Oregon Health Decisions. An experiment with informed community consent

Abstract

Oregon Health Decisions is a citizen-based project intended to develop statewide awareness of severe bioethical dilemmas. The project has set in motion civic means for addressing and resolving problems in Oregon's health provision system associated with personal autonomy, equity of access, prevention of illness, and humane cost containment. The process of civic involvement with consequent results is described together with the implications for future health policy in Oregon and elsewhere.

KIE: Oregon Health Decisions is a citizen-based nonprofit organization, established in the early 1980s to develop statewide awareness of bioethical issues and to encourage citizen participation in resolving such dilemmas. Operating through community agencies, the project recruited volunteers, held interdisciplinary workshops, and conducted 300 meetings involving more than 5,000 people. Resolutions were developed in five areas: autonomy and dignity of patients, disease prevention, access to health care, cost control, and resource allocation. The primary results have been heightened awareness within Oregon about bioethical issues, funding for other bioethics educational activities, new tasks for health planning agencies, and national media coverage that has fostered an interest in similar projects by other states and organizations.