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安楽死・尊厳死:アメリカ合衆国・オレゴン州


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児玉 真美 2013/02/05 「OR州2012年に尊厳死法を利用して死んだ人は77人の最高記録」
 http://blogs.yahoo.co.jp/spitzibara/66061172.html

児玉 真美 2012/03/14 「OR州2011年に尊厳死法を利用して死んだ人は71人の最高記録」
 http://blogs.yahoo.co.jp/spitzibara/64864565.html

International Anti-Euthanasia Task Forceのホームページより
 http://www.iaetf.org/

 ◆SPOTLIGHT on OREGON(↓)
  http://www.iaetf.org/sptlt2.htm
 ◆ASSISTED SUICIDE IN OREGON:THE FIRST TWO YEARS(↓)

 
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◆SPOTLIGHT on OREGON
http://www.iaetf.org/sptlt2.htm

Oregon is the only place in the world that has a law specifically permitting assisted suicide. Reports indicate that deaths under the Oregon law may be under-reported and inaccurately reported.
The second official report, issued in late February, 2000, contains the same flaws as the report issued the previous year. The only change in methodology appeared to be inclusion of interviews with selected family members of those whose assisted suicide deaths were reported. For details on reporting flaws, see the Analysis of Oregon's First Year under the Death with Dignity Act.
「オレゴンはとくに援助された自殺を認める法をもつ世界中でただ一つの場所である。諸報告はオレゴン州の法のもとでの死が報告されないあるいは不正確にしか報告されていないだろうことを示している。  第2の公式報告は、2000年2月末に発表されたが、前年に出された報告と同じ欠陥がある。……」

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◇Dying Patients Face Increased Pain in Oregon
 http://www.eurekalert.org:80/releases/ohsu-osr060500.html
Following implementation of a law permitting assisted suicide in Oregon, reports of pain for dying patients have soared. An Oregon Health Sciences University study finds increased pain for dying, hospitalized Oregonians since 1997. (6/00)
◆Assisted Suicide in Oregon: The First Two Years
 http://www.iaetf.org/orrpt2.htm(↓)
Documented fact sheet about the first two years of assisted suicide in Oregon. (4/00)

◇Commentary: Oregon's Assisted Suicide Deaths Increase
 http://www.iaetf.org/or2com.htm(↓)
Second official report more notable for what it omits than for what it includes.「なにを含んでいるかよりなにを除外しているかで注目される第2の公式報告」 (3/00)

◇Complications from assisted suicide(2/00)
 http://www.nejm.org/content/2000/0342/0008/0583.asp
Reports of complications in Dutch assisted suicides raises questions about accuracy of Oregon reporting. (NEJM, 2/00)

◇Analysis: Oregon's First Year under the Death with Dignity Act
 http://www.iaetf.org/orrpt1.htm
First official report reveals flawed findings.

◇Commentary on Oregon's First Year under the Death with Dignity Act
 http://www.iaetf.org/orr299.htm
Fear of future dependence primary force behind reported deaths.

◇Oregon's Death with Dignity Act: The First Year Experience
http://www.ohd.hr.state.or.us/chs/pas/year1/ar-index.htm
Official report on the first year of Oregon's assisted suicide law.

◇Oregon's Death with Dignity Act: The Second Year Experience
http://www.ohd.hr.state.or.us/chs/pas/ar-index.htm
Official report on the second year of Oregon's assisted suicide law.

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Continuing Coverage of Oregon's Assisted Suicide Law
Articles from the Oregonian, Oregon's largest newspaper (updated daily)

◇Reporting of assisted suicide in Oregon is a sham
Complications not reported - Part 1 (from the Oregonian 3/23/00)
http://www.oregonlive.com/oped/index.ssf?/oped/00/03/ed032306.frame

◇Reporting of assisted suicide in Oregon is a sham
Complications not reported - Part 2 (from the Oregonian 3/26/00)
http://www.oregonlive.com/oped/index.ssf?/oped/00/03/ed032605.frame
「sham=いんちき」

◇Is Mom capable of choosing to die?
http://www.oregonlive.com/news/99/10/st101719.html
Kate Cheney says she wants assisted suicide, but doctors and therapists wonder if it's actually her vocal daughter's wish. (Oregonian 10/17/99)

◇Oregon psychologists polled on assisted suicide and state's PAS law (7/99)
http://www.iaetf.org/iua17.htm#68

