No evidence of slippery slope in assisted deaths, research says

Despite dire predictions, "vulnerable" populations including the elderly, the poor, disabled and minorities do not make up a disproportionate number of the deaths in areas where physician-assisted death is legal, according to international research led by a bioethics expert from the University of Utah.

Margaret Battin, distinguished professor of philosophy and adjunct professor of internal medicine, and three colleagues from the Netherlands wanted to see if evidence existed to support the oft-used "slippery slope" claims regarding physician-assisted dying, she said. Those predictions have come from heavy hitters of all types, including medical associations in the United States, Canada and Britain, and have sparked concern even among proponents of assisted death.

The researchers looked at the experience in Oregon and the Netherlands, where people can receive help from a physician to die. They focused on 10 populations, including those with disabilities, low socioeconomic status, HIV/AIDS, low education levels or psychiatric issues — all factors believed by many to make one more vulnerable. Only in the case of AIDS did they see evidence of more deaths, Battin said. In the other nine categories, rates were actually lower.

The study was released today and is published in the October issue of the Journal of Medical Ethics.

In the nine years since the law took effect in Oregon, where a doctor can prescribe lethal drugs to patients diagnosed by two doctors as having a terminal illness and less than six months to live, 456 patients received lethal prescriptions and 292 used the drugs to kill themselves. That's 0.15 percent of all deaths in Oregon during that time.

In the Netherlands, a physician can either administer a life-ending medication or prescribe one a patient can take himself. The law requires "intolerable suffering," but not terminal illness. Of 136,000 deaths each year in the Netherlands, about 1.7 recent are by voluntary active euthanasia, 0.1 percent by physician-assisted suicide and 0.5 percent are "extralegal" because they involve patients with no current explicit request to die, but who made one before becoming incompetent or are perceived to be suffering intolerably, researchers said. The study centered on cases in the Netherlands between 1985 and 2005, while the Oregon data covers 1998-2006.

In both places, those most likely to choose a physician-assisted death averaged age 70; 80 percent of them had cancer. Slightly more men than women chose physician-assisted suicide.