The Oregon Death With Dignity Act, 15 years on:
As of January 14, 2013, prescriptions for lethal medications were
written for 115 people during 2012 under the provisions of the Death
With Dignity Act (DWDA), compared to 114 during 2011.
At the time of this report, there were 77 known DWDA deaths during 2012.
This corresponds to 23.5 DWDA deaths per 10,000 total deaths.
* Since the law was passed in 1997, a total of 1,050 people have had
DWDA prescriptions written and 673 patients have died from ingesting
medications prescribed under the DWDA.
* Of the 115 patients for whom DWDA prescriptions were written during
2012, 67 (58.3%) ingested the medication; 66 died from ingesting the
medication, and one patient ingested the medication but regained
consciousness before dying of underlying illness and is therefore not
counted as a DWDA death. The patient regained consciousness two days
following ingestion, but remained minimally responsive and died six days
following ingestion.
* Eleven (11) patients with prescriptions written during the previous
year (2011) died after ingesting the medication during 2012.
* Twenty-three (23) of the 115 patients who received DWDA prescriptions
during 2012 did not take the medications and subsequently died of other causes.
* Ingestion status is unknown for 25 patients who were prescribed DWDA
medications in 2012. Fourteen (14) of these patients died, but follow-up
questionnaires indicating ingestion status have not yet been received.
For the remaining 11 patients, both death and ingestion status are
pending.
* Of the 77 DWDA deaths during 2012, most (67.5%) were aged 65 years or
older; the median age was 69 years. As in previous years, most were
white (97.4%), well-educated (42.9% had a least a baccalaureate degree),
and had cancer (75.3%).
* Most (97.4%) patients died at home; and most (97.0%) were enrolled in
hospice care either at the time the DWDA prescription was written or at
the time of death. Excluding unknown cases, all (100.0%) had some form
of health care insurance, although the number of patients who had
private insurance (51.4%) was lower in 2012 than in previous years
(66.2%), and the number of patients who had only Medicare or Medicaid
insurance was higher than in previous years (48.6% compared to 32.1%).
* As in previous years, the three most frequently mentioned end-of-life
concerns were: loss of autonomy (93.5%), decreasing ability to
participate in activities that made life enjoyable (92.2%), and loss of
dignity (77.9%).
* Two of the 77 DWDA patients who died during 2012 were referred for
formal psychiatric or psychological evaluation. Prescribing physicians
were present at the time of death for seven patients (9.1%) during 2012
compared to 17.3% in previous years.
* A procedure revision was made mid-year in 2010 to standardize
reporting on the follow-up questionnaire. The new procedure accepts
information about the time of death and circumstances surrounding death
only when the physician or another health care provider was present at
the time of death. Due to this change, data on time from ingestion to
death is available for 11 of the 77 DWDA deaths during 2012. Among those
11 patients, time from ingestion until death ranged from 10 minutes to
3.5 hours.
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