Ask DDNC

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Several times a day we answer questions from students, terminally-ill individuals, and many others about the specifics of Death with Dignity laws, dying peacefully, end-of-life resources, and many other things related to death and dying. This blog category helps answer many of these frequently asked questions.

Please also see our Frequently Asked Question and Physicians' Frequently Asked Questions pages for more information.

Have other questions? Contact Melissa with your suggestions for other blog posts.

Engaging Allies and Learning the Issue

The Organizing Cycle care of COPA

Three states have laws permitting Death with Dignity: Oregon, Vermont, and Washington. Two have positive court decisions determining physicians cannot be prosecuted for prescribing medications to hasten death under certain narrow circumstances: Montana and New Mexico (under appeal). But if you live in another state and you want to help enact a Death with Dignity law, what steps can you take? This is the second in a series of five blog posts about early organizing efforts you can undertake to help pave the way for passing a law in your state.

In the first, I focused on the important first step of talking to your friends, neighbors, and family members about Death with Dignity and end-of-life care policy reform.

One of the interesting things about talking to your colleagues with intent about death and dying issues is you will find strong support in areas you did not even know existed. One political organizer told me she thought our supporters were as dedicated as the most dedicated volunteers in politics (teachers and firefighters are the most dedicated, in case you're curious).

Read more: Engaging Allies and Learning the Issue

So You Want to Pass a Death with Dignity Law in Your State

The number one constituent question we get at the National Center is, "what do I need to do to pass a Death with Dignity law in my state?" The answer is never easy because enacting a Death with Dignity law through the legislative process or ballot initiative is a complex, time-intensive, and expensive endeavor.

In a legislative environment, lawmakers are afraid of legislation focused on death even though repeated polls show a majority of Americans support Death with Dignity laws. Ballot initiatives are costly and time-consuming, requiring years of background work and the engagement of expensive professional political advisors nearly every step of the way.

The unfortunate reality is, while there's a lot of activity and momentum in the New England region, not every state is ready to move forward immediately with Death with Dignity policy reform.

There are, however, lots of things you can do in your own state to jumpstart momentum and engage others in your request to push for reform, and I'm writing a five-part blog post about different ways to begin the process of legislative engagement in your state. Today's post is focused on identifying allies because one thing is certain: you cannot do this alone.

Read more: So You Want to Pass a Death with Dignity Law in Your State

Oregon's 2013 Death with Dignity Report

Death with Dignity by the Numbers - Oregon 2013

Every year, a small number of Oregonians exercise their rights allowed under the Death with Dignity Act. One of the people who requested the medication was Ben Wald. In 2006, he was diagnosed with colon cancer. He underwent treatment, and went back to enjoying the retired life until the cancer returned and metastasized to his lungs in 2011.

He sought treatment, but the cancer didn't respond and instead advanced to his bones. He enrolled in hospice, and on April 3rd, 2012, he decided to also explore his end-of-life options allowed under Oregon's Death with Dignity Act. In an interview with the Corvallis Gazette Times, Ben's wife, Pam, recalled, "Once he learned that he was going to be given the choice to end his life, he relaxed."

Just by having the option of Death with Dignity, a person regains control over a terminal illness at a time when their illness is quickly stripping away options and control. Though rarely used, the option of Death with Dignity provides comfort to countless individuals who know they have options at the end of their lives.

Read more: Oregon's 2013 Death with Dignity Report

Ask DDNC: Safeguards for Patients

How do safeguards in Death with Dignity laws ensure patients—and no one else—are deciding their own end-of-life care?

The biggest assurance terminally ill patients—and only the patients—are making the decision about the manner and timing of their deaths is the medication request process outlined in Death with Dignity Acts. Patients must ask for the medication a total of three times—twice verbally, and once witnessed in writing. To ensure terminally ill people aren't making these decisions in haste, there's a 15 day waiting period between the first and second verbal requests.

After the second verbal request, the person may make the written request. Two people have to witness this written request, one of whom can't be the patient's doctor, a relative, an heir to the person's estate, nor an employee at a healthcare facility where the person is a patient or resident. The witnesses attest the person requesting the medication has provided proof of identity and the patient is making the decision without any sign of undue influence or coercion.

If either of the doctors, in any of their conversations with the terminally ill patient suspect the person is being coerced in any way, the request process is stopped immediately. Under Death with Dignity laws, coercion is a class A felony, punishable by life in prison and a $50,000 fine.

Read more: Ask DDNC: Safeguards for Patients

Expert Analysis of Advance Directives

"Ask DDNC" is a new column created to serve as a resource for you. Today, we'll focus on advance directives. We consulted Ann Jackson, MBA, for her advice. Ann Jackson is former director of the Oregon Hospice Association and now consults about end-of-life issues and options.

Every state has an official advance directive and is appropriate for all capable adults, regardless of health status at the time it's completed. Its purpose is to protect your right to refuse medical treatment you don't want, or request treatment you do want if or when you aren't able to make such decisions yourself.

Many people aren't aware that, without an advance directive, everything will be done to preserve life—even when it's not likely CPR or other life-sustaining treatments will be successful. In this column, I'll use Oregon's as an example. The Oregon advance directive is straightforward and relatively easy to complete. You can complete Part B, Part C, or both, depending on your advance-planning needs. You must complete Part D and your health care representative, if you appoint one, must complete Part E—Part D is for your signature and the signatures of your witnesses, and Part E is to be signed by your health care representative accepting the appointment.

Read more: Expert Analysis of Advance Directives

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Defend dignity. Take action.

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, non-profit organization, has been the leading advocate in the death with dignity movement. Member contributions helped us pass a new Death with Dignity law in Washington, defend the Oregon law, and provide education and outreach programs for the vitality of the death with dignity movement.

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