Prescriptions for Lethal Medications Under Death With Dignity Act Have Increased Slightly

Just Over Half of Patients Who Receive Prescriptions Under the Act Actually End Up Ingesting the Medication
The Lund Report

January 24, 2013 – The number of prescriptions for lethal medications – allowable for terminally ill patients under the Death With Dignity Act – and the number of deaths attributable to lethal overdose from the medications was up only slightly in 2012 versus 2011, but have climbed steadily since the law was implemented in 1998, according to a report released by the Oregon Public Health Division last week.

In 2012, 115 patients received DWDA prescriptions and 67 ingested the medication. Of the 67, one regained consciousness before dying of the underlying illness, so the state did not count this as a DWDA death.
Eleven patients with prescriptions written in 2011 died in 2012, and 23 of the patients who received DWDA prescriptions during 2012 did not take the medications and subsequently died of other causes.
For 25 patients who received the medication, it was unclear whether they ingested the medication or not: 14 of these patients died in 2012, but the state has not received follow-up questionnaires confirming whether they died from the medication or from an underlying illness.
Three-quarters of the patients who died under DWDA last year had cancer, according to Jason Renaud, executive director for Compassion and Choices of Oregon, which advocates for and assists patients seeking physician-assisted suicide. That’s because patients with other diagnoses often don't meet the criteria for
To receive prescriptions under the act, patients must have a prognosis of six months or less to live, and must be mentally competent and consent to receiving the medication. Often, patients with diagnoses like AIDS or Alzheimer's are no longer lucid enough to be eligible for prescriptions when their prognosis is
poor, Renaud said.
The median age of patients who died under DWDA was 69. The vast majority (97.4 percent) of patients who died under DWDA were white, just under half (42.9 percent) had a bachelor's degree or higher.
Renaud attributed the slow growth in the use of physician-assisted suicide to increased awareness of the law (due to media outreach and the documentary How to Die in Oregon), aging baby boomers,
Oregon's increased population and a gradual increase in use of the medication by hospices.
“There were a lot of fears when we started talking about this in 1993,” Renaud said. Organizers worried that people would take the medication accidentally – which is common with other medications, such as methadone.
Another fear not borne out was that a handful of doctors would end up writing all the prescriptions for the medication – similar to the system that's emerged with medical marijuana, where a small number of physicians write the vast majority of prescriptions issued throughout the state.
Instead, Renaud said about 60 doctors have written th prescriptions, and the doctors who write more prescriptions will not take referrals from other providers.
To use the medication, one doctor has to prescribe the medication and a second doctor has to confirm the patient's prognosis. Patients also have to get the medication from a specialty pharmacy, since the barbiturate that’s used has no other approved use, Renaud said.
The Department of Public Health did not respond to an e-mail inquiry asking for comment on the report.
The state's annual Death With Dignity reports can be downloaded here.
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