Who Uses Physician Assisted Suicide in Oregon and Washington

Most patients seeking physician assisted suicide in Oregon and Washington have medical insurance, some college education, and are white. Most are enrolled in a hospice program, but die at home.

Researchers were curious to find out if there were similarities between patients seeking medical assistance in dying, or MAID,  in Oregon and Washington. Data came from published annual reports from the Oregon Health Authority and Washington State Department of Health that ranged from 1998 to 2017 in Oregon and from 2009 to 2017 in Washington. Washington did not legalize physician assisted suicide until 2008.

The study was authored by Luai Al Rabadi, MD; Michael LeBlanc, PhD;  andTaylor Bucy, BS.

Indeed, the study did find outcomes in the two states to be quite similar. Demographically, 94.8 percent were non-Hispanic white, ages ranged from 20 to 102, but 72.4 percent were 65 years or older.  71.5 percent of the patients who received a prescription had some college education 88.5 percent had medical insurance, and  76 percent were enrolled in hospice care at the time of their death, though 81 percent died at home. 51.3 percent were male.

The only statistically significant difference between the states were rates of hospice enrollment — 87.percent for Oregon versus  64.2 percent for Washington. The study concludes this could be because a higher percentage of Oregonians were insured, but the difference may need further study.

The study also noted a very small percentage of patients seeking MAID noted financials concerns, and noted that other states considering MAID laws should anticipate similar results if they follow the legal framework used in the Pacific Northwest.

“Most patients who acquired lethal prescriptions had cancer or terminal illnesses that are difficult to palliate and lead to loss of autonomy, dignity, and quality of life. Concerns that MAID would unintentionally target socially disadvantaged patients have not materialized, as evidenced by the data presented in this article. States considering MAID legalization may see similar results if they model their rules on those put into place in the US Pacific Northwest.”

Why patients seek lethal prescriptions 

The most common underlying illness for patients seeking MAID is cancer; 76.4 percent – 10.2 percent is due to neurologic illness, 5.6 percent is due to lung disease, and 4.6 percent is due to  heart disease. Loss of autonomy, impaired quality of life, and loss of dignity are the most common reasons reported by clinicians for patients seeking lethal prescriptions.

Of 3,368 lethal prescriptions, 2,558, which is 76 percent, resulted in death. Clinicians in other studies have concluded that some patents that do not follow through either change their mind, or may have sought a lethal prescription so they would have the security of knowing the option was available.

The study noted 4 percent of patients taking lethal prescriptions experience complications, the most common being difficulty ingesting or regurgitating the drug.

The study also contends, “There is significant room for further integration of palliative care, social support services and case management in end-of-life decision-making with the intent of increasing the options available to those facing a terminal disease.”