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.

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

Oregon's 2012 Death with Dignity Report

Written into Death with Dignity laws is the requirement the state's Health Department must issue annual reports of information collected during the medication request process.

Oregon's Public Health Division recently issued their 15th annual report, and consistent with all previous years, the data continue to show the law works the way it's intended: rarely used, but providing comfort to countless individuals who know they have options at the end of their lives.

Some quick facts about the usage of Oregon's law in 2012:

  • 77 people hastened their deaths under the Oregon law.
  • This accounts for 0.2% of all deaths in Oregon.
  • The top three concerns people expressed to their doctors when requesting the medication were centered around wanting control over their final days.
  • Of the end-of-life concerns expressed, the least common was "financial implications of treatment."

The numbers also show people who request the medication under Oregon's law are receiving high quality end-of-life care:

Read more: Oregon's 2012 Death with Dignity Report

The Need for Carefully Crafted Death with Dignity Laws

The Lancet journal

Physician-assisted death happens every day in every state. This reality is often avoided by patients and the medical community in discussions about end-of-life care, and it's time we started talking about it. A new study published last week in The Lancet looked at this situation in the Netherlands.

The researchers analyzed the prevalence of assisted death before and after the Dutch law went into effect in 2002. The results of this study showed two important trends regarding assisted death:

  • The practice was already happening before the law was in place: The same percentage of deaths were attributed to physician-assisted death before and after the law was in place.
  • Presence of a law doesn't result in increased use: The law didn't lead to a common myth spouted by opponents that legally regulating assisted death will lead to people clamoring to access the law. Or as it was known in Oregon, "People would flock to our beaches to die."

Read more: The Need for Carefully Crafted Death with Dignity Laws

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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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