When television was a new thing, some futurists suggested this national medium would homogenize our accents and diminish regional differences. That didn’t happen.

Oregon continues to stand out in what we might call the political-cultural map of America. After 55 years, relatively few states have imitated Oregon’s eminently sensible Bottle Bill.

Last week’s Columbia Forum was a reminder that Oregon broke cultural ground in 1994 with its Death with Dignity initiative. End of life concerns were the heart of Dr. Susan Tolle’s presentation. Tolle is director of the Center for Ethics in Health Care of Oregon Health and Sciences University.

At the evening’s end, Dr. Tolle said the audience would not have been having that conversation 30 years ago. The remarkable thing, from an Oregonian’s perspective, is that many states still are not having the conversation, or at least are not doing much with it.

One of the most dramatic slides that Tolle shared depicted how states were implementing the Physician Orders for Life Sustaining Treatment (POLST).Oregon and West Virginia stood virtually alone in their progressivism. “POLST has helped people get their (end of life) wishes respected,” said Tolle.

Our spirited debate over the Death with Dignity law had a very positive side benefit. It drew attention to what is called palliative care, which to the layman is pain management. The new physician assisted suicide law also gave prominence to hospices around the state. Dr. Tolle noted that Oregon has among the highest use of hospice in the nation.

In POLST and hospice, there is a benefit to families in respecting the wishes of one of their members. Another frequent benefit is reducing the cost of end-of-life medical care.

In many ways, Oregon resembles the rest of American culture. But our state also has put a premium on innovation. At a time when our national political discussion is stuck in the mud, it is good to be here, out on the edge.

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