[PERSPECTIVE FROM THE 19^TH HOLE: This is the title I chose for my personal blog, which is meant to give me an outlet for one of my favorite crafts – writing – plus to use an image from my favorite sport, golf. Out of college, my first job was as a reporter for the Daily Astorian (in Astoria, Oregon) and I went on from there to practice writing in all of my professional positions, including as an Oregon state government manager and a private sector lobbyist. This blog also allows me to link another favorite pastime – politics and the art of developing pubic policy – to what I write. If you are reading this, thanks for doing so and please don’t hesitate to respond so we can engage in a dialogue, rather than just my monologue.]

A Wall Street Journal opinion piece the other day recalled for me difficult memories of the time, 20 years ago, when Oregonians voted to approve the first doctor assisted suicide measure in the country.

The headline on the piece illustrates the writer’s point of view: A Doctor-Assisted Disaster for Medicine.

Further, the writer, Dr. William L. Toffler, an Oregon physician who heads Physician for Compassionate Care, said he “had seen the dire effect of assisted-suicide laws on patients and my profession.”

For me, the piece brought to mind these facts:

THE FIRST CAMPAIGN: My firm, CFM Strategic Communications, ran the opposition campaign the first time the measure appeared on the ballot. It was a hard-fought campaign and, as you might imagine, featured themes that tugged at the emotions of Oregonians on both – if not all – sides of the debate.

The result was that Oregonian approved the measure by a 51-49 vote, which as the margin indicates, could not have been predicted by any reputable pollster.

THE LEGISLATIVE RESPONSE: It was tough for many legislators to understand the implications of this first-in-the-nation law, so, in a difficult decision, they sent the measure back out to a vote of the people. Even after “the people spoke,” legislators asked them to speak again – and they did, this time by a clear 60-40 margin. [It should be added that my firm did not run that second campaign.]

A FURTHER LEGISLATIVE RESPONSE: What follows next is a tribute to the ability of a legislature to rise to the occasion and develop a compromise that reflects true middle ground – no one is 100 per cent in favor of the compromise, but everyone gets something even while losing something.

This was the case when the legislature took on the task of revising the “immunities” section of the law that had recently cleared the ballot.

Tough work.

The task was assigned to then Senator Neil Bryant, R-Bend, a seasoned legislator with the ability to find the smart middle ground and lead his colleagues in the Senate and the House to accept the decision.

He called various interests into a back room, including representatives of the assisted suicide advocacy group, Oregon Right to Die, and me, as the representative of Oregon’s largest health care system, Providence Health & Services.

Further, in a wise move, Bryant specifically prohibited the Oregon Catholic Conference from participating in the negotiations because it would have been impossible for the religious organization to compromise on an issue of faith and principle.

Over several weeks we hammered out a compromise that allowed organizations like Providence, which were affiliated with a religious organization, to prevent assisted suicide “on their property, by their employees, and within the course and scope of contractual arrangements.”

In return, Providence had to agree to a tough corollary – it had to refer patients out for information and services related to assisted suicide. And, for some, referral is tantamount to “agentry,” which is viewed as being almost the same as engaging in the immoral action itself. For a health care provider, however, it made sense to accept the compromise in light of the new Oregon law, as well as the obligations to meet the needs of ALL patients.

IMPLEMENTING THE LAW: In his Wall Street Journal piece, Dr. Tofler says that more than 850 persons have taken their lives by ingesting massive overdoses of barbiturates prescribed under the law.

Proponents, he says, claim the system is working well with no problems. He disagrees.

“As a professor of family medicine at Oregon Health & Science University in Portland, as well as a licensed physician for 35 years, I have seen firsthand how the law has changed the relationship between doctors and patients, some of whom now fear that they are being steered toward assisted suicide.

“As a society, we should continue to reject the legalization of physician-assisted suicide as a solution to suffering. Instead, we must work to increase access to hospice and palliative care to better support those suffering from terminal illness. The sick and aging deserve better than Oregon’s mistake.”

WHAT’S AHEAD: The debate over assisted suicide is clearly not over, though the law in Oregon is not likely to change. Anyone who has been involved with loved ones or friends in the late stages of their lives can understand the interest in the poignant and emotional decisions near the end, including in the midst of suffering. At the same time, Dr. Tofler’s personal experiences propose the notion that physicians should focus on life, not death.

All of these tough issues will arise again to the south as the state of California considers an assisted suicide measure. The venue will be the California legislature where the outcome is in doubt, given religious opposition, hesitant Democrats and question marks from Governor Jerry Brown who says a special session is not the place to consider such a weighty decision.