Oregon Death with Dignity Act: Annual Reports

The Oregon Death with Dignity Act requires the Oregon Health Authority to issue annual reports on the use of the law. Reports are usually released in February.

Most Recent Annual Report: 18th for 2015

In 2015, a total of 218 qualified terminally-ill adult Oregonians received a prescription for medications under the provisions of the Oregon Death with Dignity Act in 2015. Of all patients with prescriptions for death-hastening medications, 125 died peacefully after ingesting the medications and 7 others died after ingesting medications prescribed in 2014. In all, 60.6% of people who obtained medications died after taking them. This corresponds to 38.6 Death with Dignity Act (DWDA) deaths per 10,000 total deaths, or 0.39%.

Since 1998, the year in which the first person in Oregon took medication prescribed under the law, a total of 1,545 patients have received the prescription, of whom 991 (64.1%) ingested it and died. These figures continue to underscore not only that only a small number of people use the law but also that more than one third of those who received the medication took it, finding great comfort in merely knowing it was available to them. Oregon’s Death with Dignity Act continues to work flawlessly and to provide ease of mind and relief to Oregonians facing the end of life.

Oregon Death with Dignity Act Annual Reports

2014: The 17th Annual Report

The 17th annual report, for 2014, showed that a total of 155 terminally-ill adult Oregonians received a prescription for medications under the provisions of the Oregon Death with Dignity Act, while 105 of them (67.7%) ingested the medications to die peacefully. This corresponds to 31 Death with Dignity Act (DWDA) deaths per 10,000 total deaths, or 0.31%.

Other highlights from the 2014 Annual Report:

  • Of the 105 DWDA deaths during 2014, most (67.6%) were aged 65 years or older. The median age at death was 72 years. As in previous years, decedents were commonly white (95.2%) and well-educated (47.6% had a least a BA).
  • While most patients had cancer, the percent of patients with cancer in 2014 (68.6%) was lower than in previous years (79.4%), and the percent with amyotrophic lateral sclerosis (ALS) was higher (16.2% in 2014, compared to 7.2% in previous years).
  • Most (89.5%) patients died at home, and most (93.0%) were enrolled in hospice care either at the time the DWDA prescription was written or at the time of death.
  • As in previous years, the three most frequently mentioned end-of-life concerns were: loss of autonomy (91.4%), decreasing ability to participate in activities that made life enjoyable (86.7%), and loss of dignity (71.4%).
  • During 2014, no referrals were made to the Oregon Medical Board for failure to comply with DWDA requirements.

Since 1998, the year in which the first person in Oregon took medication prescribed under the law, a total of 1,327 patients have received the prescription, of whom 859 (64.7%) ingested it and died. These figures continue to underscore not only that only a small number of people use the law but also that more than one third of those who received the medication took it, finding great comfort in merely knowing it was available to them. Oregon’s Death with Dignity Act continues to work flawlessly and to provide ease of mind and relief to Oregonians facing the end of life.

2013: The 16th Annual Report

The 16th annual report, for 2013 sheds a light on the small group of people who pursue the Death with Dignity option:

  • 71 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.

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

  • 87% of the people who died using Oregon’s law in 2013 were enrolled in hospice.
  • Over 97% of the people who used the law died at home.

2012: The 15th Annual Report

Consistent with all previous years, the 15th annual report, for 2012, showed 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. The data have been so consistent over the years that this report was published without any fanfare and attracted very little media attention.

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:

  • 97% of the people who died using Oregon’s law in 2012 were enrolled in hospice.
  • Over 97% of the people who used the law died at home.

2011

2010

2009

2008

2007

Oregon Death with Dignity Act at the 10-Year Mark

Ten years after the Oregon Death with Dignity Act went into effect, Dr. Nicholas Gideonse reviewed the experience of implementing the nation’s first physician-assisted dying law. An excerpt:

[W]e have seen careful, and flawless implementation of the law approved twice by voters in our state.

As patients approach the final months of their lives, many of them are fearful of what their lives may become; loss of autonomy and control, the inability to perform life’s most basic functions or interact in any meaningful way with their families and loved ones. It is this fear that usually causes them to inquire about the law. My response is always the same: “What more can we do to help you? Is there anything we can do to relieve the pain or the suffering?”

Often, it is simply knowing the option exists to end unbearable suffering that makes the patient feel better. In the vast majority of cases, patients take the medication and slip peacefully away as they are surrounded by family and friends. These are not people who choose to die alone and in despair. These are people who are loved and honored and respected by their families and loved ones.

Oregonians receive the best end of life care in the nation. Almost all the patients who use this law are also hospice patients. We lead the nation in controlling the pain of our patients. And we are continually evaluating and working to improve the care that our patients receive so that none of them would ever feel they had to use this law to escape their suffering.

But sometimes, even the best of care cannot relieve the suffering and loss of control our patients face. It is then that I believe the role of physician should be to make the person as comfortable as they can as they make their final decisions at the end of life. And to work closely with the patient and their family to ensure that those final days are comfortable, and that the patient remains in control.

Finally, what this law has done is bring the practice of aid-in-dying, one that has gone on for centuries, out into the open. Our reporting requirements show us clearly that while the law is used rarely, patients and their families believe it is an important option that leaves them with control and with dignity.

For my patients who have used this law, I was honored that I could be with them every step of the way, ensuring that they were cared for, and that they had control of the final days of their lives.

That’s what death with dignity really means.

2006

2005

2004

2003

2002

2001

2000: The 3rd Annual Report

The 3rd year report showed a pattern was emerging in the law’s usage: thirty-nine terminally ill patients received prescriptions under the Act from 20 doctors, 26 people took the medications to hasten their death (one 1999 prescription recipient died in 2000 after ingesting the medication).

1999: The 2nd Annual Report

In Year 2 of the Act’s implementation, 33 people received prescriptions from 22 physicians; 27 patients used the medications (one patient had received the prescription in 1998 but used it in 1999). Cancer was the leading cause of death. The median age of the patients was 71. All patients had health insurance and 21 were receiving hospice care.

1998: The 1st Annual Report

The very first annual report on the usage of the new Oregon Death with Dignity Act showed that 14 physicians prescribed medications under the law to 24 patients received prescriptions under the new law, of which 16 chose to take the medications. The patients’ median age of the patients was 69.