Death with Dignity: It's not suicide.

By Claire Simons of Portland, Oregon. Claire describes herself as "an advocate for the dying." She was the press person for the 16 patient-plaintiffs in Gonzales v. Oregon and attended oral arguments at the US Supreme Court.

As Bill Maher said, "assisted suicide isn't just for those sprout-chewing liberals up in Oregon".

But Bill... it isn't "suicide".

Last week, the Oregon Department of Human Services (DHS) adopted value-neutral language for describing practice under Oregon's Death With Dignity Act (DWDA). DHS will now use the functional term "physician assisted death" on its website and in all future reports. The language replaces the term "physican asssited suicide" used in past DHS reporting.

The Dignity Act clearly states: "Actions taken in accordance with ORS 127.800 to 127.897 shall not, for any purpose, constitute suicide, assisted suicide, mercy killing or homicide, under the law." The new language honors the intent and values of patients who access the DWDA.

Charlene Andrews of Salem, the 16th patient-plaintiff in Gonzales v. Oregon would say "yippee!" Char told the National Press Club:

"Please do not call it suicide, that is an insult to my fight against cancer. With cancer, we know when there are no treatment options. I think it is much more spiritual to be around your loved ones, know that they are there, and be conscious about when it is the end."

Char devoted her final years to clarifying the public's perception between suicide and a terminally ill patient's choice to hasten death. She understood the importance of language in framing the national debate on Oregon's landmark law. She died peacefully surrounded by her loved ones on August 2, 2006 without obtaining medication.

On Thursday, Compassion & Choices of Oregon commemorates 9 years of careful stewardship of Oregon's assisted dying law by honoring an Oregon heroine. Charlene Andrews' daughter Sue Spengler will accept the award in memory of her mother's legacy.

  • Deep Toad (unverified)

    Rubbish. The act of taking one's life is suicide and it doesn't matter how you decide to spin it. Physician assisted suicide, physician assisted dying - it's all the same thing. Here's an idea! Why don't you call it funeral arrangements acceleration? That way you can keep turning reality into ridiculous little euphamisms.

  • Lexicon (unverified)

    Oh, thank GOD! I was really worried there for a minute...but since we changed the name, it really isn't suicide after all. Pretty soon, rape will be called "unilatteral pleasuring". I bet that's a relief to countless thousands. Abortion isn't long for this world, no pun intended. Soon, it shall be known as "pre-birth reevaluation."

    Idiot liberals.

    Oh wait...we can dress that up a bit to make it mean something else. How about "intelligence-disenfranchised?"

    Quite frankly, I am pretty neutral on assisted suicide. I think it does damage to the medical ethic, but I completely understand the need and desire for a patient's control over their end-of-life events. But calling it something different is a ridiculous game of words. If terminally ill patients are upset their actions are seen as suicide, then perhaps they shouldn't be doing it. If I had terminal cancer, the LAST thing I would be worried about was the word choice of my actions.

    A rose by any other name....

  • sasha (unverified)

    Words mean things. A tried and true totalitarian tactic is to hijack definitions and terms. Thanks for highlighting the most current example.

    Is abortion now going to be called retro-active birth control?

    We can have lots of fun with new terms for well understood concepts. Let's play!

  • Buckman Res (unverified)

    ...and robbery will now be referred to as “imposed property procurement”.

    What an insult to my intelligence. I don’t need someone with too much time on their hands performing semantic gymnastics in order to make a difficult, personal decision more palatable to those who oppose it.

    People know what suicide is, what it meant when they approved the measure, and the results of the action.

    Thank God the average Oregonian has more sense than the bureaucrats in Salem.

  • (Show?)

    it's a joke to make the claim that "liberals" are the only ones who euphemize or distort language (homocide bombers, anyone?), but I have to agree with our trollish and semi-trollish friends: suicide is suicide. Taking your own life--for whatever reason--is an act of suicide. I support it, I fought for it, I think it's part of what makes Oregon a better place to live...but it's a law that lets people commit suicide.

  • (Show?)

    I agree that words mean something, and I don't know that this is spin. But I also don't think it's an improvement. Suicide is an act, death is an event. Death happens to us all, but the manner of that death is rarely suicide.

    End-of-life issues are extremely important, and as we enter this new medically-assisted phase of evolution, we must balance nature's imperative with our ability to stave it off. Oregon was one of the few places on the planet where we had a serious, honest discussion about this issue, and I think calling a suicide a suicide is part of that honesty.

    Suicide is the accurate term, etymologically: "Latin sui (genitive) of oneself + English -cide; akin to Old English & Old High German sIn his, Latin suus one's own, sed, se without, Sanskrit sva oneself, one's own." (Merriam Webster)

    From a linguistic point of view, "suicide" addresses both the actor and the act. "Death," on the other hand, is a softening of the original meaning, and throws the act into question. It removes the agency of the patient.

