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the dignity report u.s. postage
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portland OR
permit #3584 the dignity report
a publication of the oregon death with dignity center
520 sw 6th avenue, suite 1030, portland, OR 97204 a publication of the oregon deaath with dignity center
address service requested volume 11, issue 1, spring 2005

death with dignity law headed to the high court
U.S.S.C. to hear justice department appeal

On February 22nd, the U.S. Supreme Court grant- law to win at the highest level, to finally be vali-
If you have received a duplicate of this or other
ed the Justice Department’s petition for Writ of dated on a national stage. We are confident that
communications from the Death with Dignity
Certiorari (Cert Petition) in Oregon v. Gonzales states’ rights and the
National Center, please notify us at 503-228-4415 or
(formerly Oregon v. Ashcroft; Alberto Gonzales rights of the terminally
via email info@deathwithdignity.org. Thank you.
succeeded John Ashcroft as U.S. Attorney General ill will carry the day,”
earlier this month). The litigation was initiated by said Portland attorney
the Justice Department in the autumn of 2001. Eli D. Stutsman, who
tip the scales toward dignity This means that Oregon’s first-in-the-nation represents an Oregon
Death with Dignity law is headed to the nation’s physician and pharma-
highest court. cist on behalf of the
The Death with Dignity We need you to help us with this unprecedented
Death with Dignity
National Center campaign challenge. Our goal is to raise $100,000 for legal
Justice Department officials maintained that National Center. “The Eli D. Stutsman
before the US Supreme defense. The Death with Dignity National Center
Oregon’s Death with Dignity law violates the people of Oregon voted
Court. has received a challenge grant from the DoGood
Controlled Substances Act. The State of Oregon twice on this law and the courts have consistently
Fund. Your new or increased donation will be
and the Death with Dignity National Center ruled in its favor. The law has operated flawlessly
For several years the DDNC has matched dollar for dollar up to a total of $30,000.
(DDNC) sued. A U.S. District Court Judge ruled in for seven years (in March Oregon’s Department of
faced challenges to our You can double the impact of your dollars with the
favor of Oregon and the National Center in 2002. Health & Human Services released its annual
ground-breaking end-of-life DoGood Challenge Grant. With your help, we are
The Justice Department appealed and two years report on the law’s use). The Death with Dignity
legislation. This October we face confident we will be victorious.
later, the Ninth Circuit Court again upheld the law has been a catalyst to improved end-of-life
our greatest challenge ever: the US
rights of the terminally ill and state-regulated care – in Oregon and across the nation.”
Supreme Court. Please check our website at www.dwd.org for
medical practice. On the day he announced that
updates on this critical issue and to make a contri-
he was leaving office, former Attorney General The Death with Dignity National Center is pre-
Oregon v. Gonzales (formerly bution to the Tip the Scales Toward Dignity cam-
John Ashcroft appealed his case to the Supreme pared to meet this newest court challenge. DDNC
Oregon v. Ashcroft) will bring this paign.
Court. has been the vanguard for Oregon’s law, having
critical issue to a truly national platform and will
worked to successfully propose, pass and defend
help determine if the US government can usurp
“This is an opportunity for the Death with Dignity Death with Dignity since 1994.
states’ rights and deny personal freedoms.

please contact us at in this issue: u.s. supreme court takes dwd case | 7th annual report on dwd law
i n f o @ d e a t h w i t h d i g n i t y. o r g
educational forums | interview with dr. timothy quill | tip the scales toward dignity
state releases report on dwd law: in the states:
modest use & responsible
implementation vermont—Last July, DDNC coordinated materials that
were submitted to researchers for the Vermont Legislature
In March, the Oregon Department of Human Services on the Oregon Death with Dignity law for their 2005 ses-
(DHS) released its seventh annual report on the Death with sion. The research was completed in early January and
boards of directors INTRODUCING: Dignity law. The DHS, an independent, non-partisan state includes data submitted by both supporters and oppo-
Eli D. Stutsman, J.D. cindy scheel, development director agency, is responsible for monitoring and enforcing com- nents of death with dignity reform. In addition, the
researchers met with experts in end of life care, including
Timothy E. Quill, M.D. pliance with the Oregon law. The report provides a sum-
Carol Pratt, J.D. mary of the experiences of patients and physicians who Dr. Linda Ganzini from the Center for Ethics in Health Care
Death with Dignity National Center is honored to announce the hiring of
Steve Telfer participated in the law during its seventh year of imple- at Oregon Health Sciences University.
a passionate and committed development professional, Cindy Scheel.
Connie Holden, R.N., M.S.N. Many of you will have a chance to get to know her and you will be just mentation (January 1, 2004 – December 31, 2004).