Oregon report on end-of-life care shows need for improvement (7/99)

Oregon PAS law spun to look good
Oregon Health Division says reported information may be "cock and bull story" (3/99)

Oregon death highlights discriminatory side of PAS law
Now it's the "purpose" of the law (death) that counts, not the "safeguards" (3/99)
「いま問題なのは、「保護規定」でなく法の「目的」(死)だ。」

Oregon issues sketchy first report on assisted suicide deaths
Assisted suicide supporter admits many cases may be going unreported (10/98)

Federal judge dismisses latest challenge to Oregon's law
Judge Michael Hogan states that Oregon's law my be incapable of judicial review( 9/98)

Congressional bills to ban lethal prescriptions spark debate
Excerpts from debate on bills to prohibit prescriptions of controlled substances for assisted suicide. (7/98)

Reno reverses DEA ruling
Attorney general says DEA will not take action against doctors who intentionally prescribe fatal doses of controlled drugs under the provisions of Oregon's assisted suicide law.(6/98)

First Reported Assisted Suicide Death in Oregon
American Medical News (4/13/98)

Guidelines for assisted suicide in Oregon
State will fund lethal prescriptions (3/24/98)

November-December 1997 IAETF Update
Documented Special Report on the Oregon vote and its aftermath (1/15/98)

Oregon Plunges Over Legal and Ethical Cliff
IAETF Press Release on Oregon's Failure to Repeal Assisted Suicide Law (11/5/97)「援助された自殺法を破棄するするのにオレゴン州が失敗したことについてのIAETFのプレス・リリース」

Special Report: Oregon Takes a Closer Look at Assisted Suicide
In depth look at the campaign to repeal Measure 16 (10/25/97)

Flaws in Measure 16
Documented information about flaws in Oregon's assisted suicide law (10/25/97)

Liar, Liar
Bigotry and Fraud in the Oregon campaign to repeal Measure 16 (10/19/97)

What Now? The Assisted Suicide Debate after the U.S. Supreme Court Decision
Contains background information regarding Measure 16's passage and controversy over use of pills for assisted suicide (7/97)

Facts about the Measure 16
Analysis of Oregon's assisted suicide law (1994)

Oregon's Shame
1994 campaign; Measure 16's drafting and more

Court Challenge to Measure 16
News related to Court Case opposing Measure 16

Oregon's Assisted Suicide Law
Text of Oregon's Measure 16

For additional information on Oregon's law permitting assisted suicide, see the IAETF Update search regarding Oregon's "Death with Dignity" law.


Back to IAETF Main Page | Contact IAETF

International Anti-Euthanasia Task Force
P.O. Box 760
Steubenville, OH 43952
740-282-3810
Copyright 1996 - 2000 IAETF

 
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◆ASSISTED SUICIDE IN OREGON:THE FIRST TWO YEARS
 http://www.iaetf.org/orrpt2.htm

Oregon's "Death with Dignity Act," permitting physician-assisted suicide, went into effect in 1997. Under the law, the Oregon Health Division (OHD) is required to collect information and publish a yearly statistical report. [ORS 127.865 ァ3.11] Two official reports have now been published, but there is no way to know how many or under what circumstances patients have died from physician-assisted suicide in Oregon.
「…1997年の法律により、オレゴン州健康局は情報を集め、年次統計報告を刊行することを求められている。2つの公式報告が公刊された。だが、どれだけの数の人がどんな環境のもとで医師の幇助による自殺で死んだのか知ることはできない。」

The law contains no penalties for doctors who do not report prescribing lethal doses for the purpose of suicide.
The Oregon Health Division has no regulatory authority or resources to ensure compliance with reporting requirements. [American Medical News, 9/7/98]
.....
「…法律には報告しない医師に対する罰則は含まれていない。…」

DEATHS DURING 1ST TWO YEARS FROM PHYSICIAN-ASSISTED SUICIDE:

Official Reports: 43
Actual Number: Unknown
(公式報告では43 実際の数はわからない)

16 reported deaths occurred in 1998. 27 reported deaths took place in 1999. [NEJM 2/24/00, p. 601]

COMPLICATIONS OCCURRING DURING ASSISTED SUICIDE

Official Reports: 0
Actual Number: Unknown

According to OHD official Dr. Katrina Hedberg, the division has to rely on the word of doctors who prescribed the drugs. But those doctors don't need to be present when patients take the lethal medication. So they may not even know if complications take place. [Oregonian, 2/24/00]

