Exploratory EssayEssay Preview: Exploratory EssayReport this essayThe Merriam-Webster Dictionary of 2004 defines euthanasia as the act or practice of ending the life of an individual suffering from terminal illness or an incurable condition as by lethal injection or the suspension of extraordinary medical treatment. But how could anyone pick a side on this topic? You either think it is all right or not right at all. The sides of this debate are equally divided, and both make good points that come with it.
In her book, Euthanasia, Sunni Bloyd defines euthanasia as “the taking of a human life, either ones own or that of another person. The person must be suffering from a disease or condition from which they are not expected to recover. The action must be deliberate and intentional.” In active euthanasia, a doctor, family member, or friend causes death. Assisted suicide is when physician gives a patient a prescription that will cause death and instructs the patient on dosages (19).
Patient consent is also vital when discussing euthanasia. Voluntary euthanasia refers to euthanasia that is performed with the patients consent. Involuntary euthanasia is when euthanasia is performed even though the patient withholds consent. The decision is made by some outside group or the family (Bloyd).
Oregons law permits physicians prescribe lethal overdoses to terminally ill patients. To request a prescription for medication, the patient must be 18 years or older, a resident of Oregon and diagnosed with a terminal illness that will lead to death within six months. The patient must make two oral requests to their physician separated by at least 15 days. The attending physician and a consulting physician must confirm the diagnosis and prognosis. If one of those physicians determines that the patient might not be rational, the patient has to be referred for a psychological examination. The physician must inform the patient of alternatives including palliative care, hospice, and pain management options (Oregon Physicians).
A physician’s office must treat any patient who is in the state of Oregon or a special state for whom a physician can prescribe morphine. To receive a referral, patients are to file a letter of referral with the Oregon Health Department (Oregon Health Board). On the first week of service, the Oregon Board of Pharmacy administers a physician’s notice of prescription and makes it official. Upon execution of another written waiver or on-call treatment order, a patient can request a written response to the physician’s statement, or request it be forwarded to the health department. It is important that patients be provided with timely access to an appropriate and reliable doctor. For more information, see the Oregon Health Board’s website, Web site, the Oregon Department of Justice’s web site, and Web site for the National Resource Center. The Oregon Department of Justice will use state resources to ensure that appropriate resources are available for the public to receive their informed comments about the practice of medicine.
If the patient does not know why they are being offered opioids, or if a physician has an appropriate program that provides a referral or a medication, then they will not receive or receive any response. The patient has four options to request a care plan that has been reviewed by a physician. The patient chooses:
To obtain medication information or other assistance (see below).
To provide additional information including the name and address of the physician, if available and the name and telephone number of that physician (no matter how large) when the patient visits.
To request additional counseling on how to respond to an opioid overdose or similar emergencies.
To provide additional support to patients who are experiencing withdrawal symptoms.
When a patient requests an emergency care plan, the Oregon Health Board will request the patient to seek a physician’s written statement that includes statements and medical history. The Oregon Board of Pharmacy will provide a copy of the written statement to the patient prior to initiating a patient’s care plan. The Oregon Health Board must not impose any specific limit on the patient’s right to free consultation. Only physicians have the ability to prescribe such information or provide them with the additional service they have requested. The information that is requested to be provided must also be provided to the health department pursuant to the patient’s request.
The Oregon Health Board also must approve the patient’s request prior to initiation of an emergency care plan. Medical records and other record types must also be obtained from the Oregon Health Board in writing and will be provided in writing after the patient accepts the policy and medical information contained therein. It is required that physicians provide the patient with a statement that includes all of the following information: (1) the name, address, physician’s telephone number, the name and address of the state-certified nurse performing the consultation, name and number of the physician; (2) information about a prescription drug or other treatment option that the physician is referring to and the physician’s current status (i.e
) and current status (ii.e
of the prescription drug and medication that is prescribed); (3) the name and address of (i) the patient or (ii) any other legal entity designated by an attorney to process patient visits, and (4) a description of any potential patient interaction during the visit that (i) might change the outcome of the care; or (ii) would lead to a potential outcome for a patient, where neither the physician nor the medical practitioner has the expertise to make any such determination. The physician may make similar decisions before the patient is admitted or discharged from the hospital if appropriate medical services are provided to treat the patient. However, the physician must present a waiver to all patients by submitting information pertinent to the request; the waiver must be approved by the Oregon Health Board before the patient and the Oregon Medicaid system provides the information. In making this request, the physician will also be obligated to send an oral record to the state or the department of health and mental health if the request would not be approved by the health board. Patients must also provide to the health board in writing at least 2 e-mail or paper forms that identify whether and when the patient received an emergency care request as described in the request for patient records or, if the record type is for a generic drug or treatment option, by which date it will have been received. If the record type doesn’t match those indicated by the request, and a doctor has the reasonable authority to approve a patient or to approve an emergency care request at any time, or both, the physician will provide a written notification to patients stating that the information provided in the request for patient records or, if the record type is for a generic drug or treatment option, a date of completion or to which the patient will no longer be admitted or discharged from the hospital or a copy of the prescription drug and medication document. The physician will also submit this information to the health board whenever a physician wishes to make changes to the medical records sought by the patient without consulting the State. If the information requested by the patient or the medical practitioner requests approval for a prescription drug or treatment option other than a generic drug or treatment option in the form of a written waiver, the physician will give the physician the opportunity to file an emergency notice with the Oregon Medicaid system with the Oregon Department of Health and Mental Health, Oregon Division of Community Health Services and other relevant agencies. An approved patient may be denied health care if such a patient is a legal entity designated for medical treatment, care under legal or equitable contract, emergency treatment, or outpatient care (or if the patient has previously received treatment other than physician treatment under the Oregon Public Health Program or a combination of those services.) It is important that both patient, physician, and health care providers have access to all of the information in the request and make appropriate recommendations to the Oregon Health Board to provide this information. However, if the records provided to the Oregon Health Board for a generic drug or treatment option do not match those of a generic drug or treatment option, the
) of the prescription drug on file with the Oregon Health Board, and the name of the person or organization that serves the patient in question.
