The Oregon Death with Dignity Act (DWDA), which allows physician to prescribe lethal drugs to competent terminally ill patients was put in place to ensure that suffering patients end their lives in a humane and dignified manner (Smith, Goy, Harvath & Ganzini, 2011).Prior to its enactment in October 1997, numerous researches had been carried out which showed that towards the end of their lives, terminally ill patients usually suffers tremendously, thus going through a lot of pain. Family members had to sit and watch their loved ones writhe in pain and wither away to nothing. This pain had to be controlled. The core purpose as stated in the DWDA is to expand patient control over their choices and preferences during their last days of terminal illness. However, for over a decade, this act has been facing an immense level of both support and opposition in equal measure. In this paper, I will seek to critique various medical journals that further expound on this Act that encourages physician’s aid in dying.
REQUIREMENT FOR DWDA
In order to request for physician to prescribe for lethal medications, DWDA requires that a patient must be:
- An adult of 18years and above.
- Capable, i.e. able to communicate and make sane healthcare decisions.
- Must be a resident of Oregon
- Must have been diagnosed with a terminal illness that will lead to death within six months (Campbell, 2008).
After the above requirements have been met, the physician is required to file a report with the Oregon Department of Human services. Statistics from the department of Human services shows that as of January 15, 2013, a cumulative total of 1050 people had death with dignity prescriptions written and a total of 673 patients had died from lethal medications which have been prescribed under the DWDA (Dieterle, 2007).
- Lack of Evaluation for depression
According to a scholarly article by Heide Aungst, Death with dignity, the first decade of Oregon’s physician-assisted death act, most of the major challenges in regard to this act are explained. Mostly, this Act faces a lot of criticism because various political and other interested parties claim that the statute appears to have made it too easy for depressed patients to end their lives (Aungst, 2008). One of the parties that are usually opposed to this move, the Physician for Compassionate Choices (PCC) argues that, among the 49 patients that ended their lives in the year 2007, none of them had a psychiatric referral, while bearing in mind that depression is one of the major causes that lead to committing of suicide. From this assertion, it therefore appears that some patients are not properly screened by physicians for depression before the prescription of the lethal medication (Aungst, 2008). These critics conclude that, although most of the patients who requested for assistance in ending their lives were not depressed, they feel that the current Death with dignity system might not be in a position to legally and morally protect the few patients who are depressed from easily obtaining the lethal medication.
- Acceptance will weaken the prohibition on killing
In the same article, some individuals argue that the DWDA is likely to raise the specter of the possibility of physician assisted deaths being applied to children or even to various chronic diseases that may or may not lead to death within 6 months. In addition, J.M. Dieterle argued in the same line of thought in his article Physicians assisted suicide: A new look at the arguments, that in the case where DWDA, we are likely to see an increase in the homicide rate in Oregon. However, his arguments can be proven to be vague because Instead of the rate of homicide to increase since the passage of the law, the rate has significantly gone down. In the year 1985, the rate of homicide in Oregon was 4.7% per 100,000 residents but it has gradually declined to 1.9% by the year 2000 (Dieterle, 2007). Moreover, Heide Aungst is able to clarify that the statute is categorical regarding the protection of vulnerable population such as children and individuals suffering from dementia.
Death can be dehumanizing, the slow and painful ending that is characteristic to terminally patients is not only a personal issue but is of public concern. Over the years, some of the implications of DWDA which were easier to foresee such as the general improvement of pain control, confusion in regard to how the Act works in practice and also the complications arising from the lethal drugs have become prevalent(Dieterle, 2007). However, despite the numerous controversies surrounding the Oregon Death with Dignity Act, it has been able to gain popularity and wide acceptance by the general populace. In fact other states such as Washington and Vermont have already followed suit and enacted this law. There in order to weigh the claim made by both the opponents and the supporters, one needs to clearly analyze the Act according to their moral and religious beliefs and also carefully examine the results of the first decade experience with the Physician assisted suicide.
Aungst, H. (2008). 'Death with dignity': the first decade of Oregon's physician-assisted death act.
Geriatrics, 63(12), 20-22.
Campbell, C. S. (2008). Ten years of “death with dignity.”. New Atlantis, 22(33), 40-41.
Coppens, M. (1998). "Death with dignity" "Oregon's Death with Dignity Act" (August).
American Journal Of Nursing, 98(12), 23.
Dieterle, J. M. (2007). Physician assisted suicide: a new look at the arguments. Bioethics, 21(3),
Miller, P., Hedlund, S., & Soule, A. (2006). Conversations at the end of life: the challenge to
support patients who consider death with dignity in Oregon. Journal Of Social Work In End-Of-Life & Palliative Care, 2(2), 25-4
Smith, K. A., Goy, E. R., Harvath, T. A., & Ganzini, L. (2011). Quality of Death and Dying in
Patients who Request Physician-Assisted Death. Journal Of Palliative Medicine, 14(4), 445-450. doi:10.1089/jpm.2010.0425