Oregon, the first American state to permit assisted suicide, has abandoned a key safeguard in its ground-breaking legislation.

The 1997 Death With Dignity Act stipulates that a person who receives a lethal prescription must be a “resident of Oregon”.

In an unusual legal move, without waiting for a legislative amendment, the Oregon Medical Board, the Multnomah County District Attorney, and the Oregon Health Authority simply agreed not to enforce the law regarding this requirement.

The OHA will initiate a request to permanently remove the residency restriction from the Act. Theoretically, at least, the change will permit “suicide tourism”, although there are currently legal and administrative hurdles.

“Suicide: Oregon Becomes America’s Switzerland,” was the headline over a column in the National Review by Wesley J. Smith, a bioethics writer. “This change allows for anyone traveling to Oregon to seek assisted suicide and may open the door for telehealth prescriptions of lethal drugs to residents in other states,” said Laura Echevarria, of National Right to Life. “The possibility of abuse among vulnerable populations is of grave concern.”

Portland, the state’s largest and best-known city, is located in Multnomah County, which is the third-richest in the state, by per-capita income.

The change was initiated by the leading assisted suicide lobby group in the US, Compassion & Choices. In 2021, it filed a lawsuit in a federal court on behalf of Dr Nicholas Gideonse challenging the constitutionality of the residency requirement. It vaguely cited the Constitution’s interstate commerce and privileges and immunities clauses.

Dr Gideonse regularly treats patients from neighboring Washington State and says that medical aid in dying is the only type of care that he would recommend for some of them. The residency restriction formerly required these patients to either find a new doctor in Washington during the dying process or to not have the option of medical aid in dying at all. This, Compassion & Choices says, is a form of discrimination.

However, Compassion & Choices also advises people who want to take advantage of the non-enforcement of the Death with Dignity Act to proceed “with caution”. The Act may not be enforced in Multnomah County, but given the informal nature of the agreement, district attorneys in other counties might feel differently.

Some problems spring to mind immediately. If a person is terminally ill, where will they stay? Will suicide motels become a new business model? Patients will need a compliant doctor. Will quickie death doctors become a new medical specialty?

Oregon’s law is the template for other American states and even for foreign jurisdictions like Australian states. This development could foreshadow the removal of the residency requirement in their laws as well.

International helplines can be found at www.befrienders.org. In the US, the National Suicide Prevention Lifeline is at 800-273-8255 or chat for support. You can also text HOME to 741741 to connect with a crisis text line counsellor. In the UK and Ireland, Samaritans can be contacted on 116 123 or email jo@samaritans.org or jo@samaritans.ie. In Australia, the crisis support service Lifeline is 13 11 14.