Throughout time when people hear the word death it is not a conversation that they like to have. As humans its only natural to have an opinion and when it comes to the subject or death, they have one. Everyone thinks that the critically ill should pass when and how they choose. At some point in time when we think about death, we always think about the elderly passing and finally laid to rest. In most cases that’s how things are done differently. In the event that someone is passing the patient can go through a long excruciating death. On November 8, 1994 everything changed for the terminally ill that lived in Oregon. On this very day 51% of Oregon residents decided for patients that were terminally ill would have the say when and how they would be able to spend their last days once the Death with Dignity Act became a law.
When the subject of the Death with Dignity Act comes to mind, we question as to what entails in this act? In 1994 a nurse, lawyer and Chief Practitioner named Barbara Coombs and she was assisted by Dr. Peter Goodwin, a family practitioner, they work together to develop Measure 16 also known as the Death with Dignity Act. With the Death with Dignity Act this allows critically ill patients or residents of Oregon to willingly end their lives. This is done by receiving a written prescription by their provider and the medication they prescribe is Barbital, this allows the patient to end their lives with a dignified manner.
During this time, their provider will attain a list of tasks such as their diagnosis of the terminal illness, the patient needed to have a second consult with another provider to confirm the diagnosis. For this to take place the patient must have the mental capability to make choices when it come to their social insurance. When dealing with the Death with Dignity Act the Oregon Public Health Division states that the requirement that take place in this act is as follows:
- The patient must have gone to two appointments and they should be fifteen days within each other, it must be with a licensed physician that has verbally petitioned to part of this act.
- A specific document must be signed by two people that are not related to the patient and this document must be submitted to the physician.
- There must be two providers and one attending physician, lastly a consulting provider must verify the patient’s diagnosis plus their prognosis of the terminally ill patient that death has come about in six months.
- The two physicians must verify that their patient is mentally aware and their capable of making healthcare and life choices.
- If the patient has any mental disorder or diminishing of judgement the patient must be medically cleared by a psychiatrist that has done a psychological evaluation.
- A patient must be aware of all the ending of life treatments and those include hospice care, comfort care and pain control.
- A plea must be made by the provider for their patient to contact their next of kin to obtain their wishes and use of lethal medications to pass on. There must be a fifteen-day window that is provided to the patient to give them the opportunity to cancel their request.
- The provider must report that they have written a prescription to Oregon Health Authority and the pharmacist that dispenses the medication must notify the use of that medication.
To stop all or some of the misuse there are steps that must be taken to use this law. First, there is a various necessary holdup that goes on during this procedure. Second, there must be ways to stop any insulting actions that is an important step of speaking with a provider that diagnosed the patient that is terminally ill. Finally, to stop any and several therapy sessions that must be scheduled by the provider that they would have to consult at time with a psychiatrist.
Since then Oregon has created a desperately needed conversation that would share some information about the critically ill patients that want to decide how they will end their last days and they could control how much pain they would endure. Oregon is not the only state that is allowing this law to take place, there is several states that has let their residents take part in voting for this act. Currently there are nine states that authorize patients to use the Death with Dignity Act.
In 2016 California had the End of Life Option Act, Colorado as well had the End of Life Option Act, that became effective in 2016, in 2017 the Death with Dignity Act became effective in District of Columbia, Hawaii had Our Care, Our Choice Act that became effective in 2019, then in 2019 Maine made the Death with Dignity Act was made effective, New Jersey made Aid in Dying for the Terminally Act effective in 2019, in 1994/1997 the Death with Dignity Act became effective in Oregon. Then in 2013 Patient Choice and Control at the End of Life Act became effective in 2013 in Vermont, in 2018 the state of Washington made effective the Death with Dignity Act.
In the United States there is currently nineteen states that allow the physician-assisted death and those states are California, Colorado, District of Columbia, Hawaii, New Jersey, Oregon, Vermont, Washington, Alaska, Connecticut, Florida, Maryland, Massachusetts, New Mexico, New York, Nevada, Tennessee.
Despite all the disagreeing the law became accurate that the patients have only used it a few times. Meanwhile, when the Death with Dignity Act was voted into law, there were around 1,327 critically ill patients that had requested to use this act, and this took place back in 1997. However, with the 1,327 patients that received this request there was 859 critically ill patients that passed away from using the lethal drug without someone else’s terms (Death with Dignity Political Fund 2015). In regard to those figures it meant that in the last twenty years there has maybe been 48 patients (possibly more) that have decided that living with that consistent pain was too much to bare so despite passing earlier than estimated they took the their lives into their own hands and peacefully passed away.
