Oregon, laboratory of medical aid in dying in the United States

Oregon, laboratory of medical aid in dying in the United States

The Willamette glistens in the morning light, but Dr. Blanke doesn’t dream of admiring Portland, Oregon’s iconic river. Oncologist, pancreas specialist, Professor Charles Blanke is a recognized practitioner. He chairs the SWOG Cancer Research Network, a network of researchers with 12,000 members in 47 American states. In 2015, he climbed Kilimanjaro with a colleague to raise funds to improve the early detection of this particularly deadly cancer.

Over the years, by dint of treating patients with desperate prognoses, Dr. Blanke has become a specialist in medical assistance in death. Each year, he writes more lethal prescriptions than any other doctor in Oregon: 60 in 2022, 70 the year before, or about 20% of prescriptions that allow terminally ill patients to die at a time of their choosing. . Oregon was the first US state to legalize “death with dignity”according to the title of the law which came into force on October 27, 1997.

His phone calls for him, but the oncologist ignores the requests. Installed in the cafeteria of Oregon Health & Sciences University, he intends to take ” the necessary time “ to explain why medical assistance in dying means so much to him. Charles Blanke does not use the term “assisted suicide”, an expression that is now used only by those who oppose it. There is no question of suicide, he underlines, the patients ask only to live. The law expressly stipulates this. Under no circumstances may the actions of the patient, his family or his doctors be considered as “suicide, assisted suicide, mercy killing or homicide”, she specifies. No protagonist can be prosecuted and the insurance companies cannot refuse to honor the contracts concluded. For the same reasons, the word “suicide” does not appear on death certificates either. Death is attributed to the disease that took the patient.

This 1er March, Doctor Blanke returns from a difficult operation, an illustration of the painful contortions sometimes imposed by law. In the summer of 2022, he received a request for assistance in dying from a young woman in her forties, suffering from amyotrophic lateral sclerosis or Charcot’s disease. This pathology progressively deprives the individual of his motor capacities, up to suffocation. Ultimately, he is completely dependent on others. However, the Death With Dignity law requires that the patient be able to self-administer the lethal substance, without assistance and by « ingestion » : no intravenous is authorized. In January, the patient communicated only by moving her feet. When the doctor wrote the prescription, she could no longer swallow and she was approaching the threshold of paralysis which would prevent her from ingesting the lethal substance on her own. “With the family, we had to determine in which part of the body she still had enough strength to push the plunger of the syringe”he says.

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