In 1997, Oregon became the first jurisdiction to legalise physician-assisted suicide for people with a terminally illness. Since then numbers have increased year-on-year and this shows no sign of slowing.

Last week, Oregon produced its 26th report. This shows that 2023 saw a 20% increase in assisted suicide compared to 2022, which itself had been a record-breaking year.

Last year, at least 367 people died by assisted suicide, an average of one a day. This would be equivalent to 15 assisted suicides per day in population the size of the United Kingdom.

Not all these deaths were quick or easy. In 159 cases, death was motivated by a fear of being a burden on family, friends or care givers. In 28 cases, death occurred without the presence or even the knowledge of a loved one. Complications such as seizures or vomiting occurred in around ten percent of cases and this does not include lingering deaths. 

As Oregon continues to experiment with different cocktails of lethal drugs, median times to death have increased (from 22 minutes in 1998 to 52 minutes in 2023). One patient in 2023 took more than five days to die. If this had been an execution, it would have been cruel or unusual punishment.

The law is supposed to be restricted to people who would otherwise die of natural causes within six months, but in 2023 it was provided to 17 people who had outlived their six-month prognosis. One patient had lived four and a half years since being approved for assisted suicide. These were people who had decided to delay taking the lethal drugs. For the majority, who took the drugs within four weeks of requesting them, we have no way of knowing how many more months or years they otherwise could have lived.

While Oregon continues to break records for numbers of assisted suicides, numbers who did not inform their families, and numbers and length of lingering deaths by assisted suicide, its rate of non-assisted suicide also continues to climb. Statistics from the Centers of Disease Control and Prevention show that between 2005 and 2021 the (“non-assisted”) suicide rate in Oregon increased from 14.9 per 100,000 to 19.5 per 100,000. For comparison, the suicide rate in England and Wales in 2021 was 10.7 per 100,000.

Research published in 2022 demonstrated that, in the United States, legalising physician-assisted suicide had been associated with a 6% increase in the suicide rate, with a 14% increase among women. These results were statistically significant even after controlling for socio-demographic factors. Legalisation of euthanasia or assisted suicide is a threat to suicide prevention.

In England and Wales, it is illegal to encourage or assist suicide. The current law helps prevent suicide and helps protect vulnerable people. The example of Oregon this year, as in the past 25 years, continues to provide a warning of what can happen if this protection is removed.

David Albert Jones is the Director of the Anscombe Bioethics Centre, Fellow at Blackfriars Hall, Oxford, Professor of Bioethics at St Mary’s University, Twickenham, and Vice-Chair of the Ministry of Defence Research Ethics Committee.

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David Albert Jones

Professor David Albert Jones is Director of the Anscombe Bioethics Centre, Oxford; he was appointed in 2010. He is also a Research Fellow at Blackfriars Hall, Oxford University and Professor of Bioethics at St Mary's University, Twickenham. Professor Jones read Natural Sciences and Philosophy at Cambridge (1984-1987), and Theology at Oxford (1992-2000). In 2002 he was appointed Senior Lecturer at St Mary's University, Twickenham where he helped establish an MA in Bioethics. Subsequently, he was appointed Professor in Bioethics and co-founded the Centre for Bioethics and Emerging Technologies.

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