Although, the Death with Dignity Act had been voted into law there were still some issues there being brought forward. For instance, with the case Washington vs. Glucksberg court case, with this case there was an argument regarding that the critically ill should have the right to have requested that the lethal medication. But some people thought otherwise such as antagonist thought that this law was violating the values of religious learning that were led to the life and leads a “slippery slope” moving towards euthanasia (Johns, P.1)
In another illegal case there was a similar situation, these cases that are both involved to think about should or shouldn’t they help the critically ill patient end their life when they chose. Each case is different, and it was determined who held the power it was with federal or state. With Oregon residents voting the Death with Dignity Act two times but each time it was voted in there were some people that believed that the Death with Dignity had disobeyed the Controlled Substance Act which had been managed by the federal courts.
Since this case was controlled by the federal it was taken to the Supreme Court. In the evidence that was provided it stated that in what was decided to represent the right medical care. During this time, the Supreme Court validated that they came up with an agreement that the Controlled Substance Act could not overturn a law that was already in place. Within this law provides did not have to stress about having their licenses taken away if they were writing prescriptions for the deadly medication that was set forth under the Death with Dignity Act.
So, despite the disagreements within this law we have found out that there are advantages that come along with this act. While in 2015 when twenty other states made the decision to authorize physician-assisted suicide. By allowing this to happen many thinks this could be an issue. The four issues that officials see is (1) endanger the weak and vulnerable, (2) corrupt the practice of medicine and the doctor-patient relationship, (3) compromise the family and intergenerational commitments, (4) Betray human dignity and equality before the law. As many officials started to look more into things and that reviewing these issues, they started to realize that this wasn’t providers helping patient with their death it simply meant that their patient decided not to use any medical treatment to prolong their life.
Since there has been many arguments regarding the Death with Dignity Act both sides have made valid points but still many are undecisive about this law. Should a critically ill patient have the right to determine their date of passing away or should they live in pain and die a slow death? In order to make improvements the laws must construct ways to reduce drug diversion with it not effecting pain management. The options that are as followed (1) replacing triplicate forms with electronic reporting of prescriptions, (2) allowing standing prescriptions for outpatients (to be monitored by home health care professionals or pharmacists).
Furthermore, in order to lower the regulatory barriers when providers are prescribing pain medication, they must be effective so the state can help with state policies. When a patient is allowed to choose on how and when their going to die instead of being hooked up to an IV in a hospital bed and nursing staff consistently entering in and out of their room, while their loved ones watch them slowly fade away. But since the Death with Dignity Act came into law critically ill patients around the US now have a choice by using the Death with Dignity Act. Not only is the Death with Dignity Act being there to assist the patient’s decision to make their passing easier and quicker. CBS reporters Bonia and Stahl reported in 2014 that the cost for sedative disease to take place is $100,000 every year. Some cost on medications can go up as much as $35,500 and multiply monthly.
An important fact is that the cost secobarbital which is a deadly medication that is used can cost anywhere from $945 for 2 grams to $3322 for 10 grams. The Death with Dignity law assist critically ill patients for just a moment keeps them out of the providers offices and prevent them from having pointless medical treatments. This preventiveness helps the providers from making revitalizing decisions for the patient when they are experiencing lethargic, unable to speak, or unable to make those medical decisions, then the decision is left to the next of kin. During this time most critically ill patients are usually ready to pass and think about being at peace.
In this case might how it will be some patients but, many patients are educated on their condition and must save their strength to withstand the painful last days alive. Patients that are reaching their end days must view their family and friends save emotions for the time that the patient reaches that procedure. With this kind of case the family should be understanding to the choice their family member and not to endure the suffering and to not allow them to have control living out their end days. If a patient chooses to end their life no one such as administration or their family should have a say. The point of this act is that no one should determine when or how the terminally patient should pass. It is all up to the patient whether or not they want assistant from their provider in choosing the Death with Dignity Act. At some point patients will need the support and love from their loved one before they enter the light.
References
- Author unknown. (2020, April 18). Administrative Rules: Oregon’s Death with Dignity Act. https://www.oregon.gov/oha/PH/PROVIDERPARTNERRESOURCES/EVALUATIONRESEARCH/DEATHWITHDIGNITYACT/Pages/oars.aspx
- Author unknown. (2020, April 15). Death with Dignity Act. https://www.deathwithdignity.org/learn/death-with-dignity-acts/
- Anderson, R. (2015, March 30). Four Problems with Physician-Assisted Suicide. https://www.heritage.org/health-care-reform/report/four-problems-physician-assisted-suicide
- Institute of Medicine (US) Committee on Care at the End of Life; Field MJ, Cassel CK, editors. Approaching Death: Improving Care at the End of Life. Washington (DC): National Academies Press (US); 1997. 7, Legal Issues. Available from: https://www.ncbi.nlm.nih.gov/books/NBK233596/
