HBO documentary probes Oregon's euthanasia law

Rather than launching head-on into the often-contentious controversy surrounding attempts to pass similar laws in other states, director Peter Richardson provides viewers with well-grounded insight on the often difficult decisions that patients, supported by their doctors, have to make in ending their own lives. Oregon passed the nation's first Death With Dignity act in 1994, which allows terminally ill patients with less than six months left to live to request a prescription for lethal barbituates.

Opening the film with a scene of cancer patient Roger Sagner drinking a deadly dose of Seconal surrounded by loving friends and family sets the context for a sometimes harrowing journey into the lives of these brave individuals. The film's throughline is provided by 54-year-old wife and mother Cody Curtis, who is suffering from a relapse of liver cancer.

Racked with pain and the debilitating effects of the cancer, she asks her doctor to provide a prescription for barbiturates to hold "in reserve" in case she chooses to end her life. Once she receives her six-month diagnosis, Curtis begins preparing her husband and two children for her likely demise as Richardson films the family's heartrending decisionmaking process. "I'd rather go when I'm still feeling OK," and not burden the family further, she says.

Richardson also interviews uninsured prostate cancer patient Randy Stroup, who was denied further health care by Oregon's insurance program after an initial operation was unsuccessful. In a notorious case that gained nationwide attention, the state offered him the Death With Dignity option instead of further surgery. Although the agency ultimately reversed its ruling and approved chemotherapy, Stroup succumbed, bringing further attention to the inadequacies of healthcare coverage for the uninsured.

An uplifting story strand focuses on Nancy Niedzielski, who supported the passage of a Death With Dignity act in neighboring Washington state after her husband's excruciating demise from brain cancer. Niedzielski campaigns tirelessly, making public presentations, speaking with the press and canvassing for the initiative, which passed in 2008.

The priority of many of patients profiled is to maintain control over their treatment, as well as to assert their dignity in dying, if that's their choice. Many also prefer not to burden their families with further expense and suffering when their disease becomes terminal. A sobering assessment of the difficult choices involved in patient care, the film isn't without humor, most of it provided by the terminally ill, who have nothing to lose when joking darkly about their diagnoses.

Despite the highly emotional situations and sometimes awkward interview settings, Richardson and co-editor Greg Snider achieve an unfussy style that ably enhances the subject matter. In addition, the film clearly benefits from a longer-running cable format than what might be accommodated on public TV.

"How to Die in Oregon" may well turn out to be a definitive social issue documentary in the expanding right to die movement and the national healthcare debate. Despite the policy implications, however, the most affecting aspects of the film are the subjects' courage and openness discussing extremely private matters and the filmmakers' compassionate approach.