Peter Rasmussen, an Oregon physician who has prescribed lethal drugs for assisted suicides, claims that Oregon’s process is "predictably comfortable, painless." [USA Today, 11/21/99] But news accounts telling a different story have surfaced:

Patrick Matheny received his lethal prescription from Oregon Health Sciences University via Federal Express. He experienced difficulty when he tried to take the drugs four months later. His brother-in-law, Joe Hayes, said he had to "help" Matheny die. According to Hayes, "It doesn’t go smoothly for everyone. For Pat it was a huge problem. It would have not worked without help." [Oregonian, 1/17/99 and 3/11/99]
Speaking to a small group at Portland Community College in December, pro-assisted suicide attorney Cynthia Barrett let the first information slip out about a botched assisted suicide. "The man was at home. There was no doctor there," she said. "After he took it, he began to have some physical symptoms. The symptoms were hard for his wife to handle. Well, she called 911. The guy ended up being taken by 911 to a local Portland hospital. Revived. In the middle of it. And taken to a local nursing facility. I don’t know if he went back home. He died shortly ? some….period of time after that…"
Overdoses of barbiturates are known to cause vomiting as a person begins to lose consciousness. The patient then inhales the vomit. In other cases, panic, feelings of terror and assaultive behavior can occur from the drug-induced confusion. But Barrett wouldn’t say exactly which symptoms had taken place in this instance. She has refused to discuss the case since her December revelation. [Oregonian, 3/23/00 and 3/26/00]

ASSISTED SUICIDE DEATHS OF PATIENTS WITH DEMENTIA

Official Reports: 0
Actual Number: Unknown

Kate Cheney, 85, died of assisted suicide under Oregon’s "Death with Dignity Act" even though she reportedly was suffering from early dementia. Her own physician had declined to provide a lethal prescription for her.
「Kate Cheney(85歳)は、報告されているところでは初期の痴呆があったにもかかわらず、オレゴンの尊厳死法のもとで自殺幇助により死んだ。彼女自身の医師は彼女を死なせる処方を出すことを拒んでいた。」

When counseling to determine her capacity was sought, a psychiatrist determined that she was not eligible for assisted suicide since she was not explicitly pushing for it and her daughter seemed to be coaching her to do so. She was then taken to a psychologist who determined that she was competent but possibly under the influence of her daughter who was "somewhat coercive."

Finally, the managed care ethicist, who was overseeing her case, determined that she was qualified for assisted suicide, and the lethal dose was prescribed. [Oregonian, 10/17/99]


ASSISTED SUICIDE DEATHS OF DEPRESSED PATIENTS

Official Reports: 0
Actual Number: Unknown

Under the Oregon law, depressed patients can receive assisted suicide if they do not have "impaired judgment." [ORS 127.825 ァ3.03]
「オレゴン州の法では、うつの状態の患者は、「impaired judgment」を受けていなければ、幇助された自殺ができる。」

The first known legal assisted suicide was that of a woman in her mid-80s who had been battling breast cancer for twenty-two years. Two doctors, including her own physician who believed that her request was due to depression, refused to prescribe the lethal drugs.
「……2人の医師は 彼女の求めがうつによるものだとして致死薬を処方することを拒んだ。」

But Peter Goodwin, medical director of the assisted suicide group Compassion in Dying, determined that she was an "appropriate candidate" for death and referred her to a doctor who provided the lethal prescription. In an audio-tape, made two days before her death and played at a press conference, the woman said, "I will be relieved of all the stress I have." [Oregonian, 3/26/98 and Los Angeles Times, 3/26/98]
「しかし、

PATIENTS WHO RECEIVED LETHAL DOSE MORE THAN 6 MONTHS BEFORE DEATH

Official Reports: 1 (247 days)
Actual Number: Unknown

Lethal prescriptions under the "Death with Dignity Act" are supposed to be limited to patients who have a life expectancy of six months or less. However, at least one lethal dose was prescribed more than 8 months before the patient took it. [NEJM, p. 599]

The Oregon Health Division is not authorized to investigate how physicians determine their patients’ diagnoses or life expectancies. [Hastings Center Report, Jan.-Feb., 2000, p. 4.]


