POLS 1101: Paper Assignment #1 For this paper assignment, students are required to write an approx. 2 page [double-spaced, 12pt font] paper which addresses the following question. The paper assignment is due at the beginning of class on February 15th. This assignment will be worth 100pts. Please contact me via email if you have any questions. One of the potential benefits of federalism is experimentation and competition in policymaking at the state level; states can try different approaches to solving public issues, such as crime or public health. Such experimentation, however, often leads to conflict between state and national governments. Find a controversial example of state policy innovation (for example, assisted suicide in Oregon, medical marijuana in California), and explain how it conflicts with policies of the federal government or of other states. Does the particular state policy appear to have support outside its home state? Is it likely that other state governments or even the federal government will adopt this policy in the future? Be sure to fully explain the policies that you are discussing, and provide citations to any news articles or other resources used.

ASSISTED SUICIDE IN OREGON:

http://www.oregon.gov/DHS/ph/pas/ar-index.shtml

The Death with Dignity Act (the Act) allows terminally-ill Oregonians to end their lives through the voluntary self-administration of lethal medications, expressly prescribed by a physician for that purpose.

The Act was a citizens' initiative passed twice by Oregon voters. The first time was in a general election in November 1994 when it passed by a margin of 51% to 49%. An injunction delayed implementation of the Act until it was lifted on October 27, 1997. In November 1997, a measure was placed on the general election ballot to repeal the Act. Voters chose to retain the Act by a margin of 60% to 40%.

There is no state "program" for participation in the Act. People do not "make application" to the State of Oregon or the Department of Human Services. It is up to qualified patients and licensed physicians to implement the Act on an individual basis. The Act requires the Department of Human Services to collect information about patients who participate each year and to issue an annual report.

Yes. On November 4, 2008, the State of Washington passed Initiative 1000, the state's Death with Dignity Act, which became law on March 5, 2009. Information about the Washington Death with Dignity Act can be found at http://www.doh.wa.gov/dwda.

http://www.oregon.gov/DHS/ph/pas/faqs.shtml

http://www.foxnews.com/story/0,2933,392962,00.html

http://www.spiorg.org/publications/HendinFoley_MichiganLawReview.pdf

http://www.seattlepi.com/local/395517_deathdignity10.html

http://www.assistedsuicide.org/suicide_laws.html

http://www.worldrtd.net/

In November 1994 a Citizens' Initiated Referendum was held in Oregon on whether to legalise medically assisted suicide in certain limited circumstances. The measure was narrowly won by 51% to 49%, making Oregon the first government in the USA, and indeed in the world, to allow medically assisted suicide as a clear legal option for the terminally ill.

The Oregon Death with Dignity Act includes the following provisions:

Allows an attending doctor to prescribe medication to end life in a humane and dignified manner under prescribed conditions;

medication is for self administration but the doctor is allowed to be present;

Requires a fully informed, voluntary decision by the patient;

Applies to the terminally ill with a prognosis of less than 6 months to live;

Requires a concurring second medical opinion;

Requires two oral requests with a 15 day waiting period from the first;

Requires a witnessed written request with a 48 hour waiting period from time of signing;

Allows cancellation of the request at any time;

Provides for penalties in the event of coercion of patients;

Provides for counselling as appropriate;

Promotes informing next of kin at patient's discretion;

Requires documentation and reporting to a monitoring authority.

The Act does not authorise the doctor to administer the medication.

Oregon's new law was due to come into effect on 8 December 1994 but was blocked by an appeal to the District Court from a National Right to Life Committee. The appeal claimed that the new law was unconstitutional and that vulnerable people could be disadvantaged.

On 26 June 1997, the US Supreme Court ruled, in another context, that there is no right to medically assisted suicide under the US Constitution, but that legislation on the issue is up to individual States.

As the legal processes blocking the implementation of the Act drew to a close, the Oregon Government decided that the issue would be put to the people of Oregon again. The result of vote taken in November 1997 was 60% to 40% for the Act to stand.

The Oregon Government issued its first report on the use of the Act in August 98, nearly 10 months after it came into effect:

10 Oregon residents (5 men and 5 women) had obtained lethal prescriptions

8 used the medication to die and two died of their illnesses

The 10 prescriptions were written by 9 different doctors

Average age was 71: one had heart disease and the remainder cancer

No pain or distress during dying was reported in any of the cases

No doctors were disciplined for non-compliance with the requirements of the Act.

Subsequent reports have been consistent with this cautious use of the Act. The second annual

report is expected towards the end of 1999.

Oregon strengthened its Death with Dignity Act in June 1999 with a number of amendments to make it more effective. Residential requirements were clarified and protection offered to organisations and individuals not wishing to participate. The amendments made clear that the qualification for use of the Act was not to be based on age or disability, but on the requirements set out in item 2 above.

Currently the Act is under threat by proposed Federal Legislation which would ban doctors in all States from using drugs for assisting suicide. The so-called Pain Relief Promotion Act passed the Lower House (271-156) in October 99 but requires approval of the Senate and the US President before it becomes law.

