Oregon’s Death with Dignity Act
Oregon passed the Death with Dignity Act (DWDA) in the fall of 1997. Oregon releases an annual report that summarizes a variety of data including number of DWDA prescription recipients, number of DWDA deaths, patient characteristics, end of life concerns reported by patients, timing of the DWDA event, etc. You can view the full report here: Oregon 2015 Report. There are a few statistics from the 2015 report that are important to note.
Duration between first request and death
50% of the people who were told they had less than 6 months to live, lived between 11 months and 10 years.
One statistic tracked in Oregon is the number of weeks between when a person makes their first request for the DWDA prescription and when they use the prescription to take their own life. This can be an insightful statistic because according to the law, an individual needs to be considered terminally ill, or diagnosed by a doctor as having less than 6 months to live, or approximately 26 weeks.
In 2015, the range of data for the 132 people who took the prescription was between 15 weeks and 517 weeks and the median was 45 weeks. This is a large range, but unfortunately the reporting is not more specific.
DWDA patients referred for psychiatric evaluation
Only 5 out of 218 people (2.3%) who requested a DWDA prescription were first referred for psychological evaluation.
In 2015, 106 physicians wrote 218 prescriptions. Of the 218 people who received these prescriptions only 5 were first referred for psychological or psychiatric evaluation – less than 2.3%.
It is commonly known that 50% of all people who die by suicide suffer from major depression. One of the causes of depression can actually be a serious health concern or a major event – like being diagnosed with a terminal illness.
Doctors have a responsibility to make sure that their patients are not choosing DWDA over real treatment, hospice care or palliative care due to feelings of hopelessness, demoralization and depression. It is clear from Oregon’s statistics, where less than 2.3% of patients who received a lethal prescription were first referred for a psychological or psychiatric evaluation, that these psychological concerns are not being taken seriously.
Prescribing physician or other provider presence at time of death and complications associated with DWDA
A decrease in the presence of prescribing physicians or other providers at the time of death with a DWDA prescription, coincides with an apparent increase in the percentage of complications.
2015 saw a substantial drop in the presence of a prescribing physician or other provider at the time of death with a DWDA prescription. From 1998-2014, a prescribing physician was present 15.7% of the time and another provider was present 34.7% of the time. In 2015, a prescribing physician was present at the time of death only 10.8% of the time. Another provider, other than the prescribing physician was present 10.0% of the time.
This decrease coincides with an apparent increase in the percentage of complications. Complications can include regurgitation and regaining consciousness among other things. In 2015, of the 132 cases where individuals took their own life using a prescription provided by a physician, a physician or another provider was only present in 27 of the cases at the patient’s time of death. Of those 27 cases, there were 4 reported complications which is almost 15%. From 1998-2014, complications were reported in just 4% of cases where outcomes were known.
It is unclear from the available data what may have caused the increase in the percentage of complications in known cases or the decrease in the presence of a physician or other provider at the time of death.
 Out of the Darkness Walks. “Suicide Claims more lives than war, murder, and natural disasters combined.” https://theovernight.donordrive.com/?fuseaction=cms.page&id=1034. Last accessed February 23, 2016.
 Depression Health Center. “Causes of Depression.” https://www.webmd.com/depression/guide/causes-depression. Last accessed February 23, 2016.