When supporters of physician-assisted suicide announced in 1993 that they would sponsor a ballot initiative to legalize it in Oregon, they had bigger plans in mind. Coalition leader Dr. Peter Goodwin said that once voters elsewhere saw how well such laws work, "we will see death with dignity legislation sweep across the country."

Initially the practice didn't even sweep across Oregon. While voters approved the initiative in 1994, it had to survive a legal challenge -- and a later initiative aimed at rescinding it -- before taking effect in 1997. It was more than a decade later, in 2008, that a second such law passed in my home state of Washington.

Including Oregon, 10 states and the District of Columbia have legalized the prescribing of lethal drugs for patients deemed to be terminally ill.

But during the same period, 11 states have passed new laws against the practice, joining 27 others that have retained their older bans. Three-quarters of the states still forbid what proponents euphemistically call "death with dignity."

Those proponents continue to pursue legalization in states that have defeated it in the past. But they are also expressing great dissatisfaction with the laws they already passed.

What they once hailed as essential "safeguards against abuse" to win voters' support they now call "barriers" preventing too many patients from taking their lives. They say we must "expand access" to lethal overdoses.

One such campaign recently failed in Washington, after a two-year effort. One factor was that in 2020, the last reported year, the state Department of Health found that 340 lethal prescriptions were written -- seven times the number in the law's first year. This was hardly a sign of excessive strictness.

Another factor was opposition from the American Medical Association and its state affiliate -- and most important, opposition from the state's disability rights organizations. They knew what "expansion" meant.

Supporters of assisted suicide, including former Gov. Booth Gardner who sponsored Washington's 2008 law, have said that people with chronic illness and disability are future targets.

Finally, more careful study of the Department of Health's reports brought a surprise.

Those reports are based on the forms that prescribing physicians are legally required to submit, to show their compliance with the safeguards: the patient's signed and witnessed request for lethal drugs; the doctor's assessment that the patient is of sound mind, has a terminal illness and is likely to die in six months or less; and another physician's "second opinion" confirming these claims.

Groups supporting "expansion" had assured legislators that "there is no data suggesting that medical aid in dying puts people with disabilities at risk of abuse or misuse or that people access the law through abuse or coercion."

But the state's reports show that, in about 200 cases since 2009, physicians did not submit these forms. There is nothing to indicate that the patient voluntarily requested the drugs, had a serious illness or was seen by a second physician. About half of the cases are from the past three years, showing "expansion" in doctors willing to violate the law.

Because these physicians did not comply with the Death with Dignity Act, they cannot claim its exemption from legal liability. They could even be prosecuted for the felony of assisting a suicide. Yet the department has listed these cases as being conducted "under the terms of the law."

What should "sweep across the country" now is a severe mistrust of this agenda and how it is already quietly expanding to endanger many vulnerable people's lives.



- Richard Doerflinger worked for 36 years in the Secretariat of Pro-Life Activities of the U.S. Conference of Catholic Bishops. He writes from Washington state.