Measure 16

November 8, 1994 (1994-11-08)
Death with Dignity Act: Allows Terminally Ill Adults to Obtain Prescription for Lethal Drugs
Results
Choice Votes % Yes 627,980 51.31% No 596,018 48.69%
Yes:     50-60%     60-70% No:     50-60%     60-70%

Measure 51

November 4, 1997 (1997-11-04)
Would have repealed Measure 16 if successful; referred by legislature
Results
Choice Votes % Yes 445,830 40.09% No 666,275 59.91%
Yes:     50-60% No:     50-60%     60-70%

Measure 16 of 1994 established theU.S. state ofOregon'sDeath with Dignity Act (ORS 127.800–995),^[1] which legalizesmedical aid in dying (commonly referred to asphysician-assisted suicide) with certain restrictions. Passage of thisinitiative made Oregon the first U.S. state and one of the first jurisdictions in the world to permit someterminally ill patients to determine the time of their own death.^{[citation needed]}

The measure was narrowly approved in the November 8, 1994, general election. 627,980 votes (51.3%) were cast in favor, 596,018 votes (48.7%) against.^[2] An injunction delayed implementation of the Act until it was lifted on October 27, 1997.^[3]Measure 51, referred in the wake of theUS Supreme Court's 1997 ruling inWashington v. Glucksberg by thestate legislature in November 1997, sought to repeal the Death with Dignity Act, but was rejected by nearly 60% of voters.^[4] The act was challenged by theGeorge W. Bush administration, but was upheld by theSupreme Court of the United States inGonzales v. Oregon in 2006.Measure 16 Results by County:

Measure 51 Results by County:

Under the law, any competent adult^[5] who has been diagnosed, by a physician, with a terminal illness that will kill the patient within six months may request in writing, from his or her physician, a prescription for a lethal dose of medication for the purpose of ending the patient's life. Exercise of the option under this law is voluntary and the patient must initiate the request. Any physician, pharmacist, or other healthcare provider who has moral objections has the right to refuse to participate.

The request must be confirmed by two witnesses, at least one of whom is not related to the patient, is not entitled to any portion of the patient'sestate, is not the patient's physician, and is not employed by a health care facility caring for the patient. After the request is made, another physician must examine the patient's medical records and confirm the diagnosis. The patient must be determined to be free of amental condition impairing judgment. If the request is authorized, the patient must wait at least fifteen days and make a second oral request before the prescription may be written. The patient has a right to rescind the request at any time. Should either physician have concerns about the patient's ability to make an informed decision, or feel the patient's request may be motivated by depression or coercion, the patient must be referred for a psychological evaluation.

The law protects doctors fromliability for providing a lethal prescription for a terminally ill, competent adult in compliance with the statute's restrictions. Participation by physicians, pharmacists, and health care providers is voluntary. The law also specifies a patient's decision to end his or her life shall not "have an effect upon a life, health, or accident insurance orannuity policy."

From the beginning of 1999 through the end of 2015, a total of 1,545 people have had prescriptions written and 991 patients have died from ingesting medications prescribed under the act.^[6]

The median age of the 991 patients who died from ingesting medication was 71; 77.1 percent of patients had malignant neoplasms (cancer). Of the 991, 51.4% were male (48.6% female); 45.5% had aBaccalaureate degree or higher; 45.3% were married; primary end of life concerns were loss of autonomy (91.6%), inability to make life enjoyable (89.7%), and loss of dignity (78.7%).^[6]

An independent study published in the October 2007 issue of theJournal of Medical Ethics reports there was "no evidence of heightened risk for the elderly, women, the uninsured, 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."^[7]

The Death with Dignity Act was the basis of theWashington Death with Dignity Act in 2008. In 2011 the documentary filmHow to Die in Oregon was released. It won the Grand Jury prize for documentary film at the27th Sundance Film Festival.

According toDignity in Dying,Lord Falconer's Assisted Dying Bill, firsttabled in theHouse of Lords in June 2014, "draws on the experience" of the Death with Dignity Act.^[8]

In addition toarguments against physician-assisted dying, opponents feared that terminally ill people throughout the nation would flock to Oregon to take advantage of the law. This fear has not been realized, largely because drafters of the law limited its use to Oregon residents.^[9]Despite the measure's passage, implementation was tied up in the courts for several years.

In 1997, theOregon Legislative Assembly referred Measure 51, which would have repealed the act, to the ballot.

Proponents of Measure 51 argued that the Death with Dignity Act lacked a mandatory counseling provision, a family notification provision, strong reporting requirements, or a strong residency requirement.^[10] Measure 51 opponents argued that sending the measure back to voters was disrespectful considering they had already passed Measure 16 via the initiative process. They also felt that the safeguards in the Death with Dignity Act were adequate.

Measure 51 was defeated in the November 4, 1997,special election with 445,830 votes in favor, and 666,275 votes against.^[11]

Some members of theUnited States Congress, notably SenatorDon Nickles ofOklahoma, tried to block implementation of Measure 16, but failed.^[12][13]

In 2002, federal judgeRobert E. Jones blocked a move byUnited States Attorney GeneralJohn Ashcroft to suspend the license for prescribing drugs covered in theControlled Substances Act of doctors who prescribed life-ending medications under the Oregon law.^[14] TheNinth Circuit Court of Appeals affirmed the block, stating that the "Attorney General lacked Congress' requisite authorization".^[15]

In October 2005, theU.S. Supreme Court heard arguments in the case ofGonzales v. Oregon to determine the fate of the Death with Dignity law. Arguing on behalf of the state was Oregon Senior Assistant Attorney General Robert Atkinson. Oregon's fiveDemocratic members of Congress also filed a brief in support of the State's position.^[16]United States Solicitor GeneralPaul Clement argued on behalf of the Bush administration, which challenged Oregon's right to regulate the practice of medicine when that practice entails prescribing federally controlled substances. On January 17, 2006, the court ruled 6–3 in favor of Oregon, upholding the law.^[17]

• Act 39 inVermont, the first state to pass a death with dignity law by legislative action
• Assisted suicide in the United States
• List of Oregon ballot measures
• California End of Life Option Act
• Compassion & Choices of Oregon, providing medical consultation and direct service for persons eligible for the Oregon Death with Dignity law
• Death with Dignity, song by Sufjan Stevens
• Death with Dignity Act, disambiguation page that lists similar laws
• Death with Dignity National Center, an organization founded to pass and support the law
• Massachusetts Death with Dignity Initiative
• Washington Death with Dignity Act, a similar measure passed in November 2008 in the state ofWashington
• Baxter v. Montana, a court decision legalizing aid in dying in Montana
• Gonzales v. Oregon
• Washington v. Glucksberg
• Euthanasia in Australia
• Voluntary Assisted Dying Act 2017 (Victoria)

• Measure 16, Physician-Assisted Death Initiative (1994) 1994 Oregon Ballot Measure 16 atBallotpedia
• Official Oregon Health Authority page on the DWDA with Annual Reports
• Web site in favor of law
• Briefs filed by the state of Oregon in theOregon v. Gonzales case
• Is the Oregon Death with Dignity Act a good law? Website with pros and cons
• Oregon Voter's Pamphlet Special Election November 1997 – Measure 51 – includes the full text of the measure, and arguments for and against
• The New Atlantis: Ten Years of "Death with Dignity"

• 1994 Oregon ballot measures
• Death in Oregon
• Initiatives in the United States
• Assisted suicide in the United States

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