Oregon nixes use of term "physician-assisted suicide"

Oregon's Dept. of Human Services announced last month that it no longer would use the term "physician-assisted suicide" to describe terminally ill patients who ask doctors to help them die.

Supporters of terminally ill patients' right to die prompted the move when they brought lawyers to a meeting with agency officials to argue that using the word "suicide" violated the state's Death With Dignity Act. Portland-based advocacy group Compassion & Choices asked the agency to consider substituting terms such as "physician-assisted death," "physician aid in dying" and "hastened death." Polls show that people are more likely to approve legalizing the practice when the word "suicide" is not used in describing it.

Not willing to litigate the matter and aspiring to be a neutral voice in the contentious debate, the agency said it would refer to the terminally ill patients who ask physicians to help them die as "persons who use the Oregon Death With Dignity Act."

The law states that "actions taken in accordance with [the statute] shall not, for any purpose, constitute suicide, assisted suicide, mercy killing or homicide, under the law."

Katrina Hedberg, MD, MPH, a medical epidemiologist in the agency's Public Health Division who produces an annual report about patients who use the law, said it "probably has not been correct for us to be using this language all along."

E. James Lieberman, MD, clinical professor of psychiatry and behavioral sciences at the George Washington University School of Medicine and Health Sciences in Washington, D.C., has written that terminally ill patients who ask for a doctor's help in dying are not making the desperate, impulsive choice associated with suicide.

The change, Dr. Lieberman said, "is a watershed in the sense that the stigma of 'suicide' is being lifted."

Others disagree.

"They are manipulating language for political purposes," said Kenneth R. Stevens, MD, vice president of Physicians for Compassionate Care Education Foundation, which opposes physician-assisted suicide.

The Oregon Medical Assn. is neutral on the matter of physician-assisted suicide per se, but the group supported a 1997 ballot initiative to repeal the state law and reaffirmed that position last year. AMA delegates have on multiple occasions passed policy stating that physician-assisted suicide is "fundamentally inconsistent with the physician's role as healer."