Ask DDNC: Safeguards for Patients


How do safeguards in Death with Dignity laws ensure patients—and no one else—are deciding their own end-of-life care?

The biggest assurance terminally ill patients—and only the patients—are making the decision about the manner and timing of their deaths is the medication request process outlined in Death with Dignity Acts. Patients must ask for the medication a total of three times—twice verbally, and once witnessed in writing. To ensure terminally ill people aren’t making these decisions in haste, there’s a 15 day waiting period between the first and second verbal requests.

After the second verbal request, the person may make the written request. Two people have to witness this written request, one of whom can’t be the patient’s doctor, a relative, an heir to the person’s estate, nor an employee at a healthcare facility where the person is a patient or resident. The witnesses attest the person requesting the medication has provided proof of identity and the patient is making the decision without any sign of undue influence or coercion.

If either of the doctors, in any of their conversations with the terminally ill patient suspect the person is being coerced in any way, the request process is stopped immediately. Under Death with Dignity laws, coercion is a class A felony, punishable by life in prison and a $50,000 fine.

Patients can opt out of the request process at any time and they’re the only ones who decide whether or when to take the prescribed medication. The states’ departments of health only track people who completed the request process, and among the people who complete the process and receive the prescription, 1/3 never take the medication.

To ensure terminally ill people aren’t requesting the medication because of severe depression or another form of mental illness, Death with Dignity laws stipulate a patient must undergo a psychological evaluation if either the attending or consulting physician suspects the patient’s judgment might be impaired by mental illness.

Another key protection for patients is the medication must be ingested. Injections are never allowed and euthanasia is specifically outlawed in the statutes.

Patients are clearly protected with multiple safeguards written into Death with Dignity laws. This end-of-life healthcare policy reform has worked so well in Oregon since 1997 and Washington since 2008 that this year, Vermont lawmakers emulated our model legislation and became the third state in the US to enact a Death with Dignity law.

The national conversation about end-of-life care options is changing faster than ever, and more states are looking to enact their own laws. The Death with Dignity National Center is in it for the long-haul, and we’re steadfastly helping people in all states have more say in their end-of-life care options. I hope you’ll stand with us with your financial gift today.

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