Tuesday, March 3, 2009

2008 Summary of Oregon's Death with Dignity Act

The 2008 Summary of Oregon's Death with Dignity Act was released on March 3, 2009.

The report stated that:
During 2008, 88 prescriptions for lethal medications were written under the provisions of the DWDA compared to 85 during 2007 (and 65 during 2006). Of these, 54 patients took the (lethal) medications, 22 died of their underlying disease, and 12 were alive at the end of 2008. In addition, 6 people with earlier prescriptions died from taking the (lethal) medications, resulting in a total of 60 DWDA deaths during 2008, which was up from 49 DWDA deaths during 2007 and 46 DWDA deaths during 2006. This corresponds to an estimated 19.4 DWDA deaths per 10,000 total deaths, up from an estimated 14.7 DWDA deaths per 10,000 total death in 2006.

There has therefore been an increase by 30% in the total estimated DWDA deaths in two years between 2006 - 2008.

The report stated that:
- 59 physicians wrote 88 prescriptions
- Since the law was passed in 1997, 401 people died under the terms of the law.
- 78% were between 55 and 84 years of age, 98% were white, 60% were well educated, 80% were believed to have cancer, and the median age was 72 years old.
- 97% had some form of health insurance,
- The stated reason for wanting suicide assistance were - 95% loss of autonomy, 92% decreasing ability to participate in activities, 92% loss of dignity, 5% (3 people) inadequate pain control
- No complications were reported in 2008.
- 2 referrals were made to the Oregon Medical Board for incorrectly completed reporting forms. The Oregon Medical Board found no violations of "good faith compliance" with the act and did not sanction any physicians for "unprofessional conduct" regarding the Act.
- 2 people were referred for a psychiatric evaluation, up from none last year.

The annual report continues to lack the essential information for determining the social context of these decisions and the reporting system continues to lack any safeguards for the people who die by assisted suicide based on the fact that reporting is completed by the physician who prescribes the lethal drugs while the physician was only present at the time of ingesting the lethal drugs 11 times or (18.3%). Further, there are no third party reports or investigations to ensure that the cases fulfilled the requirements of the law and/or that the reports are accurately reported and there are no investigations to confirm that reports were submitted for all assisted suicide deaths.

In otherwords, we do not know whether other assisted suicide deaths occured and we do not know if any of the people who died by assisted suicide were socially pressured or died outside of the guidelines of the law. The Oregon Death with Dignity Act relies on physicians to submit reports based on their own decisions or actions. It is unlikely that a physician would submit a report that admits to decisions or actions that are outside of the legal parameters.

Even though concerns about inadequate pain control are the reason that most people support legalizing assisted suicide, only 3 of the 60 people who died by assisted suicide in Oregon listed concerns about inadequate pain control as a reason for them to request assisted suicide.

The 2008 report, like the previous reports lacks the necessary information to assure the public that all is well in Oregon. As the Oregonian Editorial Board stated on September 20, 2008 in their article: Washington state's assisted suicide measure: Don't go there: Oregon's physician-assisted suicide program has not been sufficiently transparent. Essentially, a coterie of insiders run the program, with a handful of doctors and others deciding what the public may know. We're aware of no substantiated abuses, but we'd feel more confident with more sunlight on the program.

Link to the Oregonian Editorial comment: Washington state's assisted suicide measure: Don't go there:

Euthanasia Prevention Coalition, Phone toll free: 1-877-439-3348, Email: info@epcc.ca, Website: www.epcc.ca


Kateryna said...

In reading the listed causes for the suicides, I noted most of those items can be changed. Sometimes pain management is impossible, but, inadequate care seems to be a not so secret cause for most of these deaths.

Does the law require a psychological evaluation in tandem with a doctor's evaluation? What about an assessment of the care level that is received by a social worker?

I am just learning about these laws, facing my fears that someone might decide I need to just die.



KathleenLundquist said...

Thanks for this analysis.

Three years ago, the DWDA report from Oregon's Dept. of Health and Human Services was 24 pages long.

Now it's four and a half pages long.

From the article in today's Oregonian: "The 11th annual report is the briefest so far, suggesting the absence of surprises in year-to-year data compiled by the state."

Um, no. It suggests an absence of data and investigative information - and even more covering up than ever occurred before the legalization of PAS.

Maddening. Chilling.

KathleenLundquist said...


The guidelines that were published in 1998 by a state ethics committee to help in implementing Oregon's PAS law recommend that all patients requesting assisted suicide be evaluated by a mental health professional. However, these referrals are rarely (if ever) being made. This year's report states that out of 60 people requesting suicide, only two were referred for psychiatric evaluation. Last year, out of over 40 people who made a suicide request, none were referred for such an evaluation.

This is because many of the doctors who are sympathetic to the PAS cause (and end up writing these prescriptions) take the philosophical stance that suicidal wishes are rational in the face of the patient's disease and are not a symptom of underlying depression. Therefore, they consider the patient's death wish normal - they don't see the need for psychiatric intervention.

No mention of social work or nursing care is mentioned in the Oregon law. Unfortunately, the only "social work" services most people seeking assisted suicide receive is from the mis-named Compassion & Choices organization, which is filled with people who will come alongside the suffering person - and reinforce and enable their death wish.

I recommend the website of Physicians for Compassionate Care, an association of Oregon doctors and health care workers opposed to assisted suicide and euthanasia: http://www.pccef.org/

Mikael said...

"It is unlikely that a physician would submit a report that admits to decisions or actions that are outside of the legal parameters."

You sound like Joseph McCarthy or Glenn Beck when you use this kind of fearmongering and baseless accusal to attempt to convince people that something horrible is happening that isn't. You and all the other anti-assisted suicide advocates use fear and religious dribble to preach to a choir who is already set on their beliefs.

Nobody cares. Most of the academic community is against you because your claims are based on like 2 examples of horror stories from Oregon.

Its been 15 years, get over it.

Alex Schadenberg said...

Dear Mikael:

If you were an academic you would have read all of the studies by Linda Ganzini and concluded that all is not well in Oregon.

When 15 of 58 people who ask for assisted suicide are found to be depressed or mentally incompetent and in the same year (2007) none of the 49 people who died by assised suicide were sent for a psychiatric assessment, then you would have to conclude that people with depression are dying by assisted suicide in Oregon.

Further to that, it isn't religious dribble that creates a concern for people, but rather concern for the public safety. It is inconcievable that a system that uses a self-reporting mechanism would be considered an acceptable level of safeguard. In fact it is a joke.

Finally, if you don't wish to argue your point honestly, but rather attack others as aspousing religious dribble, then I guess the real dribble comes from you. Instead of thinking about the arguement you only care to attack the arguer. That is not only immature, but stupid. I guess your the educated one.