Washington State Releases 2014 Death with Dignity Report

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The Washington State Department of Health yesterday released the 2014 annual report on the implementation of the Washington Death with Dignity Act. The figures underscore not only that only a small number of people use the law, but also that the Washington Death with Dignity Act continues to work flawlessly and provides ease of mind and relief to Washingtonians facing the end of life.

In 2014, 176 terminally ill Washington residents received a prescription under the Act to help hasten their death. This is a 2% increase over the previous year. Of patients with the prescription, 170 are known to have died: 126 after ingesting the medication and the rest either let the disease take its course or their status is unknown. Since 2008, when the Act went into effect, “725 adults with terminal illness have chosen to end their lives with a physician-prescribed lethal dose of medication,” according to the report.

Fifty-seven percent of participants in the Washington Death with Dignity Act were women. Ages ranged from 21 to 101 years. A vast majority, 92 percent, were Caucasian, and 75 percent had at least some post-secondary education.

Cancer was the underlying illness for 3 out of 4 participants, ALS contributed with 13 percent. Ninety-three percent of patients had some form of insurance.

The three chief end-of-life concerns for the Death with Dignity Act participants who have died were losing the ability to engage in activities that make life enjoyable, losing autonomy, and losing dignity. Ninety-two percent of patients died at home, five in a long-term care facility. Ninety-six percent of patients experienced no complications after ingesting the medication.

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A Report from Maine Death with Dignity Bill Hearing

This is a report from last Friday’s Maine House Committee Hearing on LD1270 – An Act Regarding Patient Self-Directed Care at End-of-Life by our long-time supporter, Valerie Lovelace.

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Val is the executive director of the nonprofit It’s My Death, which she founded to honor a promise to her sister Dee, dying of cancer, “to teach others how to be with dying, how to speak and listen to one another the way we had learned to speak and listen, and how to go on even when afraid.” She is an inter-faith minister, ordained by calling, studying and practicing in the traditions of her elders and teachers, who are Native American, Christian, and Buddhist. She is a hospice volunteer, artist, and the parent of three adult children. She is also a homeopathic practitioner and a Reiki Master, retired from the U.S. Navy, and a trained EMT. She lives in Maine.

Maine’s Motto is “Dirigo” or “I Direct” or “I Lead” and its tagline “The Way Life Should Be.” I’m proud of how hard my legislators work to ensure our laws are fair, straight forward, and seek to ensure as much freedom as possible. It’s a balancing act, for sure. What I love about the process is that at the end of the day, when a piece of legislation is enacted, it’s been hammered over to produce the best and safest possible piece of legislation.

Attending the First Hearing for LD1270

Maine’s LD1270, An Act Regarding Patient Self-Directed Care at End-of-Life, enjoyed its first public hearing on Friday, May 15, 2015, in Augusta before the Joint Standing Committee for Health and Human Services. The bill, sponsored by Senator Roger Katz and co-sponsored by nine others, is closely modeled on Vermont’s Act 39, Patient Choice and Control at End of Life.

I was excited to go to the hearing for a number of reasons.

  • Foremost, I am committed to the needs of dying people and believe our dying is the most intimate event we will ever experience – our final act of living. As such, I hold it sacred to the individual.
  • Secondly, it was my first time to the State House and first time being an actual participant in the legislative process as a concerned citizen.
  • Finally, the bonus for me is that it was my birthday.

Legal, Professional, and Emotional Testimonies

It was a rare gift, indeed, to hear testimony after testimony regarding the need for a safe, legal end-of-life prescription process in Maine. Senator Katz spoke eloquently about the bill and what it offers, what it safeguards, and how it addresses concerns generally voiced in opposition. He was followed by a number of co-sponsors who also testified, some with profoundly personal stories of loss. Following that testimony, citizens had three minutes each to speak for, against, or neither-for-or-against the bill.

Supporters came forward with both professional and deeply moving personal stories, demonstrating a clear understanding of the bill. Voices in support, voices in opposition, voices offering neither for-or-against critiques: all heard, all noted, and all to be taken into working session.

I spoke briefly and submitted written testimony. My feeling is that the personal stories and experiences of all who came to support LD1270 sent a clear, unified message to our legislators: “Dirigo.” The way life (and the end of life) should be: self-directed.

Next Steps for Maine’s Death with Dignity Bill

I’m awestruck by the enormity of the task that lay ahead for this committee, who will enter working session for the bill on May 22, 2015. They will read mountains of testimony, research key points they want to understand better, dig into the legislative workings of the bill, challenge whether safeguards are reasonable, whether choice is reasonable, and whether, in the grand scheme of our living and dying, it makes good sense to embrace this end-of-life option for Maine.

I trust the process. Each of these legislators, I believe, will do their best to comprehend the bill, learn about end-of-life prescriptions and how LD1270 proposes to make that a safe process for competent, terminally ill adults who want to choose an end-of-life prescription to use as their death becomes more imminent.

We here in Maine took a good first step.

View full post on Death with Dignity National Center

Oregon Health Authority Releases 2014 Death with Dignity Report

Oregon Health Authority, the state agency that oversees the implementation of and compliance with the Oregon Death with Dignity Act, has just released the 2014 Annual Report.

A total of 155 terminally-ill adult Oregonians received a prescription for medications under the provisions of the Oregon Death with Dignity Act in 2014, while 105 of them (67.7%) ingested the medications to die peacefully. This corresponds to 31 Death with Dignity Act (DWDA) deaths per 10,000 total deaths, or 0.3%.

