A report that raises some questions.

Washington State’s latest report on physician-assisted suicide prompts questions about the reliability of prognosis of terminal illness

We now have the latest official report on the working of Washington State’s 2008 physician-assisted suicide law.  It shows that in 2012 there was a further (17 per cent) increase in the number of terminally ill people to whom lethal drugs were legally supplied in order to assist them to take their own lives.  This is not in itself surprising: it mirrors the experience of neighbouring Oregon State since 1998.  

However, there are some other data in the report which need to be considered.  In each year from 2009 to 2012 the number of deaths of recipients of lethal drugs has been less than the number of people to whom drugs were supplied.  This is to be expected as sometimes drugs issued in one year may not be ingested until the next year.  So, for example, the report on Year 2010 tells us that 72 of the 87 people who received lethal drugs in that year had died.  By the time of the report on 2011, however, the figure of 72 deaths in 2010 had increased to 84 and the report on 2012 puts it at 85.

It is inevitable, given the unreliability of prognoses of terminal illness at the six months range prescribed in Washington’s law, that there will be some recipients of lethal drugs who outlive the predictions made for them.  But the latest report indicates that 17 per cent (one in six) of deaths in 2012 were of recipients who had held the drugs supplied to them for more than 25 weeks – a range of 3 to 150 weeks is given.  Indeed, according to the report, it is not known whether two recipients of lethal drugs in each of the years 2009, 2010 and 2011 have died or are still alive.

These longer-than-predicted survival rates corroborate expert medical evidence given to Parliament in Britain a few years ago that prognoses of terminal illness at six months range are unreliable.  Yet the proposals that have been put forward for legalising physician-assisted suicide in England and Wales, from Lord Joffe’s Private Member’s bill in 2005 to Lord Falconer’s in 2013, persist in replicating Washington’s and Oregon’s six-months-to-live criteria. 

Washington’s latest report should give us pause for thought.