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Brendon Nafziger, DOTmed News Associate Editor | March 20, 2011
From the March 2011 issue of HealthCare Business News magazine
At the Sundance Festival this year, the winner of the Grand Jury Prize for documentaries is not what you would call life-affirming. Apparently, it opens with a patient dying on camera after taking a lethal dose of barbiturates. The film, “How to Die in Oregon,” directed by Peter D. Richardson, follows patients as they choose to participate with Oregon’s controversial Death with Dignity Act.
This act, now in its 13th year, lets patients whom doctors believe only have six months or less to live, obtain a prescription for lethal drugs. It survived two ballot measures in the state, the final time in late 1997, after unsuccessful attempts by the federal government to block it.
As the act enters its teens, Oregon is no longer alone. An almost identical law was passed in Washington in 2008. And a 2009 ruling by the Montana Supreme Court, Baxter v. Montana, found that state’s laws let patients determine their end-of-life care – including opting for, in the preferred parlance out West, “aid in dying.”
There is now more than a decade of data on Death with Dignity for researchers to draw on. And the numbers tell an interesting story — not a story most would have expected when the law passed. Overall, the rate of participation has been somewhat low, about 21 out of every 10,000 deaths, according to the Oregon Health Department, which is required under the act to publish a yearly account of DWDA deaths reported to them by doctors.
As of January, about 525 have died under the act during its first 12 years, the state said. In 2010, the most recent year for which data are available, 65 died after ingesting lethal medication.
However, more people get prescriptions than ever use them – for the most recent years, it’s 40 percent more. Last year, 96 scripts were written for those 65 deaths.
Intriguingly, doctor participation is also somewhat low. In 2007, there were 85 prescriptions, but only about 45 prescribing doctors. Many physicians who participate are believed to be recommended by Compassion & Choices, an advocacy group that connects patients with doctors willing to prescribe the drugs. The Patients Rights Council, a pro-life group, said published reports suggest it sees about 75 to 90 percent of all aid-in-dying patients.
“Why are medical professionals slow to adapt to Death with Dignity Laws?” asked Melissa Barber, a spokeswoman for Death with Dignity, an Oregon-based pro-DWDA organization, on a blog last fall.
Barber speculates that it’s a matter of outreach and education, pointing out the low rate of involvement the first year lethal prescriptions were available – there were only 16 reported DWDA deaths.
