Oregon has become America’s first ‘death tourism’ destination, where terminally ill people from Texas and other states that have outlawed assisted suicide have started travelling to get their hands on a deadly cocktail of drugs to end their lives.
In the liberal bastion Portland, at least one clinic has started receiving out-of-staters who have less than six months to live and meet the other strict requirements of the state’s Death with Dignity (DWD) law.
Dr. Nicholas Gideonse, the director of End of Life Choices Oregon, recently told a panel that he was advising terminally ill non-residents on travelling to Oregon to end their lives, despite a legal gray area.
Dr. Gideonse, an advocate of ‘magic mushroom’ therapy, said he was helping a Texan man suffering from Lou Gehrig’s disease and a hospice patient on the East Coast, but added that there were not yet ‘tons of people coming from all over’.
‘But for a small number of patients who otherwise qualify or are determined to go through that and who have the energy and the resources … it has started to happen,’ he said.
Out-of-state residents must be able to spend at least 15 days in Oregon to process the paperwork, which requires sign-offs from two doctors and witnesses, before administering the fatal dose themselves, says the clinic’s website.
Dr. Gideonse and the clinic operate in a legal gray zone — the state last year agreed to extend access to doctor-assisted suicide to out-of-staters, but this is not expected to be codified into law until later this year.
But, America’s first ‘death tourism’ destination throws up tough legal questions for family members who may help a loved one reach Oregon from a prohibitionist state. They could face arrest or even be prosecuted in their home state as a result.
For critics, Oregon’s nascent ‘death tourism’ industry, and efforts to create another in Vermont, show how the US is on a slippery slope to following in Canada’s footsteps — where lax rules have allowed people with so little as hearing loss to be euthanized.
While US assisted suicide rules are comparatively strict and help some desperately sick people end their agony, critics say they also devalue human life and make deadly drugs a solution for the infirm, disabled and even those who are cash-strapped or feel like a burden.
Jonathan Modie, a spokesman for Oregon Health Authority, said the state stopped enforcing the residency requirement last March, but that he was not aware of any out-of staters travelling to use Oregon’s DWD law so far.
Matt Vallière, executive director of the Patients Rights Action Fund, a campaign group, said America’s medical aid-in-dying (MAiD) rules were already ‘flimsy and easy to circumvent’ and that allowing suicide tourism deepened the problems of a flawed system.
‘You end up in this Wild West scenario where people take the drugs back to their home states, and there are a lot more questions than there are answers about what would happen after that,’ Vallière said.
Diane Coleman, president of Not Dead Yet, another campaign group, said the clinic and Oregon officials were bypassing laws in other states, where lawmakers had decided against having their own assisted suicide rules.
‘Many view these laws as a danger to people with serious illnesses, chronic conditions and significant disabilities in our cost-conscious healthcare system,’ Coleman told said.
Oregon became the first US state to allow physician-assisted suicide in 1997, allowing terminally ill adult Oregonians, with less than six months left to live, to ask doctors for a fatal dose of drugs they then administer themselves, typically at home.
In 2021, the most recent year for which data are available, doctors prescribed 383 fatal drug doses and 238 people ended their lives — mostly white people aged 65 and above suffering from cancer or diseases of the brain or heart.
Dr. Gideonse in 2021 sued Oregon, challenging the constitutionality of the residency restriction in its DWD law, with support from Compassion & Choices, which leads the US campaign to expand America’s MAiD rules.
Oregon health chiefs in 2022 settled the case and agreed to lift the residency rule, but the state’s legislature has only begun considering the repeal this session through House Bill 2279, which looks set to pass in the Democrat-led chamber.
Dr. Gideonse initially complained that the residency requirement blocked him from signing lethal prescriptions for nearby residents of Washington state, who often cross the Columbia River for doctor’s appointments in his city.
In recent weeks, however, it has emerged that Dr Gideonse has also opened up procedures to far-flung non-residents, including those living in states that prohibit suicide assistance, according to his comments as a panelist with The Completed Life Initiative.
After the lawsuit wrapped up, Dr Gideonse has communicated with terminally ill patients from states that prohibit medically-assisted suicides to assess whether they met Oregon’s criteria and to advise them on how they could relocate there for hospice care, he said.
‘Some of those conversations have become material,’ Dr Gideonse added, including the Texan sufferer of Lou Gehrig’s disease, an incurable neurodegenerative condition, who was then ‘in the process’ of coming to a hospice in Portland.
He also described communicating with a terminally sick patient in ‘one of the Carolinas,’ who was weighing whether to travel to Oregon or Switzerland — which has for decades facilitated assisted suicides for foreigners — to end their life.
Dr Gideonse, an associate professor at Oregon Health and Science University (OHSU), is respected by peers, but has also courted controversy in the past, campaigning to legalize psilocybin, the active ingredient in ‘magic mushrooms,’ to help treat depression among those with cancer and other mortal conditions.
Critics point to his ties to Compassion & Choices, which grew out of the 1980s right-to-die movement of the Hemlock Society and Jack Kevorkian — the pathologist and notorious ‘Dr Death’ who assisted scores of suicides and was ultimately convicted of murder.
Dr. Gideonse and EOLCOR did not answer requests for comment. OHSU said in a statement that it followed state and federal laws and ‘supports patients’ rights to seek the care they choose.’
Following the success of last year’s lawsuit in Oregon, Compassion & Choices in 2022 launched a similar case seeking to scrap the residency requirement for Vermont’s MAiD law.
It argues that Lynda Bluestein, 76, a cancer-afflicted resident of Bridgeport, Connecticut, should be able to access MAiD in Vermont, and that Dr Diana Barnard, in Middlebury, Vermont, should be able to prescribe fatal doses to her patients in nearby upstate New York.
Corinne Carey, the New York campaign director for Compassion & Choices, said safeguards in the US remained rigorous enough to ensure that only those needing to end genuine suffering would benefit.
‘Every US jurisdiction that has authorized medical aid in dying, starting with Oregon in 1997, has limited this peaceful dying option to mentally capable, terminally ill adults with six months or less to live who can self-ingest the medication,’ she said.
‘These US laws simply don’t compare to euthanasia laws in Canada and other nations that are not limited to mentally capable, terminally ill adults and allow someone other than the dying person to administer the medication.’
Dr. Peg Sandeen, the CEO of Death with Dignity, another pro-MAiD campaign group, said the safeguards were strong enough, and that they were working ‘towards an America where every patient has this right everywhere.’
‘The US. model is notable for its reliance on safeguards,’ said Dr. Sandeen. ‘Our model provides an option to those who otherwise have no options left and protects everyone else.’