FIRST PHYSICIAN THAT PATIENT APPROACHED AGREED TO WRITE PRESCRIPTION

Official Reports: 16 (39%)
Actual number: Unknown

"Many patients who sought assistance with suicide had to ask more than one physician for a prescription for lethal medication." [NEJM, p. 603] There is no way to know why 61% of physicians refused to lethally prescribe (because the patient was not terminally ill, not competent, etc.) since they were not interviewed for the official reports. The only physicians interviewed were prescribing physicians. [OHD 2nd Year Report, p. 7]


SHORTEST LENGTH OF RELATIONSHIP BETWEEN PATIENT & PRESCRIBING PHYSICIAN

Official Reports: 2 weeks
Actual length: Unknown

The official report indicates that some patients knew their doctors for only two weeks before the lethal dose was prescribed. [OHD 2nd Year Report, Table 2 and NEJM, Table 1]
「公式報告は、何人かの患者は致死薬が処方されるたった2週間前に医師を知ったことをしるしている。」

Since at least 2 weeks must elapse between the first and last requests for the lethal dose, this indicates that the physician-patient relationship was established for the specific purpose of obtaining the drugs for assisted suicide.


REQUESTS FOR ASSISTED SUICIDE BASED ON FINANCIAL CONCERNS

Official Reports: 0
Actual number: Unknown

Six (14.3%) of the patients whose deaths were reported were on Medicaid. [NEJM, p. 600] Their doctors did not report that they had any financial concerns. However those who qualify for Medicaid are among the poorest Oregonians for whom financial difficulties are a fact of life. The report noted that one family member said a patient (who had private medical insurance) expressed concern about financial matters, but the patient "was concerned about all issues except physical suffering." [NEJM, p. 601]
「死が報告されたうちの6人(14.3%)はメディケイドを受けていた。…」

THE OFFICIAL REPORTS DO NOT TELL THE WHOLE STORY OF PHYSICIAN-ASSISTED SUICIDE IN OREGON
「公式報告はオレゴン州での医師の幇助による自殺の全容を語っていない」

The Oregon Health Division acknowledges that information on which its official reports are based may be incomplete and inaccurate:

A limitation of the report includes the fact that "the possibility of physician bias must be considered." [OHD 1st Year Report , p. 9]
"[W]e cannot detect or collect data on issues of noncompliance with any accuracy" [OHD 1st Year Report , p. 9]
"We do not know if covert physician-assisted suicide continued to be practiced in Oregon in 1998." [OHD 1st Year Report 1, p. 9]
"Underreporting cannot be assessed, and noncompliance is difficult to assess because of the possible repercussions for noncompliant physicians reporting data to the division." [NEJM 2/24/00, p. 603 and OHD 2nd Year Report, p. 12]

The Oregon Health Division admits that reporting physicians may have fabricated their version of the circumstances surrounding the prescriptions written for patients:

"For that matter, the entire account could have been a cock-and-bull story. We assume, however, that physicians were their usual careful and accurate selves." [OHD, CD Summary 3/16/99, p. 2]
..............

OHD Sources:
Oregon's Death with Dignity Act: The First Year Experience
Official report on the first year of Oregon's assisted suicide law.

Oregon's Death with Dignity Act: The Second Year Experience
Official report on the second year of Oregon's assisted suicide law.

OHD CD Summary, 3/16/99

Back to Oregon Main Page
Back to IAETF Main Page | Contact IAETF

International Anti-Euthanasia Task Force
P.O. Box 760
Steubenville, OH 43952
740-282-3810
Copyright 2000 IAETF


◆アメリカ(オレゴン地区)連邦地方裁判所 19950803 「アメリカ(オレゴン地区)連邦地方裁判所1995年8月3日判決(オレゴン州尊厳死差止訴訟)」
 町野朔他編[1997:098-102]
星野 一正 19971130 「オレゴン州尊厳死法の住民投票による容認」,『時の法令』1558:62
◆久山 亜耶子・岩田 太 20051230 「尊厳死と自己決定権――オレゴン州尊厳死法を題材に」,樋口・土屋編[2005:51-69]*
樋口 範雄・土屋 裕子 編 20051230 『生命倫理と法――東京大学学術創成プロジェクト「生命工学・生命倫理と法政策」』,弘文堂,423p. ASIN: 433535343X 2940 [amazon][boople] ※, b be d01


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