The Etymology of Palliative Care: Why Oregon Law Uses “Insure” in ORS 127.642
tl;dr: Linguistic Evolution, Not a Clerical Error
If you are a detail-oriented person reading through the Oregon Revised Statutes to understand your end-of-life rights, your inner grammarian is going to screech to a halt at ORS 127.642.
This is the statute that mandates comfort care for patients when life support is withdrawn. But look at how it’s written:
“...individuals caring for a principal... shall provide care to insure comfort and cleanliness...”
To a modern reader trained to fiercely separate ensure (to make certain an outcome) from insure (to issue a financial policy of indemnification), this looks like a glaring mistake. It naturally sparks two theories: either a tired legislative editor made a typo, or the statute was subtly designed to legally compel health insurance companies to financially underwrite -- or “insure” --palliative care.
The reality is far more interesting (to me): it is neither. It is a pristine example of linguistic drift in statutory drafting.
The Etymological Reality: Two Spells, One Root
To understand why this word is in the statute, we have to look at the etymology. Both ensure and insure trace back to the same identical root: the Old French enseurer (meaning to assure, make sure, or guarantee). For centuries in English common law, the “in-” and “en-” prefixes were completely fluid.
Look at the U.S. Constitution: the Preamble explicitly states its purpose is to “insure domestic Tranquility.” The Founding Fathers weren’t buying a financial policy against riots; they were guaranteeing an outcome. Well into the 20th century, major dictionaries and legal style guides treated “insure” as a perfectly acceptable, interchangeable spelling for making an outcome certain.
When the Oregon Legislature enacted this specific statute in 1993 (1993 c.767 §11), legislative counsel was simply using the traditional, older legal usage of the word. It was only in the late 1990s and early 2000s that modern statutory drafting manuals cracked down, building a strict wall between the two words to prevent modern readers from getting confused.
Why the Context Eliminates All Ambiguity
In statutory interpretation, context is king. Even if a modern insurance company tried to point at this 1993 spelling to claim a financial loophole, the plain text of ORS 127.642 makes that argument dead on arrival.
The legal mandate applies explicitly to “Individuals caring for a principal” -- meaning the physical doctors, nurses, hospice workers, or family members standing at your bedside. The law then details specific, non-financial physical duties:
Oral and body hygiene.
Reasonable efforts to offer food and fluids orally.
Medication, positioning, warmth, appropriate lighting, and other measures to relieve pain and suffering.
Privacy and respect for the dignity and humanity of the principal.
Because a corporate health insurance entity is not an “individual caring for a principal,” and because you literally cannot financially underwrite a sponge bath or the physical positioning of a pillow, the financial definition of “insure” is contextually impossible here.
The Takeaway for Your Estate Plan
At my firm, I sweat the hyper-technical details of the law so you don’t have to.
When I build your Advance Directive, you can rest easy knowing that ORS 127.642 isn’t a mistake, and it isn’t a trap. It is just a time capsule from 1993, capturing the tail end of an era before legal drafting became hyper-standardized. Oregon law firmly guarantees your right to comfort, cleanliness, and dignity in your final moments -- backed by historical language that means exactly what it says.