The Vermont House Human Services Committee held hear-
Alan Meisel, J.D. as impressed as we were. ings in April, but a vote is considered unlikely this session
Mike White, J.D. The report’s findings include:
Charles Baron, J.D. Cindy brings over 25 years of non-profit fundraising, management and 1. Thirty-seven individuals availed themselves of the law in To learn more about the Vermont’s Death With Dignity
Betty Rollin financial experience to our organization, most recently with a national 2004 (approximately 12/10,000 total deaths in Oregon legislation, visit www.deathwithdignityvermont.org,
David Mayo, Ph.D. health organization. She chose Death with Dignity because it allows her last year); which is also available as a link on our website in the “in
to combine her skills and personal dedication. 2. All the individuals were covered by some form of health the states” section.
insurance;
advisory board A native or Portland, Oregon, she has followed the DWD cause since its 3. 89% were enrolled in hospice care;
beginning. Her father’s death from cancer a few years before the move- 4. Those choosing Death with Dignity were well-educated california—The Assembly Judiciary Committee voted 5-
Margaret P. Battin, Ph.D. ment was started gives her an inside view and strong dedication to our (51% with college degrees) and cited loss of autonomy, 4 on April 12 to endorse AB654, which is modeled on the
Samuel C. Klagsbrun, M.D. mission. decreasing ability to engage in enjoyable activities and Oregon Death with Dignity Act. The bill now moves to the
Midge Levy, A.C.S.W. loss of dignity as their primary end-of-life concerns; appropriations committee. A senior aide for Governor
Charles F. McKhann, M.D. She graduated from the University of Portland with a degree in modern 5. 97% of the individuals were able to die at home; Arnold Schwarzenegger has indicated that the governor is
David Orentlicher, M.D., J.D. languages. She serves on the board of directors of the Willamette Valley 6. Cancer was the most common diagnosis. “very open minded” about the issue. AB654 is sponsored
Sharon M. Valente, R.N., Ph.D. Development Officers, the largest fundraising professionals’ organization by our colleagues, Compassion & Choices, headquartered
James L. Werth, Jr., Ph.D. in the area. Her other interests include animal rescue, topiary and car- For the seventh consecutive year, data continues to in Denver, Colorado.
pentry. demonstrate that the law works as intended.
interim executive director
John Duncan Serving you better Despite the care with which the law has been implement-
ed and the peace of mind it has provided to those at the
death with dignity national center In order to respond more efficiently to individual requests for informa- end of life, the Oregon Death with Dignity law remains The Court will likely hear the case this fall. The Death with
oregon death with dignity political action fund tion, communication preferences and provide greater internal efficiency, under attack. Dignity law remains in effect.
v 503/228-4415 f 503/228-7454 we have been making some changes for the better. We are currently in
the process of upgrading our database. During this time of transition, On February 22, 2005, the U.S. Supreme Court granted the Since 1994, the Death with Dignity National Center has
questions or comments? you may inadvertently receive duplicate communications. If so, please Department of Justice's request for a hearing in Gonzales fought to support and defend the Death with Dignity law-

please contact us at notify us at 503-228-4415 or via email at info@deathwithdignity.org and v. Oregon, No. 04-623 (formerly Oregon v. Ashcroft;
Alberto Gonzales succeeded John Ashcroft as U.S. Attorney
-on the local ballot, in federal courts, in the halls of
Congress, and now, before the U.S. Supreme Court. We are
i n f o @ d e a t h w i t h d i g n i t y. o r g we will correct your records promptly. Thank you for your understanding
and continued support of the Death with Dignity National Center. General in February 2005). committed to choice and patient control at the end-of-life.
educating medical students AMSA 2005 Annual
leadership circle — in the end-of-life movement. We could not do this with- Con-vention in Wash-
out you. THANK YOU. across the country ington, DC. Dr. Quill,
making a difference a practicing primary
Individuals Through the Next Generation program, the Death with care physician, is
The Death with Dignity National Center is funded exclu- James Allen Margaret Lund Dignity National Center has continued improving the educa- Professor of Med-
sively by the generous support of individuals, philan- Anonymous Linda McCammon tion for medical students, exposing them to expanded dia- icine, Psychiatry, and
thropic organizations and caring businesses. Ruth Bowers Alan Meisel logue and choices in end-of-life care. The program, an out- Medical Humanities
Becky Breeze Susan Nestor growth of seminars we have held annually at Oregon Health at the University of
Myrtle Brickman Marcia Petty
We gratefully acknowledge the support of ALL our & Science University and partially supported by the Rochester, where he
Joan Cudhea Richard Rosenberg Medical students gather at DDNC’s 10th
donors. Every gift matters, regardless of size, and helps Educational Foundation of America, helps prepare the future directs palliative care
Lawrence Dewitt Frederick Rudolph Anniversary Gala.
us provide education, defend the Death with Dignity doctors of America to provide better care at end of life. and biopsychosocial
Ernest Fontan Caron Santesson
Sterling Franklin Howard Shookhoff programs.
law and encourage and assist other states to create sim-
Margaret Fuller Eli Stutsman At the Ten Years of Dignity Conference, held in
ilar legislation.
