At a Glance:

In Gideonse v. Brown, et al., Compassion & Choices filed a federal lawsuit in the U.S. District Court of Oregon on behalf of physician Dr. Nick Gideonse, a family practice and palliative care doctor and associate professor of family medicine at OHSU licensed in Oregon. Dr. Gideonse treats patients from both Oregon and Washington. While Washington also has a medical aid-in-dying law, the Oregon residency requirement forces Dr. Gideonse to disrupt the continuum of care for his non-resident patients who want this option. Currently, he must refer such patients to another provider in Washington who will agree to support the patient’s wishes for medical aid in dying. The suit challenges the constitutionality of the residency requirement in the current Oregon medical aid-in-dying law because it unlawfully prevents out-of-state patients, such as those from Dr. Gideonse’s practice, from seeking medical aid in dying.

The Details:

On October 28, 2021, Compassion & Choices filed a lawsuit on behalf of Nicholas Gideonse, an Oregon physician who regularly attends to patients from neighboring Vancouver, Washington. Dr. Gideonse is unable to assist his Washington patients if they request medical aid in dying, due solely to a provision of the  Oregon Death with Dignity Act, that restricts the option to Oregon residents. The lawsuit alleges that the residency requirement contained in the Oregon Death with Dignity Act is unconstitutional. This lawsuit is the first in the nation to challenge the residency requirement of a medical aid-in-dying law.

In the course of his practice, Dr. Gideonse regularly treats patients who reside in Washington. It is particularly difficult to access medical aid in dying in Clark County, Washington, where a number of his patients live, because 61 percent of the county’s hospital beds are in healthcare facilities with religious restrictions that bar physicians from prescribing such medication.

In the past, Dr. Gideonse has received requests from Washington residents seeking assistance with qualifying for and obtaining a prescription for medication under the Oregon Death with Dignity Act. Despite the likelihood that these individuals were otherwise eligible for medical aid in dying, he was unable to consider these requests solely on the basis of residency.

The lawsuit alleges that The Oregon Death with Dignity Act’s residency requirement violates:

  • The U.S. Constitution’s Privileges and Immunities Clause that “prevents a state from restricting non-resident visitors access to medical care within its borders absent a substantial state interest and restrictions narrowly tailored to those interests … The differential treatment between resident and non-resident patients established by the Act is not necessary to achieve any substantial state interest.”
  • The U.S. Constitution’s Commerce Clause that prohibits state laws that discriminate against interstate commerce by preventing Dr. Gideonse from providing specific medical services to existing patients crossing state lines from Washington to Oregon.

On March 28, 2022, Dr. Gideonse and the State of Oregon defendants reached a settlement in the case. As a result of this settlement, the Oregon Health Authority (OHA), Oregon Medical Board, and the Multnomah County District Attorney have all agreed not to enforce the residency restriction. Further, the OHA has also agreed to initiate a legislative request to permanently remove the residency restriction from the law. 

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