Wednesday, March 20, 2024

Oregon assisted suicide poison prescriptions increase by 29% in 2023.

The longest time of death was 137 hours (more than 5.5 days).
The complications rate was almost 10% of the assisted suicide deaths.
Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The number of lethal poison prescriptions written under the Oregon assisted suicide law increased substantially with 566 lethal poison prescriptions written in 2023 up by 29% from 433 in 2022.
The 2023 Oregon assisted suicide report indicates that there were 367 reported assisted suicide deaths up by 21% from 304 in 2022. 

The 2022 Oregon assisted suicide report indicated that there were 278 reported assisted suicide deaths meaning that the Oregon Health Authority received 26 assisted suicide reports after January 20, 2023; the date that the 2022 data was compiled. 

The Oregon report under reported the number of assisted suicide deaths by 26 in 2022 and corrected it in the 2023 report. I estimate that the 2024 report will say that there had been approximately 400 assisted suicide deaths in 2023.

The 2023 Oregon assisted suicide report indicates that the ingestion status was unknown in 141 cases. This means that the 141 "unknown" people were approved and received the lethal drugs but the Oregon Health Authority does not know how they died. Some of these cases are assisted suicide deaths that will appear in the 2024 report. Some of these people died a natural death and some of these people died by assisted suicide but no report was submitted. 

Other important data is that 30 of the deaths in 2023 were people who received their lethal poison in 2022. Only 3 of the 566 people who were prescribed lethal poison, were referred for a psychiatric assessment. 

Complications are only known when a health care provider is present at the death. There were 10 known complications based on 102 of the deaths, representing almost a 10% complication rate. In 2022 there were 7 known complications based on 76 deaths, representing a 9% complication rate.

The report indicated that 23 of the 367 reported assisted suicide deaths were out-of-state residents. There could be more than 23 out-of-state assisted suicide deaths. The report included the following disclaimer related to out-of-state assisted suicide deaths:

Information on a patient’s state of residence is not collected during the DWDA prescription process. OHA does not receive death certificates from other states unless the decedent was an Oregon resident. Therefore, if an Oregon DWDA patient dies out of state and was not a resident of Oregon, OHA is unlikely to obtain notice of the death. The out-of-state deaths reported in Table 1 thus may not represent all DWDA deaths from out-of-state residents who obtained a DWDA prescription from an Oregon health care provider.

As with previous years, the report implies that the deaths were voluntary (self-administered), but the information in the report does not address that subject.

Oregon Governor Kate Brown, in July 2019, signing Bill SB 0579 into law to essentially eliminate the 15 day assisted suicide waiting period. This expansion of assisted suicide allows the physician to waive the waiting period, and if the patient is depressed, the patient loses the opportunity to change their mind.
In 2023, in 154 deaths the physician waived the 15 day waiting period - in some cases the lethal poison was ingested the day after being first requested.

An article by David Jones (ethicist) was published by the British Medical Journal of Medical Ethics on October 27, 2023. In his article Jones examines 25 years of Oregon assisted suicide reports and comments on what is missing in the data. Jones concludes that there are significant data gaps in the Oregon assisted suicide report which was not re-assuring.


gadfly said...

The numbers in the Oregon reports are out by about one thousand. You have to look at the adjustments they made in the following years. That skews the data. Yes, the point is taken, but look at the numbers in next year's report to get a more closely accurate raw number. As well, remember that the adjustments year over year skew the specific data: "...the reason this person chose death was because of being a burden..." Those numbers change as a result. So these are approximations at best.

Alex Schadenberg said...

We agree completely. You may notice that I am estimating that the actual number in 2023 was likely around 400. Also, the data concerning complications is completely skewed. The 2023 data states that there were 10 complications but there was only information from 102 of the deaths.

Anyway, I am fully aware of the data issues, but I cannot correct inaccurate data because I have no way of accessing the original data and even then, the original data is skewed because it comes from the doctors who did the act.

Anonymous said...

In regards to out-of-state people who come to Oregon to get a prescription for lethal poisons: I wonder if their deaths in their place of residence are recorded as suicides in those places, and also whether prosecutors in those places have any ability to charge the Oregon doctors who prescribed the lethal poisons with being accessories to suicide?

Alex Schadenberg said...

Usually I don't publish Anonymous comments but this is an important comment. The greater issue is how many out-of-state poison prescriptions were received in Oregon. All we know is that there were 23 out-of-state resident assisted suicide deaths in Oregon.

Anonymous said...

My “anonymous” followup: Not to belabor the point, but if someone goes to Oregon and gets a prescription for lethal poisons, and then takes the lethal poisons back home to, say, another state and then kills themselves in that state, their death certificate in their home state would record their death as being caused by suicide, correct? But if the person chose to stay in Oregon to kill themselves, their death certificate in Oregon would record a phony, “underlying” cause for their death, correct? It seems to me that public health officials would object to that inconsistency - that in one place the cause of death is recorded as suicide, while in another place, the exact same death would be recorded as something else. Am I on to something here, or no?
Best, Thomas Lester