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The Facts about Death with Dignity

Oregon and Washington are currently the only two states with Death with Dignity Acts.

Today, I was looking at a copy of the Washington Death with Dignity Act to check out a specific piece of information, and I realized the law is 20 pages long. Because I work with it everyday, I'm familiar with the law's intricacies, but seeing it laid out page after page, I realized many individuals who are looking at it for the first time may be overwhelmed. I thought I'd provide a bit of a recap for our followers.

Oregon and Washington are currently the only two states with Death with Dignity Acts. The laws are similar in both states, allowing terminally ill adult residents who are mentally competent to request a prescription from a physician for a medication to hasten death. These patients must also be able to self-administer the medication. The process is voluntary for everyone involved — patient, physician, pharmacist, health care facility.

Who's eligible to use the Oregon or Washington laws?

  • Eligibility:
    To use the Oregon or Washington law, patients must be 18 years old or older, residents of Oregon or Washington diagnosed with a terminal illness with six months or less to live. The patients must be free of any mental health condition, such as depression, which impairs their ability to make health care decisions. Two physicians must examine the patient and confirm the diagnosis and prognosis. Both physicians must determine the patient is capable of making and communicating health care decisions.
  • Can a non-Oregonian or non-Washingtonian use the law?
    No. Only patients who establish Oregon or Washington residency can use the law if they meet the states' residency requirements (state drivers license, documentation proving the patient rents or owns Oregon or Washington property, state voter registration, or a recent state tax return).

How do Death with Dignity laws protect all citizens?
Several safeguards in Death with Dignity laws ensure all citizens of the state are protected. Any eligible patient must be able to self-administer the medication and may stop the process at any time. The multiple safeguards and the request process ensure there's no chance patients are coerced to hasten their deaths. The terminally-ill patient:

  • verbally requests the medication from the physician twice; each request is separated by 15 days.
  • makes a written request to the attending physician; the request is witnessed by two individuals, one of whom isn't a primary care giver or family member.
  • can rescind the verbal and written requests at any time.
  • must be able to self-administer the prescribed medication.

The law further requires...

  • The attending physician must be licensed in the same state as the patient.
  • The physician's diagnosis must include a terminal illness, with six months or fewer to live.
  • The diagnosis must be certified by a consulting physician, who must also confirm the patient is mentally competent to make and communicate health care decisions.
  • If either physician determines the patient's judgment is impaired, the patient must be referred for a psychological examination.
  • The attending physician must inform the patient of alternatives, including palliative care, hospice and pain management options.
  • The attending physician must request that the patient notify their next-of-kin of the prescription request.
  • Use of the law cannot affect the status of a patient's health or life insurance policies.

The Oregon Department of Human Services and Washington State Department of Health enforce compliance with the law. Compliance requires physicians to report all prescriptions to the state, and annually, the states publish information about their residents' usage of their Death with Dignity Acts.

Assisted suicide, active euthanasia, and mercy killing are all banned practices under these laws. Here are some definitions of these terms to help distinguish between the lawfully, codified practice known as Death with Dignity.

Assisted Suicide is a term used by opponents to scare people, and assisting a suicide is a banned practice under the law. Assisted suicide more accurately refers to criminals like this guy.

Involuntary Euthanasia/Mercy Killing occurs when a patient's death is hastened without the patient's consent. Mercy killing is most frequently associated with military settings.

Active Euthanasia is generally understood as the deliberate action of a medial professional or layperson to hasten a patient's death, and may be in the form of a lethal injection.

Suicide is also inaccurate. A terminally ill patient making a request under the Oregon or Washington law is doing so to hasten an already inevitable and imminent death; therefore, the act cannot properly be equated with suicide. None of the moral, existential, or religious connotations of suicide apply when the patient's primary objective is not to end an otherwise open-ended span of life but to find dignity in an already impending exit from this world. Individuals who use the law may be offended by the use of "assisted suicide," because they're participating in an act to shorten the agony of their final hours, not killing themselves. Cancer (or another underlying condition) is killing them.

The Death with Dignity National Center works to promote and educate people about the importance of Death with Dignity Acts throughout the US. These laws provide guidelines for a rarely-used end-of-life option for the terminally ill. They lend peace of mind to countless individuals diagnosed with a terminal illness facing perhaps the most difficult decision of their lives.

Posted on August 3, 2011 in Ask DDNC

Comments

  • Posted by dean gettig on Monday, August 08 at 05:30 p.m.

    I read the above info. & am lead to beleive that I don't have to have a psychological evaluaton by a psycholigist firet , if at all.

  • Posted by Melissa Barber on Wednesday, August 10 at 12:32 p.m.

    Thanks for asking, Dean. If either the attending or consulting physician suspects their patient's judgement is inhibited by mental illness, their patient must be referred for psychological evaluation to determine mental competency and the patient can't continue the process until he or she has been determined to be capable to make his or her own medical decisions.

    Please let me know if you have further questions.

    Best,
    Melissa
    -------------------
    Melissa Barber
    Electronic Communications Specialist
    Death with Dignity National Center

  • Posted by Terri on Monday, October 03 at 01:57 p.m.

    Hi, My friend is considering a rental in Ore. or WA and is wondering where one finds a physician willing to evaluate the patient for this process.

    thank you,

  • Posted by Melissa Barber on Tuesday, October 04 at 12:21 p.m.

    Thank you for contacting us, Terri. Oregonians and Washingtonians go through the request process for medication with their state-licensed physicians who are familiar with their medical history and terminal diagnosis. I've not heard of anyone other than current Oregon and Washington residents making a request under the states' Death with Dignity Acts, and don't have any advice to offer.

    I would, however, like to pass along these end-of-life resources which are available in all states:

    The National Hospice and Palliative Care Organization may be able to help you find a local organization which focuses on comfort care:
    http://www.nhpco.org/i4a/pages/Index.cfm?pageID=3254
    • Contact information: 800/658-8898 (M-F, 9:00am-5:00pm Eastern) or e-mail at consumers@nhpco.org

    The website of palliative care doctors may also be helpful because it allows you to enter a zip code and locate doctors in the area who specialize in pain management and providing comfort:
    http://www.palliativedoctors.org/
    • This is the link to the directory of physicians: http://www.association-office.com/ABHPM/etools/publicdir/search.cfm

    I hope this information is helpful for you and your friend.

    Best,
    Melissa
    --------------
    Melissa Barber
    Electronic Communications Specialist
    Death with Dignity National Center

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You are the key to ensuring well-crafted Death with Dignity laws for all Americans. With your financial and volunteer help, the Death with Dignity National Center, a 501(c)(3), non-partisan, nonprofit organization, has been the leading advocate in the Death with Dignity movement. Individual contributions helped us pass new Death with Dignity laws in Washington and Vermont, defend the Oregon law, and provide education and outreach programs for the vitality of the Death with Dignity movement.

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