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Ore. assisted-death bill allows some patients to be starved to death

March 5, 2017

Savagery can be subtle.

Oregon, which in 1997 became the first state in the U.S. to legalize assisted suicide, is considering tweaking the laws surrounding advance directives, the legal documents by means of which a person can dictate ahead of time his desires for end-of-life care.

The innocuous-seeming changes that Senate Bill 494 proposes would permit the state to starve certain patients to death.

Under current state law, “artificially administered nutrition and hydration” — intravenous feeding by tubes — does not include food administered normally: “by cup, hand, bottle, drinking straw or eating utensil.”

The latter category, unlike the former, is considered part of the basic provision of care required for the sick, and required by law as long as the patient is mentally incompetent to say otherwise.

In 2016, Bill Harris of Ashland, Ore., asked a state court to order a nursing facility to stop providing food and water to his wife, Nora, who suffers from Alzheimer’s disease. Nora could no longer communicate and had lost use of her fine-motor skills, making it impossible for her to use utensils, so the facility had begun spoon-feeding her.

According to the nursing facility, Nora continued to choose whether she wanted to eat or not, and the facility never coerced her.

Nonetheless, her husband maintained that when she stated in her advance directive that she did not want artificial nutrition, she intended all forms of feeding.

The courts decided against Bill Harris, but S.B. 494, introduced last month and currently under consideration in committee, would reshape the law to suit him.

The bill removes the statutory definition of “tube feeding” and “life support,” and replaces the word “desires” with “preferences.”

To the requirement in its advance-directive forms that “my healthcare representative must follow my instructions,” the bill adds: “to the extent appropriate.”

It also removes the statutory definition of “health care instruction.”

These understated changes are intended to create interpretive ambiguity. Under the amended bill, would Nora Harris’s rejection of “artificial” nutrition and hydration include being fed by a nurse at her bedside? Even though she is conscious, willful, and able to eat, does continuing to feed her constitute “life support”?

Under S.B. 494, these questions would be left up to the courts, or to regulatory bodies such as the Advance Directive Rules Adoption Committee, which the bill creates ex nihilo.

The committee’s members would be appointed by the governor and have sole authority to revise the state’s advance-directive forms — that is, to continue the subversive work of the legislature without meaningful oversight.

The state of Oregon is, in a word, making it easier for the state of Oregon to kill its most vulnerable citizens. It seems of little interest to the state’s legislators that their enterprise is a reversal of the state’s purpose — to protect the preexisting right to life, not to bestow that right on citizens of its choosing.

Likewise, Oregon’s legislators seem little concerned with the possibility that the expansion of a government’s claim to its citizens’ lives accrues a momentum of its own; there is a straight line between this bill and a recent incident in the Netherlands, where the family of a dementia patient held her down as she resisted euthanasia.

But it is worse. Having destroyed the professional oath to which doctors are bound, Oregon would destroy the basic ethic of care that is the mark of a humane society — the expectation that says to tend the sick, to clothe the naked, to shelter the homeless. “I was hungry and you gave me food.”

Under the auspices of a false mercy, Oregon would demand the opposite: to greet Nora Harris, or someone like her — a person who is conscious, who is mobile, who expresses emotion and harbors desires — and to reject her.

Human beings meet each other in the recognition of mutual vulnerability. Oregon would craft a society only for the strong. That has been attempted before, of course, many times, and it has effected only more brutality. Weakness, by contrast, is an occasion for love to reveal itself, unfolding in a moment of grace. No suffering can entirely occlude this hope. In the final accounting, life is always and everywhere good, and so it is where it is most vulnerable that it demands the fiercest defense.

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