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May 25, 2011

'How to Die in Oregon'

HBO doc depicts how one state’s controversial law affects those faced with impossible choices.

Before the opening credits roll for How to Die in Oregon—airing on HBO tonight—we have watched one man, Roger Sagner, end his own life.

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In the documentary’s closing minutes, Cody Curtis, a woman with terminal cancer and living with escalating and excruciating pain schedules her own “death with dignity.” Here, tellingly, the camera parks outside her window. Perhaps that was her choice and not the director’s, but it feels as though the time we’ve spent with her through the film has made her a real person rather than a cause, and it is hard to not wonder whether the camera’s rather sudden reserve implies any particular feelings about what is going on.

Whether one agrees or disagrees with the Oregon law, one must concede the earnestness with which director Peter Richardson approaches his topic. And who amongst us is brave enough to stand in judgment of Sagner and Curtis?

I would be careful not to mistake the documentary’s soberness for diffidence, however. Good cases often make bad law, and those who want to shape public policy tend to do so by looking for the cases that best frame the issue in the way they want it looked at. I don’t knock the film for having a point of view—I prefer honest advocacy to feigned neutrality—but I confess to wishing that it had a little more breadth in examining the issues surrounding the law. It is worth noting, for example, that the right to request a prescription for a terminal quantity of drugs (the law’s advocates insist on calling it “medication” even when it is not being used for treatment) is limited to those who have been diagnosed with an illness that will kill them within six months. One certainly hopes that the fact that at least two of the participants in the film live significantly longer than six months after receiving such a diagnosis wasn’t deliberately downplayed for fear that it might undercut the premise that the Death With Dignity Act is sufficiently narrow in scope.

Most telling, perhaps, of whether the film is depicting or advocating is the way it deals with the case of Randy Shoup. He is interviewed at the 52-minute mark, railing against Oregon Health Plan correspondence refusing to pay for stronger chemotherapy (because it can’t be shown to probably increase his life by five years) but telling him he is qualified to receive aid for comfort and “palliative care,” including physician aid in dying. “No man has the right to offer money to have somebody else killed,” Shoup says.

By going public with his letter, Shoup was able to get the Oregon Health Plan to reverse its decision and approve the chemotherapy recommended by his physician. The film states in printed text that he died four weeks later, leaving the impression that the questions he raises are easily dismissed technicalities. It is easy to miss on a first viewing that Shoup had already lived more than a year fighting prostate cancer after he was given “two to four months.” It is also worth pointing out that Shoup is given three minutes of screen time in the middle of a 107-minute film, so, by the end, the quite reasonable questions and concerns raised by his case have been pretty much pushed aside rather than answered.

In other words, people on both sides of the issue are allowed to speak in How to Die in Oregon, but we are encouraged to listen to some of them more than others.

Here's the trailer:

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