Gregor Gamble Michael White Washington, DC in the fall of 2004, Next Generation spon- Like Next Generation, the American Medical Student
Richard Geary sored and hosted more than 20 medical and law students Association Foundation is working to improve end of life
The following are donors to our Leadership Circle, who
Albert Gentner Foundations from Georgetown University, George Washington care education through their End of Life Education
have made a gift of $1,000 or more during our last fis- Billie Herron Anonymous University, the University of Pennsylvania, and other area Fellowship Program. For more information, visit
cal year, April 2004 to March 2005. Your vision and com- Derek Humphry The Columbia law and medical programs. In addition, Next Generation www.amsa.org/programs/EOL.cfm.
mitment to our mission makes a significant difference John Knobel Foundation contacted all DC area (DC, VA, MD) medical schools, law
Mary Ellen Kullman Courtright The Educational schools, bioethics and geriatrics centers Next Generation speakers will be visit-
Kris Kurtenbach Foundation of America in its outreach and educational efforts. ing additional medical schools in
Leland Larson The Gerbode Foundation
The extraordinary opportunity for “As a future physician, I Washington and Pennsylvania in the
not your everyday intern Sustainers
medical and law students to learn from
really feel like I need to
coming months, as well as working to
panels of nationally recognized inform every medical program in the

In mid-February, Marian George was hired as the Spring A key element to our Annual Fund are Sustainers. These
experts in end-of-life care was made figure out where I stand country about the work and opportu-
possible by the generous contributions nities offered through Next
term Next Generation intern. Marian brings with her over donors have made a regular, monthly or quarterly contri-
of individuals around the country. on [these issues]…I really Generation.
20 years of experience in program management, speaker bution to the Death with Dignity National Center. Your
and student contact ongoing support provides a platform of stable funding appreciate that Death
In recent months, Next Generation has For more information, to tell us what
and conference facili- that is critical to our success. THANK YOU.
hosted speakers at medical schools at with Dignity is about you think, or if you have a question,
tation, much of which the University of Vermont, Stanford please email us at nextgen@deathwith-
has been working in Linda Bass Diane McCann
University, and Oregon Health
personal liberty and dignity.org, visit www.nextgendocs.org,
Diane Benjamin Lynn McClenahan
support of seniors,
Tania Bloom Alan Meisel
Sciences University, speaking with over individual responsibility.” or call toll free at 1-877-830-3252.
people with disabili- 100 medical students about the med-
Verla Cook Nora Miller
ties and students. She ical, clinical and emotional aspects of Next Generation would like to wel-
David Davies David Patek
also has a law degree, treating patients at end of life. Speakers have included come Marian George to its team. Marian brings with her
Andrea J. Drury Patricia Patten
experience in non- renowned researchers, bioethicists and physicians, the over 20 years of experience in program management,
Janet Eixenberg Beverlee Petersen
profit studies, includ- Barbara Hultgren Claire Reaume Director of Oregon hospice and family members of termi- speaker and student education and conference facilitation,
ing grant writing and strategic planning, Marian is also an Eleanor Katzman Joseph G. Ryan nally ill patients. much of which has been working in support of seniors, peo-
actress and playwright and works in the theater with the Marilyn Kauffman Cindy Scheel ple with disabilities and students. She holds a law degree
disability community. She is a welcome addition to the Melissa Kirchoffer-Talbott Mary Swain In March, Next Generation and the Death and Dying and experience in nonprofit studies. Marian is a welcome
Death with Dignity staff and brings Next Generation a Terry Lambeth Scott Swenson Interest Group of the American Medical Student Association addition to the Death with Dignity staff and brings Next
wealth of experience and energy. Donna Larson (AMSA) hosted board member Dr. Timothy Quill at the Generation a wealth of experience and energy.
