A new poll by National Journal and The Regence Foundation found residents in Oregon and Washington were more supportive of a variety of end-of-life options than most Americans. This is the second poll in a three-part series, "Living Well at the End of Life: A National Conversation", which explores the conversations Americans have about death and dying. The findings illustrate some interesting similarities between the two states with Death with Dignity Acts and the conversations taking place about end-of-life care. From the PR Newswire:

"The Northwest is the region of the country that has grappled most directly with the complex and emotional issues surrounding care for people at the end of life," said National Journal editorial director Ronald Brownstein. "And this survey shows that most people in these states are comfortable with an approach that emphasizes not just the duration, but also the quality, of life — though they share the concerns we've seen nationally about cost, information and control at this difficult and vulnerable juncture for families."

Washingtonians and Oregonians are also overwhelmingly supportive of local legislation that has created more opportunities for end-of-life care options, including the POLST, physician directive on life sustaining care, and the Death with Dignity Act allowing for physician-assisted [death].

The most significant result in this poll is as Oregonians and Washingtonians learn more about their Death with Dignity Acts and become more familiar with what these laws allow, their support continues to increase. After giving the participants a more detailed explanation about how the law works, 77% of Oregonians and 70% of Washingtonians have a favorable opinion of their Death with Dignity Acts.

The Oregon and Washington Death with Dignity Acts have been the subject of healthy local and national debates for quite some time. When participants were asked about the tenor of debate and discussion of their states' unique policies, the majority (63% in Oregon and 60% in Washington) stated, "mostly positive because it has led to an increased discussion of what people want if they are terminally ill."

Perhaps as a result of these laws, both Oregonians and Washingtonians were more familiar with the terminology "end-of-life care" than the rest of the country, and both states are slightly more aware of the terms palliative and hospice care. It was interesting to note Oregonians, who passed their Death with Dignity law 14 years before Washington, were more aware of hospice and palliative care than their Washington counterparts:

• Palliative care: 32% of Oregonians were familiar with the term and 26% of Washingtonians
• Hospice Care: 94% of Oregonians and 87% of Washingtonians

These results bolster the anecdotal evidence presented in the video above where Oregon end-of-life health care leaders discuss what they learned in the first ten years after implementation of Oregon's Death with Dignity Act. These medical professionals found not only did many of the common myths purported by the opposition not come to fruition, the state's law had created a starting point for discussing options when people face death because of illness. To help make sure these discussions include all end of life options, a safeguard in the Oregon and Washington laws is the prescribing physician must discuss the "feasible alternatives including, but not limited to, comfort care, hospice care, and pain control."

As a result, the vast majority of terminally ill individuals who use the Oregon and Washington laws are enrolled in hospice and die at home. According to the 2010 reports of usage of the states' Death with Dignity Acts by Oregon Department of Human Services and Washington State Department of Health:

• In Oregon, 92% of the patients who ingested the prescribed medication were enrolled in hospice and nearly 97% died at home.
• In Washington, passed in 2008, 84% were enrolled in hospice and 90% of the patients died at home.

Overall, this poll is very encouraging. It strongly indicates states which offer expanded end-of-life options, like Oregon and Washington, also have citizens who tend to know more about end-of-life care in general — including hospice and palliative care. A ripple effect of passing Death with Dignity Acts appears to result in a public which is better informed of all end-of-life options.