    Politically, too, I distrust this distancing. It seems to me like a lack of nerve. I am a fan of the law, though I would never use it. I tend to be very libertarian about people having control over the acts that affect their bodies. I think the serious debate we had about this issue is hidden slightly as we lose the forthrightness of what the law's intention was. It was a suicide law, not a "death" law. Even the powerful state has no control over death.

  • KISS (unverified)

    And again, I find Jeff's articulation to be very thoughtful and precise. Semantics be damned! Dignity is the key-word and nothing else really matters. I hope someday the topic of pain management comes to this forum.

  • Righty (unverified)

    I find Torridjoe's statement a bit ironic.

    "I support it, I fought for it, I think it's part of what makes Oregon a better place to live..."

    Why does it make it a better place to live? Because you don't have to pay for grandpa's care anymore - or what? It necessarily doesn't make it a better place to live for those who kill themselves.

    However, I agree that this is not necessarily a left-only occurrence. People hide their actions with a cloak of honey-butter sweetness when they are ashamed of what they are really about. Examples are...

    Pro-choice - generic term when the issue is specific (abortion)

    Compassionate Conservative - completely meaningless

    The Nazi's called imprisonment "protective custody"

    These examples are all around us. It seems to me that the problem with the left is that they always think that government domination will occur through the means shown in 1984 (the book). Well, read "Brave New World" because that seems more and more to be the path we are headed down.

    It is a tragedy that old folks are not given every option of pain management (no - not legalized drugs) but heck, we'll pay for them to kill themselves. The state doesn't have to pay for any services, the insurance company is off the if we could just get the kids to feel a little less guilty about getting their parents killed off.

    Call it what you will it is suicide, doctors shouldn't be killers, and Oregon should be ashamed.

  • timothy (unverified)

    I suffered brain cancer, and going into the situation, the odds were very bad. It is a VERY painful disease. My only fear was painfully wasting away, just like my Mom did.

    My mother died of breast cancer in 2001. When she died she was yellow, bleeding, bald and she looked like a skeleton. They , with our familiy's permission, removed her feeding and water, she was in a coma/unresponsive state and the cancer was all through her body- she had no chance. Watching anyone, even in that state, die of lack of water, was horrifying and I am still not over it. I was grateful that I could make that decision, if need be, about how my life would end.

    The small government types always seem to feel that this is a fine area to butt into. Troll all you want, call it what you want, but this is the will of the people. If you want to have a culture of life, meet me at a peace rally.

  • Sally (unverified)

    Outstanding comments.

    I would note, further, that the newly adopted phraseology of "physican assisted death" is almost guaranteed to garner more, not less, anger and opposition than did "physican assisted suicide". Along with the honesty needed to call it "suicide," it should also be carefully noted that the only "physican assistance" is in the provision of a prescription. No other "assistance" is sanctioned or allowed. This is a difference of critical distinction. State-licensed doctors hold sole control of the use of most of the keys of the medical kingdom. At its bottom line the already-euphemistically named "Death With Dignity" act simply allowed individuals access to certain drugs.

    "Physician assisted death sounds like mercy killing, the most common criticism and fear of the original law. Too clever by half, Ms. Simons and the DHS. Read it and weep.

  • (Show?)

    The problem, Jeff, is that to matter what its etymology, in the popular vernacular "suicide" means taking one's own life due to mental distress. Not slightly hastening the very end of a horrific illness. And because of that, the law is filled with all sorts of disincentives for suicide that don't cover the final situation.

    Life Insurance, for example, always has clauses against suicide, to prevent from getting policies and then committing suicide to provide benefits to people they can't support in life. That's obviously much different than someone with advanced colon cancer hastening their deaths to avoid vomiting up their own fecees.

    It is not Orwellian to call "assisted suicide" "physician assisted death". We all know what's really going on. If it helps some people to futher disinguish the two situations, I see no problem with it.

  • (Show?)

    Righty--I'm glad you asked why I think it's one of the things that makes Oregon a better place to live:

    a) it validates the freedom and responsibility we have of and for ourselves. I feel better living in Oregon as a (currently) healthy person, knowing that if I should contract a terminal and painfully disabling condition, I would maintain that personal autonomy, and have the opportunity to decide when my life was over, pragmatically speaking.

    b) it allows families of the seriously ill to be relieved both of financial burden and emotional stress caused by a relative who does not wish to continue living in such a fashion, but would be prevented from ending their life by the laws of the other 49 states. (Do NOT confuse this point with euthanasia; we're talking only about people who have the mental faculty to make the decision for themselves--so don't get any ideas about family members seeking to pull the plug out of craven desire).

    c) it frees doctors to be honest brokers of medical care, able to truthfully discuss dire prospects for survival or improvement, the dulling cumulative effect of pain management as palliative care, and to fulfill their vows to truly serve the patient's needs and desires, rather than adhere to lowest-common-denominator protocols for treatment.

    Oregon should not be ashamed; quite the contrary. We should be proud that we don't banish serious and painful discussions and decisions simply on the basis that they bring up difficult choices. And we should be overjoyed that at least in this instance, the state fully embraces the notion of personal autonomy, as the Founders indicated was the natural state of man.

