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Death with dignity
Your right to die in Oregon may improve your quality of life
BY B R A D L E Y J. W O O D W O R T H
Note: No two legal situations are exactly the
same. This column discusses general legal
principles only. For specific advice, consult
your lawyer.
M
uch attention has been focused lately
on legal issues of the “right to die” with
dignity. The United States Supreme Court, in
its recent Cruz an case held that, at least where a
comatose patient had not clearly and unequivo
cally recorded her desire prior to becoming dis
abled, there was no constitutional right to have
life support technology removed, even when
the patient is in a “persistent vegetative state.”
Janet Adkins, a Portland, woman, gained
national media attention when she took her own
life by means of a doctor-built “suicide
machine,” rather than suffer a long and painful
decline from her Alzheimer’s Disease.
A related issue in such cases is who decides
what medical treatments will be given or
withheld from the patient, when the patient is
no longer able to make his or her own deci
sions. Unfortunately, this has an immediacy for
many young and middle-aged gay men who,
but for the AIDS epidemic, would probably not
have to consider such issues for many years.
.
C oum UX
What, me worry?
Every one knows that American medical
technology has exploded in recent years. It is
now possible for high-technology (and high-
cost) medical treatments to sustain a semblance
of physical life, even when the patient is irre
versibly comatose, and the question is not
whether the patient will die but when and how.
Being unconscious, debilitated and kept alive
by artificial means, including a respirator and
feeding tube, is something many people simply
do not want Additionally, some people have
substantial assets that they would like to pass
on to their lover or family members. Even a
short period of time on full life support systems
can suck up all your money. A month spent in
intensive care on life support can run to, or
even exceed, $50,000. Some people would
rather have their last $50,000 go to their
surviving loved ones than to a hospital.
There is also something very disquieting
about contemplating such a total absence of
control over one’s life (or death). You are
unable to make your own decisions and are
completely dependent on others to decide what
to do to, or for, you, for how long, and so forth.
Given these substantial concerns, it is not
surprising that may people want to limit the
amount and type of medical treatment they
receive, particularly if they have no realistic
chance of recovering from their illness, or
leading any type of normal life again.
What you can do under Oregon law
Thanks to the recent session of the Oregon
legislature, Oregonians now enjoy some of the
most liberal laws in the nation regarding the
right to die with dignity. For many years,
Oregonians have been able to execute a “Living
Will,” also known as a “Directive to Physi
cians." This document instructs your physi-
cian, in the event of your terminal illness and
imminent death, not to prolong your life by use
of extraordinary medical means.
The advantage to such a document is clear.
However, the living will also has some
limitations: It does not specifically cover the
situation of withdrawing life support systems,
nor does it specifically cover withdrawing
artificially administered food and water. In the
absence of such specific instructions, many
physicians and hospitals are reluctant, or will
refuse altogether, to withdraw these life-
sustaining procedures.
Fortunately, these problems were solved in
great measure when the Oregon legislature
adopted a form of “Durable Power of Attorney
for Healthcare (POA).” Under a durable POA,
you can specifically make known your wishes
that life support treatments, including respira
tion, not be started or be withdrawn, even if if is
likely that death will result or be hastened by
such action. Further, the durable POA permits
you to record your wish that artificially
administered nutrition and hydration be with
drawn, again with the understanding that death
may result or be hastened by that action.
Perhaps the most important provision you
can make in a durable POA is to appoint a
loved one, other than a family member, to make
medical decisions for you when you are
disabled. Thus, many gay couples, or gay indi
viduals who have close gay friends, want to
execute a durable POA, so that their lover or
gay family member has full legal authority to
make the necessary decisions when they cannot
make their own decisions.
Why is this important? In the absence of
such an appointment of a person to make the
decisions, the law provides that your next of kin
make the decisions. For some people this is
fine, but for others, who may be estranged from
their families, or whose families may have
different religious or other values, it can be
very difficult. I observed a very tragic situation
in which a disabled person, unable to make
decisions, and requiring long-term rehabilita
tive care, had failed to designate his lover to
make decisions. The patient's parents, from
California, intervened at the hospital, with the
end result being that the patient ended up trans
ported to California to receive the long-term
treatment there, far from his lover, friends,
home and community.
Such nightmares are easily avoided.
Durable Power of Attorney forms and Living
Will forms can be prepared for you by nearly
any gay community lawyer. The forms are
simple and straightforward and the fee for
preparing them is relatively modest, usually be
tween $25 and $50. Additionally, a small fee is
charged for recording the documents in the
public records if you choose to do that
As a gay person, you may have important
rights you want to protect, and non-family
loved ones who you may want to appoint to
assist in your affairs if you are disabled. Under
Oregon law, you have ample opportunity to do
so. However, you must take these actions when
you are fully mentally competent.
The author is an attorney in private practice
and maintains his office in the Crown Plaza
Building in downtown Portland.