters, according to Gallup.
Will the escalation of doctor-assisted suicide eventually destroy the long-held belief that we should value and protect life, especially the life of this society, which is viewed as marginal?
Now, after nearly 25 years, disability rights groups in Oregon are seeing a growing callousness in some health care providers who seem not to value some lives as much as others.
In particular, the NPR story makes no mention of Oregon’s Doctor-Aid Suicide Act. The story tries to link neglect to a broader problem: inequalities in health care for people with disabilities. “For the first time we see in an urgent and more public way how deadly this can be,” said Senator Gelser.
To get back to the original question, I don’t know if A (Oregon’s Law on Death with Dignity) caused B (Denial of some care for disabled COVID-19 patients). But I know that 20 years ago many people predicted and feared this.
Merrill Matthews is a resident researcher at the Institute for Political Innovation in Dallas, Texas. Follow him on Twitter @MerrillMatthews.