Press Release – Anscombe Centre Welcomes West Virginia Constitutional Protections Against Euthanasia and Assisted Suicide

It has been a week since the U.S. Federal Elections took place, and whilst much attention was taken over that period by the controversy and international implications of the Presidential and Congressional results, much less note was taken of those for Ballot Initiative votes held in State Elections. One such relevant to the UK and Ireland was the passing of an amendment to the Constitution of West Virginia which expressly prohibited ‘the practice of medically assisted suicide, euthanasia, or mercy killing of a person’.

Whilst those practices are already illegal in the State, the amendment was a proactive measure to ensure that medically assisted suicide does not one day become legal in West Virginia through a Bill in the State legislature. West Virginia becomes the first American State to proactively protect all its citizens, and medical practitioners and institutions, from the dangerous trend of Euthanasia and Assisted Suicide (EAS) by a constitutional amendment.

This action particularly involves a rejection of the Oregon model of assisted suicide on which the proposed Terminally Ill Adults (End of Life) Bill is based, claiming that in Oregon there have been no cases of abuse of the law and no widening of its initial, limited scope.

Both these claims are misleading. In terms of the scope of the law:

• In 2019, the Oregon Legislative Assembly expanded their State’s law by removing one of its purported ‘safeguards’, allowing those who procure assisted suicide to forego a 15-day waiting period before accessing lethal drugs (Washington State removed its 48-hour waiting period in 2023);
• In 2023, the legislature dropped another limitation to the law – the residency requirement (Vermont followed suit that same year);
• Assisted suicide in Oregon is ostensibly only for terminal illness – which is commonly understood to mean illnesses such as advanced cancer or heart disease – but in 2021 two patients with anorexia underwent assisted suicide after their physician deemed their condition to be ‘terminal’;
• Other States using the Oregon model have gone further:
• allowing for ‘telemedicine’ requests for lethal drugs with a required physical examination to be conducted by a doctor other than the one prescribing them (Vermont, 2023);
• allowing nurses to prescribe lethal drugs (Hawaii and Washington State, 2023);
• reducing the time between two oral requests for assisted suicide (from 15 days to 2 days in California, 2022; from 15 days to 7 days in Washington State, 2023; and from 20 to 5 days in Hawaii, 2023). 

As for (further) abuses, an overview of practice in Oregon, including some case studies as well as statistical evidence, showed problems with doctor shopping, suspect coercion and lack of sufficient psychiatric evaluation. More recently, a 25-year analysis of the Reports made by palliative care specialists Dr Ilora Finlay and Dr Claud Regnard found a reduction in the length of the average physician-patient relationship from 18 weeks in 2010 to 5 weeks in 2022, the a low proportion of patients referred for psychiatric assessment (1%), and an increasing trend of those citing fear of being a burden and financial concerns for opting to undergo assisted suicide.

There may be other more disturbing problems, but we cannot know due to the lack of transparency of Oregon’s system and consequent difficulty of determining how well it works. Even the Annual Reports published by the Oregon State Public Health Division every year on which the long-term analyses above are based constitute minimal data collection, requiring doctors to report any lethal drug prescriptions they make but without any enforcing penalties for those who fail to report, or monitoring of non-compliance or under-reporting. Since the information is voluntarily reported by doctors, it is only the most conscientious that do so, and the underlying data records are destroyed each year.

Also, worryingly, even this minimal data collection has declined, including in important areas. As Finlay and Regnard point out, between 2010 and 2022 there were complications in 11% those assisted suicides that were reported, but in 2022 the cases on which data complications-related data existed per se was only 26%.

Meanwhile, no information is collected from patients or their relatives, and there is no official means by which the public can complain about abuses of assisted suicide. There is no strong oversight of assisted suicide exercised by the State Government. Little wonder that an editorial in The Oregonian in 2008 described assisted suicide in the State as “a system that seems rigged to avoid finding” abuses.

Despite this, what we do know about the Oregon system is extremely troubling. The action of West Virginia voters should be telling and instructive for UK legislators as Westminster prepares to debate the Terminally Ill Adults (End of Life) Bill on Friday 29 November.

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Notes to Editors:

• Any part of the above can be quoted as coming from our Director, Professor David Albert Jones.
• If the issues discussed here affect you or someone close to you, you can call Samaritans on 116 123 (UK and ROI), visit their website or contact them on: jo@samaritans.org
• If you are reporting or writing about a case of death by suicide, whether assisted or non-assisted, please consult the Samaritans’ media guidelines on how to do so responsibly.
• For more information on the Anscombe Bioethics Centre, see our website: www.bioethics.org.uk
• For interviews or comment, contact: media@bioethics.org.uk