Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2007 Oct;33(10):591-7.
doi: 10.1136/jme.2007.022335.

Legal physician-assisted dying in Oregon and the Netherlands: evidence concerning the impact on patients in "vulnerable" groups

Margaret P Battin  1 , Agnes van der Heide, Linda Ganzini, Gerrit van der Wal, Bregje D Onwuteaka-Philipsen
Affiliations

Legal physician-assisted dying in Oregon and the Netherlands: evidence concerning the impact on patients in "vulnerable" groups

Margaret P Battin et al. J Med Ethics. 2007 Oct.

Abstract

Background: Debates over legalisation of physician-assisted suicide (PAS) or euthanasia often warn of a "slippery slope", predicting abuse of people in vulnerable groups. To assess this concern, the authors examined data from Oregon and the Netherlands, the two principal jurisdictions in which physician-assisted dying is legal and data have been collected over a substantial period.

Methods: The data from Oregon (where PAS, now called death under the Oregon Death with Dignity Act, is legal) comprised all annual and cumulative Department of Human Services reports 1998-2006 and three independent studies; the data from the Netherlands (where both PAS and euthanasia are now legal) comprised all four government-commissioned nationwide studies of end-of-life decision making (1990, 1995, 2001 and 2005) and specialised studies. Evidence of any disproportionate impact on 10 groups of potentially vulnerable patients was sought.

Results: Rates of assisted dying in Oregon and in the Netherlands showed no evidence of heightened risk for the elderly, women, the uninsured (inapplicable in the Netherlands, where all are insured), people with low educational status, the poor, the physically disabled or chronically ill, minors, people with psychiatric illnesses including depression, or racial or ethnic minorities, compared with background populations. The only group with a heightened risk was people with AIDS. While extralegal cases were not the focus of this study, none have been uncovered in Oregon; among extralegal cases in the Netherlands, there was no evidence of higher rates in vulnerable groups.

Conclusions: Where assisted dying is already legal, there is no current evidence for the claim that legalised PAS or euthanasia will have disproportionate impact on patients in vulnerable groups. Those who received physician-assisted dying in the jurisdictions studied appeared to enjoy comparative social, economic, educational, professional and other privileges.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Comment in

References

    1. New York State Task Force on Life and the Law When death is sought. Assisted suicide and euthanasia in the medical context. New York: New York State Task Force on Life and the Law, May 1994 (executive summary, p, xiii)
    1. Washington v Glucksberg, 521 US 702 (1997) and Vacco v Quill, 521 US 793 (1997)
    1. Canadian Medical Association Euthanasia and assisted suicide (update 1998). Ottawa: CMA, 1998
    1. Snyder L, Sulmasy D P, for the Ethics and Human Rights Committee, American College of Physicians–American Society of Internal Medicine Physician‐assisted suicide. Ann Intern Med 2001135209–216. - PubMed
    1. Snyder L, Leffler C, for the Ethics and Human Rights Committee, American College of Physicians Ethics manual: fifth edition [position paper]. Ann Intern Med 2005142560–582. - PubMed

MeSH terms