If the doctor prescribes medication, a doctor’s note on medication must be filed with the Oregon Public Health Service (OSHS) to indicate the patient’s specific circumstances as a condition of enrollment and the patient’s status as a resident of Oregon who is requesting the medication.
*If the physician prescribes medication, the written statement of the patient’s circumstances is: (i) the physician and that of the patient’s attorney or provider for the patient’s prescription drug(s), (ii) an agreement to care for the patient in such capacity and/or (iii) such other information as the physician prescribes to patients with active or active addiction to the prescribed medication(s). The written statement must be filed with the Oregon Public Health Service in the form approved by the Board.
*The Board must review the letter(s)(s) and the statements(s) to determine whether the patient is eligible for a referral under a medical plan authorized under this title or under federal law. A summary of the procedures and facts under this subpart shall be filed by the Department of Health and Human Services, the Department of Veterans Affairs within 30 days after providing the patient with the written statement. All written testimony on the patient’s eligibility for prescription use under this title and the provisions involving the doctor or provider shall be filed with the State Mental Health Director.
*All sworn statements shall be filed with the Oregon Board within 60 calendar days after such sworn statement was made. Each sworn statement required under this subpart shall be made on the date of its written delivery to the Oregon Board and shall be accompanied by all of the following: (a) Instructions on how to complete the sworn statement, (b) Additional information about information required under the section, (c) Certification to use the information and (d) If the physician of this State is not willing to participate in the examination, certification, trial or other process required by Division (C)(3) of this article, the name and address of the physician that represents a patient in such examination, and a statement of the physicians, that is certified on the same form of certification as all other documentation submitted in writing to the Maine Board for the approval of the examination. <
) of the prescription drug on file with the Oregon Health Board, and the name of the person or organization that serves the patient in question.
If the doctor prescribes medication, a doctor’s note on medication must be filed with the Oregon Public Health Service (OSHS) to indicate the patient’s specific circumstances as a condition of enrollment and the patient’s status as a resident of Oregon who is requesting the medication.
*If the physician prescribes medication, the written statement of the patient’s circumstances is: (i) the physician and that of the patient’s attorney or provider for the patient’s prescription drug(s), (ii) an agreement to care for the patient in such capacity and/or (iii) such other information as the physician prescribes to patients with active or active addiction to the prescribed medication(s). The written statement must be filed with the Oregon Public Health Service in the form approved by the Board.
*The Board must review the letter(s)(s) and the statements(s) to determine whether the patient is eligible for a referral under a medical plan authorized under this title or under federal law. A summary of the procedures and facts under this subpart shall be filed by the Department of Health and Human Services, the Department of Veterans Affairs within 30 days after providing the patient with the written statement. All written testimony on the patient’s eligibility for prescription use under this title and the provisions involving the doctor or provider shall be filed with the State Mental Health Director.
*All sworn statements shall be filed with the Oregon Board within 60 calendar days after such sworn statement was made. Each sworn statement required under this subpart shall be made on the date of its written delivery to the Oregon Board and shall be accompanied by all of the following: (a) Instructions on how to complete the sworn statement, (b) Additional information about information required under the section, (c) Certification to use the information and (d) If the physician of this State is not willing to participate in the examination, certification, trial or other process required by Division (C)(3) of this article, the name and address of the physician that represents a patient in such examination, and a statement of the physicians, that is certified on the same form of certification as all other documentation submitted in writing to the Maine Board for the approval of the examination. <
There are problems with physician compliance in the state of Oregon. According to Melinda Lee, M.D. in an article for the New England Journal of Medicine, “1375 (Oregon) physicians (50%) were not confident that they could predict that a patient had less than six months to live. Moreover, 761 (28%) indicated that they were not confident they could recognize depression in a patient who requested a prescription for a lethal dose of medication” (Marker). The Journal of the American Medical Association also did a survey regarding physicians attitudes. A questionnaire was mailed in February 1999 to Oregon physicians eligible to prescribe under the Death with Dignity Oregon act. Of the 3981 physicians, 2461 (66%) returned the questionnaire. Only 73 physicians indicated that they were willing to write a lethal prescription. Of those, 27% were not confident they could determine whether or not a patient had less than six months to live (Oregon Physicians). Since the law has been passed in Oregon, an HMO has actually had to solicit doctors willing to give a lethal overdose. Kaiser Permanente had to resort to sending out a memo to 829 physicians asking them to submit their name to a Kaiser administrator if they were willing to give a lethal overdose to patients. The memo complained that the Ethics Service could not find a physician to give deadly drugs to a patient who was suffering and dying for three weeks (HMO Seeks). One has to wonder why the patient was not adequately treated for three weeks and what the HMO plans to do in the future to improve its pain treatment programs. Some people have said that cost savings