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Public Health's Role: Oregon's Death with Dignity Act

On October 27, 1997 Oregon enacted the Death with Dignity Act (the Act) which allows terminally ill individuals who meet specific qualifications to end their lives through the voluntary self-administration of a lethal dose of medications, expressly prescribed by a physician for that purpose. The Act requires the Oregon Health Authority (OHA), Public Health Division, to collect information about the patients and physicians who participate in the Act and to publish an annual statistical report. While OHA is neutral about the Act itself, we believe these data are important to parties on both sides of the debate.

The Act outlines specific patient requirements to participate. A patient must be: 1) 18 years of age or older, 2) capable of making and communicating health care decisions for him/herself, and 3) diagnosed with a terminal illness that will lead to death within six months. It is up to the attending and consulting physicians to determine whether these criteria have been met, and report that fact to OHA at the time a prescription is written. If any issues of non-compliance with the statutory requirements are identified, OHA reports that fact to the appropriate licensing board.

The Death with Dignity Act is a permissive law that allows qualified patients to request a prescription and allows a physician to write the prescription. The Act as written requires that two physicians agree that the patient is suffering from a terminal disease, the patient is capable of making a decision to request life-ending medication, and the patient has made an informed decision. The Act does not specify whether or not all treatment options must be exhausted prior to a prescription being written, nor does it specify health insurance payment requirements for disease treatment. OHA does not interpret the statute, other than the portion related to the reporting requirements.

To monitor compliance with the Act, OHA has incorporated a basic reporting process into our administrative rules. When a prescription is written under the Act, the prescribing doctor must either submit Death with Dignity forms to OHA or make available relevant portions of the medical record. Either method must clearly show that the doctor and patient have followed the requirements of the Act. After the patient has died, the death certificate will be matched with the Death with Dignity forms or copies of the medical record, and then reviewed by OHA staff. The physician is then contacted to confirm whether their patient died from a lethal prescription or from the terminal illness.

To identify possible reasons for the request and assess circumstances surrounding the time of death, OHA developed a follow-up questionnaire to be completed by the physician or licensed health care provider who was present at the time of death. The interview questions were developed with help from the Oregon Task Force to Improve the Care of Terminally Ill Oregonians. Information collected includes patient characteristics, motivations for requesting a prescription, end-of-life care issues (e.g., whether the patient was enrolled in hospice), events surrounding the patient's death (e.g., the time it took for the patient to die after taking the lethal medications), and characteristics of physicians who participate in the Act.

OHA is responsible for providing the public with accurate information about the Death with Dignity Act. We believe that our reporting system, follow-up questionnaires filled out by providers, and information policy will protect the privacy of patients who choose DWDA, their families, and their providers. At the same time, it will provide important information on the impact of Oregon's Death with Dignity Act.

Contact Us

Center for Health Statistics staff can answer questions about Oregon's Death with Dignity Act