  • Johnny (unverified)

    I think that "death with dignity" is a misnomer itself. Like most people at age 63, I have certainly seen my share of death, and I expect to arrive at my own before too long. Dignity is a trumped-up issue when it comes to dying.

    It's almost as if someone is declaring that the normal process of dying is somehow "disrespecting" them. Perhaps there are people who would benefit from a self-examination to see if they are being driven by an excess of personal pride and lack of humility and a reluctance to admit their own humanity.

    We are all human, and we all die, by whatever process. To label assisted dying as "death with dignity" implies, no, declares, that those who choose to die without this "assistance" are somehow less than dignified. Do we really need to strut so proudly into our graves with our heads held so high?

  • (Show?)

    in the popular vernacular "suicide" means taking one's own life due to mental distress.

    Steven, I question this. It's an interesting point, though. I'll give it some thought.

  • (Show?)

    It's death with dignity restored. The lack of dignity comes from no longer being able to care for yourself or fully function as a member of society. I'm not usually one to bless human vanity or pride, but I can only imagine how I might feel if I had built a life of esteem and vitality--and then found myself wasting away helplessly, prone to wetting and crapping myself if someone doesn't check up on the bags connected to my orifices. I'm entirely sympathetic to the decision of such people that those circumstances do not constitute "living." They feel they are ALREADY dead, without their dignity intact. Retaking control of their own existence restores the dignity of self-determination.

  • Lil' Scrappy (unverified)

    What we are missing is that under state law:

    "Actions taken in accordance with ORS 127.800 to 127.897 shall not, for any purpose, constitute suicide, assisted suicide, mercy killing or homicide..."

    As DHS is a state agency, they must honor this law in their actions and words. To them, it doesn't matter what we think it should be called. They must comply with and honor the laws of the state they function for.

    That being said, this is still (and was prior to it passing) a great discussion and subject of public discourse.

  • Marvin McConoughey (unverified)

    My sentiments are with Torridjoe. Additionally, old age and extreme disease are conditions of disempowerment. As others increasingly make decisions that were once personal to the dying, those about to die should at least have the option to choose the timing of their own deaths.

    The word "suicide" is better reserved for extreme acts of self-destruction by persons who had the potential for a better, longer life. Many of the dying who choose assisted death have no better life to look forward to. Some face desperate financial straits should they continue to live. Still others have seen their friends and peers die with little hope of gaining new companions.

    We may not choose physician assisted suicide for ourselves, but I favor letting others make their own choices. My best wishes go to them, regardless of their decision.

  • dyspeptic (unverified)

    My Mom went through the kind of death right-wingers want to mandate, in another state, and I won't go into the details, but having seen her experience, I came away more convinced than ever of the rightness of the DWDA. Someone said they wanted to see the topic of pain management discussed here. That comment is right on target. My Mom refused a feeding tube and other invasive measures, which the right wingers will allow, but is just as surely suicide as taking a drug, and as nature took its course, she was forced to endure far more pain than I think was humane. Oregonians have spoken correctly on this issue. There shouldn't be any shame in making a less painful option available for those that choose it. PS Making an anti-troll donation to the DPO. <sound of="" raspberry="">

  • Claire Simons (unverified)

    If your core belief is only God can control a death and there is value in redemptive suffering, then the Dignity Act is beyond your experience.

    You may reconsider your beliefs if diagnosed with prostrate cancer metastized to the bones or 4th stage breast cancer spread to the lungs. Cancer "kills" ALS "kills" AIDS "kills" We live in a culture in denial of mortality. We live in a state with a humane law; 20 years ahead of the curve.

  • jami (unverified)

    meh. semantics.

    i really love the hell out of the whole "life" thing (in more of a war-protest, fight-parkinson's sort of way than a save-the-snowflakes sort of way). but i do worry about the slippery slope toward people getting pressured to "unburden" their families (and insurance companies) at the ends of their lives. i respect individuals' right to decide how they want to end it, but i worry that that decision might one day be based on more than just their own physical suffering. i'd rather see people worrying about possible pressure on patients than what word will be used to describe the unburdening/death/suicide.

  • theberle (unverified)

    Is putting suffering livestock or a pet to sleep considered animal cruelty? Why not, if "assisted suicide" of an animal is the same as killing them?

    So, why should humans be forced by the government to suffer through pain and huge medical bills just to prolong their lives a few more months or years?

  • Rob (unverified)

    Suicide should not be considered an ugly word-it's simply a state of existence, or designating the end of one. Hopefully, you've done worthwhile things for yourself or society in the time window you are given.

    Hey "Righty" you and John Ashcroft are the ones who should be ashamed. It is not your place to dictate your Christian fundamentalist-based view on to others who do not share such beliefs. Oregon finally gets to be innovative for a change with a CHOICE people may or may not use, legally, and backed multiple times by the voters.

    You are not only a confused individual, you are the source of confusion in others. Enjoy your delusions of adequacy...

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