Oregon, the first American state to permit assisted suicide, has abandoned a key safeguard in its ground-breaking legislation.

Its 1997 Death With Dignity Act stipulated that a person who receives a lethal prescription must be a “resident of Oregon”. This makes it more likely that the person’s doctor will be able to assess his eligibility for assisted suicide – that he really is terminally ill and that he is able to give informed consent.

However, in an unusual legal move, without waiting for the approval of the state’s legislature, the Oregon Medical Board, the Multnomah County District Attorney, and the Oregon Health Authority simply agreed not to enforce the law regarding this requirement. (The ultra-progressive city of Portland, the state’s largest, is located in Multnomah County.)

The Oregon Health Authority is going to initiate a request to permanently remove the residency restriction from the Act.

“Suicide: Oregon Becomes America’s Switzerland,” was the headline over a column in the National Review by Wesley J. Smith, a bioethics writer. “This change allows for anyone traveling to Oregon to seek assisted suicide and may open the door for telehealth prescriptions of lethal drugs to residents in other states,” said Laura Echevarria, of National Right to Life. “The possibility of abuse among vulnerable populations is of grave concern.”

They are absolutely right. This disgraceful legal subterfuge opens the door to the kind of suicide tourism which recently drew two middle-aged sisters from Arizona to Switzerland to be killed there — even though they were not terminally ill.

Some problems spring to mind immediately. If a person is terminally ill, where will they stay? Will suicide motels become a new business model? Patients will need a compliant doctor. Will quickie death doctors become a new medical specialty?

The change was initiated by the leading assisted suicide lobby group in the US, Compassion & Choices. In 2021, it filed a lawsuit in a federal court on behalf of Dr Nicholas Gideonse challenging the constitutionality of the residency requirement. It vaguely cited the Constitution’s interstate commerce and privileges and immunities clauses.

Dr Gideonse regularly treats patients from neighboring Washington State and says that medical aid in dying is the only type of care that he would recommend for some of them. Oregon’s residency restriction formerly required these patients to either find a new doctor across the state line in Washington or to not have the option of medical aid in dying at all.

Multnomah County’s settlement will be used to press the eight other American states and Washington DC which have medically assisted suicide laws to drop their residency requirements as well. “This requirement was both discriminatory and profoundly unfair to dying patients at the most critical time of their life,” said Kevin Diaz, an attorney with Compassion & Choices.

For the time being, Compassion & Choices advises non-residents who want to take advantage of the non-enforcement of the Death with Dignity Act to proceed “with caution”. The Act may not be enforced in Multnomah County, but given the informal nature of the agreement, district attorneys in other counties might feel differently.

Residency is a key safeguard in nearly all jurisdictions which have assisted dying legislation, even the Netherlands and Belgium. Switzerland is a notorious exception. But according to Compassion & Choices, residency is a form of discrimination. “Firsthand experiences from doctors and patients, and decades of data, make it clear that the residency restriction functions more as a barrier to access than as a safeguard,” it declares on its website.

Yes, that’s correct and that’s the way it should be. Outside of right-to-die fever-swamps, “barriers to access” are known as safeguards. They exist to ensure that vulnerable people receive the best medical care possible — under the circumstances.

It is becoming clearer and clearer that the assisted dying lobby wants to remove all “barriers to access” because they are suicide fundamentalists. They believe that everyone has a right to end their lives whenever they want. “Safeguards” are just window-dressing to oil the passage of assisted dying bills through legislatures.

Which safeguards will be the next to go? Oregon’s law is a template for other American states and even for foreign jurisdictions like Australian states. This development could foreshadow the removal of the residency requirement in their laws as well.

International helplines can be found at www.befrienders.org. In the US, the National Suicide Prevention Lifeline is at 800-273-8255 or chat for support. You can also text HOME to 741741 to connect with a crisis text line counsellor. In the UK and Ireland, Samaritans can be contacted on 116 123 or email jo@samaritans.org or jo@samaritans.ie. In Australia, the crisis support service Lifeline is 13 11 14.

Michael Cook

Michael Cook is the editor of MercatorNet. He lives in Sydney, Australia.