PORTLAND, Ore. — More people are having themselves put to death under Oregon's Death with Dignity Act, but they are not the horribly suffering terminal patients the law's proponents predicted five years ago.

The results suggest Oregon voters were hoodwinked by the assisted-suicide movement when they first voted for the law and later reaffirmed their support of it.

The Oregon Department of Human Services reported March 5 that nearly twice as many people used the law to kill themselves in 2002 as in the previous year. A total of 38 people were reported to have died from a deliberate overdose of tranquilizers prescribed by a physician during 2002. That's 80% higher than the 21 who killed themselves under the act in 2001 and 11 people more than the previous high of 27 reported in 1999 and 2000.

During the first five years of legal physician-assisted suicide in Oregon, 197 people have received a lethal prescription and 129 people hastened their deaths under the act.

But they are a dramatically different group than the terminally ill and suffering people the act's proponents described in 1994, when 51% of Oregon's voters approved the act, or in 1997, when 60% of the electorate re-approved it.

Demographic data included in the report describe the average person seeking physician-assisted suicide as neither poor, old nor in severe pain.

Rather, 97% of suicide victims were non-Hispanic whites; 89% had a high school diploma or higher education; and 64% had private health insurance. Nearly half were married and 55% were male. The average age of victims was 69.

Among the reasons given for seeking to end their lives, 85% said they feared losing autonomy and 79% said they had a decreased ability to participate in activities that make life enjoyable.

Only 22% cited inadequate pain control as a reason for suicide. That ranked lower than concern over the loss of bodily functions (58%) and fear of being a burden on family or friends (35%).

Despite the steady increase in lethal prescriptions written under the act — from 23 in 1998 to 58 in 2002 — Oregon State Epidemiologist Dr. Mel Kohn said assisted suicide remains extremely rare. Almost all patients who took a lethal dose of medication under the act suffered from cancer, emphysema and ALS (Lou Gehrig's disease). Yet they accounted for less than one-eighth of a percent of the 42,275 people who died from those diseases during the same five-year period.

The variance from the picture given Oregon voters — one of a person enduring extreme pain — doesn't bother George Eighmey, executive director of Compassion in Dying of Oregon, the Death With Dignity Act's sponsor and chief proponent. He doesn't agree the picture of suffering painted for Oregon's voters by his organization is at odds with the results of the act.

“Suffering is defined by the individual,” Eighmey said. “I'm not going to define it for them, and neither are the voters.”

“Doctors have been able to prevent pain,” he said. “However, over and over again, I hear people say that everything around them is gone. Everything they used to do, they can't do anymore. They are fiercely independent people who want the dignity to be able to choose.”

However, Dr. Kenneth Stevens, head of the department of radiation and oncology at Oregon Health and Sciences University and president of Physicians for Compassionate Care, said the decision of voters was based on a deliberate fallacy.

“The assisted-suicide movement has been great at the process of defining the issue as compassion,” he said. “The whole push was that people were dying painful deaths, and that was a myth.”

Stevens rejects both the definition of the victims of assisted suicide as “independent” and their act as dignified. He said fear and depression are the reasons for physician-assisted suicide.

“They are despondent and they fear future pain or disability,” he said. “Rather than helping them to overcome their depression, we're saying, ‘Sure, kill yourself. We can help.’”

In addition, Stevens dismisses the idea that the doctor is providing a choice.

“A prescription from a doctor is an order. Writing a prescription like this means the doctor is directing the patient to die. The promoters of this act say it's about autonomy and the right to die. Everyone dies and anyone can kill themselves,” he said. “This is about the power to kill. This law doesn't protect patients. It protects doctors and pharmacists.”

Gayle Atteberry, executive director of Oregon Right to Life, thinks implicit in the Death With Dignity Act is the idea that “some lives are not worth living, and some are not worth saving. If a sick 70-year-old has suicidal thoughts, the state is saying, ‘go ahead.’”

“We are dismayed to see the number of patients who have killed themselves and especially dismayed to see the reasons, since better psychological care and support could have prevented them,” Atteberry said.

Money Problems

The fifth anniversary of the act, implemented in 1998, comes at a time when the state government's and the medical profession's commitment to the elderly and handicapped is under fire from the media and advocates for senior citizens. Seniors are protesting health-care cuts while state officials are admitting that $244 million in federal Medicaid money was siphoned off to support other programs.

At a time of escalating health care costs and diminishing resources, the advocates say some lives are seen as less valuable than others.

Facing a $2 billion budget shortfall, the state has been curtailing prescription drug coverage provided through the Oregon Health Plan. Even further cuts are planned, leaving 9,000 elderly or handicapped Medicaid patients without lifesaving medications.

“While physician-assisted suicide is supported by Oregon Medicaid tax dollars,” Physicians for Compassionate Care said in a statement, “financial support for life-sustaining care for Oregon's medically needy is being significantly reduced.”

Philip S. Moore writes from

Portland, Oregon.