Quill: Many medical schools across the country open practice is better and safer for patients. Not
are beginning to address end-of-life issues, includ- only is pain management improving there, but
ing pain management, advance directives, do-not- hospice referrals are increasing and the numbers
resuscitate issues, and the proper role of hospice of patients dying at home is higher than anywhere
and palliative care, all of which are part of the else in the nation. In Oregon, only 1/1000 deaths
standard of practice. As a part of this discussion, occur by physician-assisted death, but 1/50 talk to
some schools are beginning to teach about last their doctors about it, and 1/6 talk to their fami-
resort options for the tough cases where suffering lies. Clearly Oregon is ahead of the rest of the
becomes unacceptable despite unrestrained nation in all areas of end-of-life care.
efforts at palliative care. This exploration includes
dwd interviews tim quill, m.d. stopping life supports, stopping eating and drink- DWD: Our supporters who are reading this inter-
ing, terminal sedation, and physician-assisted view will certainly enjoy the book as it will help
death as potential last resort possibilities. We them make the case to their friends and families,
DWD: What is the significance of this book at this moment in need to continue to challenge medical educators but can you tell us how this book is being market-
the movement's history? (as well as policy makers, ethicists and clinicians) ed by Johns Hopkins University, how it will reach
not to forget the patients with this challenging people who need to be persuaded and what your
Dr. Tim Quill, M.D.
Quill: The debate about what kinds of choices patients should problem, for they are counting on us to be respon- hopes are for its impact? For example, DDNC will
have at the end of their lives has substantially changed in the last sive to them. be using it in our Next Generation program with
10 years based on two main factors: 1) The growth and expansion Med Students, we will be sending it to Congress,
of palliative care and hospice as the standard of care for the dying DWD: You have been an influential voice in state legislators, health care policy advocates,
In conjunction with the Ten (there is now little question that most, but not all, end-of-life suf- shaping this debate, and this book is just the latest media - how else will it reach people?
fering can be adequately addressed with state-of-the-art pallia- contribution you have made. Compare the issue
Years of Dignity Conference in Quill: First, the book will be marketed to those
tive care and hospice programs), and 2) The results of the remark- today to where it was when you first published on
this subject? Is there progress? involved in the movement for choice in this
Washington, DC, a major new able seven year experience in Oregon showing the safety of
allowing patients legal access to physician-assisted death as a last domain so that they can improve their under-
book was released edited by resort, and showing the profound compatibility of that practice Quill: When I first published my article about standing of the underlying issues outside of their
with simultaneous improvements in all other aspects of end-of- Diane in the New England Journal of Medicine in areas of expertise. Second, we hope that law
Death with Dignity National 1991, the issue of physician assisted death was in schools, ethics training programs, public policy
life care.
the margins of public discussion, and Dr. Kevorkian schools, and palliative care/hospice training pro-
Center Vice President Tim Quill,
DWD: This book is in part a response to a book published by was the main voice speaking on behalf of the med- grams will use both our book and the
M.D. and Advisory Board opponents last year. How has the issue evolved since the oppo- ical profession's obligation to address intractable Hendin/Foley book to help their trainees explore
nent's published? human suffering. Now there are mainstream and understand both sides of this issue, and in
Member Margaret Battin, Ph.D. organizations like the Death with Dignity National doing so have a more complex and deep discus-
Quill: It is very clarifying to have the best clinical, ethical, policy Center helping to articulate these issues on behalf sion. In this increasingly polarized world in which
The book: Physician Assisted we live, having an in depth understanding of all
and legal arguments in favor of allowing legal access to physician- of patients and families. Many mainstream schol-
ars who are well known in their primary fields aspects of such complex questions will ultimately
Dying: The Case for Palliative assisted death put together in the same place, so that readers can
carefully think through this complex issue and many of its ramifi- (some of whom are chapter authors in our book) lead to a system that is safer and more responsive
Care and Patient Choice, is cations. Although it does not alter the ethical and philosophical are clearly arguing for legal access to physician- to the real dilemmas faced by dying patients and
dimensions of the discussion, the empirical data from Oregon has assisted death as a last resort to replace the cur- their families.
published by Johns Hopkins rent practice of turning our backs on patients with
changed the playing field since the publication of the
Foley/Hendin book. The suggestions that there would be wide- this problem, or averting our eyes as patients, fam-
University Press. This is the first
spread abuse of the practice if legalized and that it would under- ilies and a few doctors secretly act on their own.
of a series of interviews with mine efforts to improve palliative care have been disproved. The Oregon experience clearly illustrates that an

the book’s editors and chapter DWD: Our Next Generation program promotes better under-
authors that will continue in standing of end of life issues facing doctors on medical school
campuses across the country. How will this book be useful to med
upcoming issues of The Dignity students, and do you have any faith that medical schools will
actually include more literature about end of life care any time
Report. soon?