In creating a new legal option for terminally-ill patients, the Oregon Death With Dignity Act has added a new dimension to medical practice. This guidebook was designed to be a comprehensive reference book on all aspects of putting the Act into practice. Some users may wish to read it from beginning to end, while others will prefer to skip to chapters that interest them. Because each chapter can stand alone, some ideas appear in more than one chapter. Each chapter begins with a philosophy section, followed by guidelines and references.
Longer chapters have headings to direct the reader.
The guidelines are recommendations for practice based on Task Force consensus. We recognize that some patients who request a lethal prescription as set forth in the Act will never take the medication. We also acknowledge that health systems and physicians will have differing views about the acceptability of providing such a prescription and about the appropriate degree of involvement. Our intent in developing the guidebook has been to carefully think through scenarios in detail and to recommend actions that will optimize care and minimize harm, no matter where the provider sets the limit of involvement along the spectrum of possible scenarios. In our discussions we go beyond the letter of the law because the attending physician is the health care provider who is most intimately involved with the patient at this time and who has the greatest responsibility under the Act.