Main features and safeguards of the Oregon 'Death with Dignity Act'

1. The patient must be terminally ill and expected to die within six months; mentally competent; fully informed about his or her diagnosis, prognosis, risks and alternatives, such as comfort care; and making a voluntary choice.

2. A second doctor must agree that the patient is terminally ill; acting on his or her own free will; fully informed; and capable of making health-care decisions.

3. If either doctor thinks that the patient is suffering from any form of mental illness that could affect his or her judgment, they must refer the patient for counseling.

4. The patient must make one written request and two spoken requests.

5. The doctor must ask the patient to tell the next of kin, but the patient may decide not to do so.

6. The patient is free to change his or her mind at any time.

7. There is a 15 day waiting period between the patient making the request and the doctor writing the prescription.

8. All information must be written down in the medical records.

9. Only people who normally live in Oregon may use the Act.

10. Mercy killing, lethal injection and active euthanasia are not permitted.

Almost as soon the Act had passed, groups who were against the right to die started legal action against it. Led by a lawyer from the 'National Right to Life Organisation', they managed to block the law by getting restraining orders and holding it up in court challenges. Oregon also had to wait six months for the result of the Supreme Court enquiry into assisted dying. Finally, in October 1997, Oregon courts disallowed the legal complaints, and people were free to use the Act.

However, another complication arose. Pro-life members of the Oregon government persuaded the state government to send the whole Act back to the people to vote on it again. This was the first time an issue decided by the voters had been questioned in this way. On 4 November 1997, instead of rejecting the law, Oregonians voted by an increased majority to keep their 'Death with Dignity Act'. Support had grown to 60% in favour, while only 40% wanted it abolished. The 'Death with Dignity Act' was now definitely law.

Anyone who wants to use the Act can rely on having their privacy respected. Oregon's Health Division is collecting information about cases of assisted suicide to make a report every year. However, they will not give details of individual cases.

Their second report was published in February 2000. It showed that, in the previous year, 27 people used the law to die peacefully at a time of their choice. The main reason for asking for help to die was quality of life – not pain or worries about finances. There were no reports of any problems with the law. In every death all the guidelines and regulations in the law were followed properly.

http://www.internationaltaskforce.org/sptlt2.htm

Oregon's law has become the "model" that is being or will be considered in other states and countries. As those proposals are under consideration, it remains to be seen whether decision-makers will rely on the deceptively rosy picture painted by assisted-suicide supporters - or on the documented reality of the Oregon Experience.

http://www.oregonlive.com/opinion/index.ssf/2008/09/washington_states_assistedsuic.html

As Washington state voters decide this fall on a physician-assisted suicide law much like Oregon's, we won't be repeating the warnings we raised more than a decade ago when this state was debating the issue.

Ten years' experience with Oregon's one-of-a-kind Death With Dignity Act has shown that our deepest concerns were unfounded. Safeguards built into the law appear to be working.

Terminally ill people from other states have not flocked to Oregon to commit suicide, and Oregonians themselves are not using the law in large numbers. It has not targeted the disabled as feared, nor has it steamrollered vulnerable people into taking their lives.

Still, even though Washington's initiative closely parallels Oregon's law, we won't be endorsing it.

Our fundamental objection is the same it has always been -- that's it's wrong to use physicians and pharmacists to hasten patients' deaths.

Washington's proposed law, like Oregon's, would allow terminally ill people to legally obtain lethal prescription drugs for ending their own lives. To qualify, the patient must be diagnosed by two physicians as having less than six months to live, must make two independently witnessed requests and must self-administer the medication.

Those and other safeguards appear to be working in Oregon. Washington voters should be aware, however, that this state's experience has been mixed.

On the plus side, the law has not created a tidal wave of assisted suicide since its enactment in 1997. Only 341 patients, 86percent of them with terminal cancer, have died under its provisions. More than a third of those who have obtained lethal prescriptions never used them.

It's also true that the law is popular, twice winning voter approval, and that vigorous public debate over it has led to much-improved end-of-life care in Oregon. The state is recognized today as the national leader in providing access to palliative medicine and pain treatment.

The Oregon experience, however, has brought similar reform in many other states, including Washington, where most physicians don't want to write prescriptions to hasten patients' deaths. An argument can be made that Oregon's influence has already improved end-of-life care in Washington so much that the new law is not needed.

On the negative side, Oregon's physician-assisted suicide program has not been sufficiently transparent. Essentially, a coterie of insiders run the program, with a handful of doctors and others deciding what the public may know. We're aware of no substantiated abuses, but we'd feel more confident with more sunlight on the program.

We defended Oregon's right to this law when it was under attack by the Bush administration, and we have taken sharp issue with claims that the worst fears about the program have been borne out. But our basic unease with physician-assisted suicide has not changed, and we cannot exhort Washington voters to take the same path.

-- Bob Caldwell, editorial page editor;