The Washington Death with Dignity Act (DWDA) came into force on the 5th of March 2009. It enables terminally ill adults with less than 6 months to live to request a prescription for life-ending medication from their physician, following a series of safeguards. As in the neighbouring state of Oregon where assisted dying has been legal since 1997, each year an annual report is produced on how the DWDA is working. The latest report for Washington has just been released.
In 2012 there were 83 assisted deaths in Washington as a result of the DWDA – this represents 0.17% of deaths in the state (compared with 0.24% in Oregon). Crucially, this is up just 0.03% from the previous year – not the 17% which has been misleadingly reported by some opponents of the legislation.
The key findings from the report are:
14% of patients received a prescription but then chose not to take it, taking comfort in having the option available to them.
The characteristics of patients who receive a prescription has been consistent – generally 70-80% have cancer and almost 90% have health insurance.
The vast majority of patients who chose to take the medication are enrolled in hospice care and die in their own homes.
The main reasons reported for requesting an assisted death have also remained consistent over the years with the majority of patients worrying about loss of autonomy, loss of dignity, and loss of the ability to participate in activities that make life enjoyable.
The death with dignity act in practice
Interestingly, a recent article has also been published examining the way in which the DWDA is enacted in a Washington cancer centre. This found that having first developed a clear policy on the act, the cancer centre assigns every eligible patient who has expressed a desire for an assisted death a social worker advocate. This enables them and their family to be supported in exploring their end-of-life care and treatment options.
Throughout their time enacting the DWDA, the cancer centre has received no complaints from patients or their families whatsoever, and indeed, some staff members who were initially opposed to its introduction have subsequently changed their minds having seen it in action. This supports the evidence from Oregon that suggests a high level of public satisfaction with assisted dying being available as part of a range of end-of-life options for terminally ill patients.
It also begs the question that if a safeguarded assisted dying law works in the US states of Oregon and Washington, why wouldn’t a similar law work in Britain?