Lessons that should be heeded, not brushed under the carpet.

Report on Oregon and Washington’s Death with Dignity Acts warns of ‘important’ lessons to be learned

The 2011 death rate is the equivalent of around 1,100 such suicide deaths a year in England and Wales.

In a report published today (‘Physician-Assisted Suicide in Oregon and Washington’), Catherine Simon updates Living and Dying Well’s 2010 survey of Oregon’s physician-assisted suicide (PAS) law (in force since 1997) and extends this to include official data on the working of neighbouring Washington State’s similar law (in force since 2009).

The report, which is based on information published in annual reports by the relevant State authorities in Oregon and Washington, notes the continuing rise in the death rate from PAS in Oregon – in 2011 there were four and a half times as many deaths from this cause as in 1998. The 2011 death rate is the equivalent of around 1,100 such suicide deaths a year in England and Wales.

The report notes also that the practice of ‘doctor shopping’ – whereby those seeking PAS are sometimes assessed by, and receive lethal drugs from, physicians who are not their regular doctors – is continuing, as is the practice of multiple prescribing of lethal drugs by a minority of physicians, with one doctor in 2011 having written one eighth of all such prescriptions.

The report notes that Washington State appears, on the basis of its first three annual reports, to be following the same pattern as Oregon – though the rise in the number of PAS deaths is steeper, with a 94 per cent increase between 2009 and 2011.

The report draws attention to a number of “worrying features ” which, it suggests, “cannot be reconciled with claims by campaigners for legalisation of ‘assisted dying’ in Britain that the laws in these two States are working well”.

It instances the assessment of some applicants for PAS by doctors who have no long-term knowledge of them as patients and of persons receiving lethal drugs on the basis of a six-months-or-less prognosis of life remaining (as required by the two laws in question) who lived for longer, sometimes much longer, before ingesting those drugs. “This is not to suggest any malpractice on the part of the assessing
physicians”, says the report. “It does, however, illustrate the fallibility of prognosis as a safeguard in the licensing of PAS”.

The report concludes that “there are lessons to be learned from Oregon’s and Washington’s experience of licensing physician-assisted suicide” and that “these are too important to be brushed under the carpet with assurances that all is well”.