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Jack Kevorkian drove the debate on physician-assisted suicide

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Between those dates, the effort to legalize controlled suicide involving help from a medical doctor took form with advocacy organizations like the Hemlock Society and Compassion & Choices.

'Death with Dignity' law breaks new ground

After two ballot measures in which voters approved the procedure (the second time in a rebuff to the state legislature), Oregon’s “Death with Dignity” law became the first in the country.

The Oregon law, enacted in 1997, strictly prohibits “lethal injection, mercy killing, or active euthanasia.” But it allows mentally competent adults who declare their intentions in writing, and have been diagnosed as terminally ill, to take a doctor-prescribed lethal drug themselves, orally, after a waiting period.

Critics had predicted that vulnerable patients could be pressured by doctors or family members to end their lives, and they also warned that out-of-staters might rush to Oregon to take advantage of its law.

Apparently, neither has happened. Since 1998, 525 patients have taken their own lives under the law, averaging about 60 a year for 2008-10.

At the same time, what medical practitioners consider ideal end-of-life care has increased here, including palliative treatment for discomfort, hospice care, and care that allows patients to spend their last days at home with families and friends.

Oregonians are also more likely to have "living wills" – documents in which they ask not to be kept alive by artificial means if recovery seems improbable – and medical directives on file, and they're more likely to decline medical treatments (including feeding and hydration tubes) that prolong life.

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