Death with Dignity: A Case Study

• Suicide, assisted
• Oregon
• Physician role
• Ethics, medical
• S90010
• Suicide, assisted
• Oregon
• Physician role
• Terminally ill
• Decision making

I voted twice against legislative measures in Oregon that would allow physician-assisted suicide. Within months after the Death with Dignity Act became law, I received a call from the parents of a patient of mine requesting that I assist their daughter in her suicide.

My patient was then only 29 years old, but she seemed much older and wiser. I had diagnosed her non-Hodgkin lymphoma almost 10 years earlier. She was not only bright but also intensely perceptive and private. With a thin, angled countenance, thick, dark hair, and rich, introspective eyes, she was a startlingly handsome young woman. For several years she had lived independently from her parents in a smaller community adjoining ours.

During one of her periodic visits home a decade ago, my patient's father became concerned about her frail appearance and asked that I see her. I was not concerned after the first evaluation and attributed her minimal complaints to youthful fatigue. Only at her father's urging did I take a second evaluation further. I will never forget my shock when I viewed her chest x-ray to find the mediastinum bulging into both hemithoraces. The course of her disease during the subsequent years was relentless. Conventional therapy and bone marrow transplantation ultimately failed. Alternative medicine failed. Experimental protocols failed.

She became slowly, but quite assuredly, terminally ill. Still, she managed to lead an amazingly active, full life. She continued work on an advanced college degree and nearly finished it. She became engaged to a young man who shared her values and perspectives, such that the two of them seemed almost to merge into one. She maintained her talents in the arts, writing short stories, pursuing the theater, appreciating the beauty of the world in ways that few seem capable of.

As she became progressively sicker, she …