Other highlights from the 2014 Annual Report:

  • Of the 105 DWDA deaths during 2014, most (67.6%) were aged 65 years or older. The median age at death was 72 years. As in previous years, decedents were commonly white (95.2%) and well-educated (47.6% had a least a BA).
  • While most patients had cancer, the percent of patients with cancer in 2014 (68.6%) was lower than in previous years (79.4%), and the percent with amyotrophic lateral sclerosis (ALS) was higher (16.2% in 2014, compared to 7.2% in previous years).
  • Most (89.5%) patients died at home, and most (93.0%) were enrolled in hospice care either at the time the DWDA prescription was written or at the time of death.
  • As in previous years, the three most frequently mentioned end-of-life concerns were: loss of autonomy (91.4%), decreasing ability to participate in activities that made life enjoyable (86.7%), and loss of dignity (71.4%).
  • During 2014, no referrals were made to the Oregon Medical Board for failure to comply with DWDA requirements.

Since 1998, the year in which the first person in Oregon took medication prescribed under the law, a total of 1,327 patients have received the prescription, of whom 859 (64.7%) ingested it and died. These figures continue to underscore not only that only a small number of people use the law but also that more than one third of those who received the medication took it, finding great comfort in merely knowing it was available to them. Oregon’s Death with Dignity Act continues to work flawlessly and to provide ease of mind and relief to Oregonians facing the end of life.

The board members and staff of Death with Dignity National Center, as the successor of the organization that passed Oregon’s law in 1994, are proud of our accomplishments. We are honored to be able to count on your support in promoting and passing Death with Dignity laws based on the Oregon model throughout the United States.

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Washington’s 2013 Death with Dignity Report

Death with Dignity by the numbers 2013
Death with Dignity by the numbers

Death with Dignity laws take what’s happening in the shadows everyday, in every state, and create an open, safeguarded process to allow terminally ill people to decide their own fate. These laws protect everyone involved—patients, their families, doctors and pharmacists—and provide a transparent process which leaves no doubt the decision rests solely in the hands of people who are dying and no one else.

As part of this transparency, the Washington State Department of Health is required by law to report information collected during the medication request and dispensing process. The 5th annual report was recently issued. One of my colleagues in the Death with Dignity movement explained, “there are no surprises, and the law remains remarkably unremarkable.”

After five years, more Washingtonians have come to understand Washington’s Death with Dignity Act, and not surprisingly, more people requested the prescribed medication.

Some quick facts about the usage of Washington’s law in 2013:

  • 119 people hastened their deaths under the Washington Death with Dignity Act, and a fourth of the people who requested the medication didn’t take it.
  • Prescriptions were written by 89 different physicians.
  • 77% of the participants had been diagnosed with terminal cancer, an additional 15% with ALS.

The numbers also show people who request the medication under Washington’s law are receiving high quality end-of-life care:

  • 86% of the people who died after exercising their rights allowed under Washington’s law in 2013 were enrolled in hospice.
  • Over 96% of the people who used the law died at home or in a long term care facility.

Much like the 16 years of data from Oregon, these five years of Washington’s statistics reveal no surprises. The patterns in the data haven’t changed.

View full post on Death with Dignity National Center

Oregon’s 2013 Death with Dignity Report

Every year, a small number of Oregonians exercise their rights allowed under the Death with Dignity Act. One of the people who requested the medication was Ben Wald. In 2006, he was diagnosed with colon cancer. He underwent treatment, and went back to enjoying the retired life until the cancer returned and metastasized to his lungs in 2011.

He sought treatment, but the cancer didn’t respond and instead advanced to his bones. He enrolled in hospice, and on April 3rd, 2012, he decided to also explore his end-of-life options allowed under Oregon’s Death with Dignity Act. In an interview with the Corvallis Gazette Times, Ben’s wife, Pam, recalled, “Once he learned that he was going to be given the choice to end his life, he relaxed.”

Just by having the option of Death with Dignity, a person regains control over a terminal illness at a time when their illness is quickly stripping away options and control. Though rarely used, the option of Death with Dignity provides comfort to countless individuals who know they have options at the end of their lives.

Each year, the Oregon Health Authority issues an annual report which sheds a light on the small group of people who pursue this option.

Some quick facts about the usage of Oregon’s law in 2013:

  • 71 people hastened their deaths under the Oregon law.
  • This accounts for 0.2% of all deaths in Oregon.
  • The top three concerns people expressed to their doctors when requesting the medication were centered around wanting control over their final days.

The numbers also show people who request the medication under Oregon’s law receive high quality end-of-life care:

  • 87% of the people who died using Oregon’s law in 2013 were enrolled in hospice. (By way of comparison, the National Hospice and Palliative Care Organization estimates 45% of deaths in the US are under the care of hospice.)
  • Over 97% of the people who used the law died at home.

The numbers point out the bare facts around these small number of deaths, but they don’t tell the whole story. Simply having the option is what’s important. Many terminally ill Oregonians wouldn’t consider asking their doctors for the prescription. For Ben and his family, however, having this option was a gift and a blessing.

A month after beginning the medication request process, Ben and Pam invited 10 of their dearest friends to join them in celebrating a life well lived and be a comfort as Ben drifted off to a peaceful death.

View full post on Death with Dignity National Center

Washington’s 2012 Death with Dignity Report

WA's Death with Dignity Act by the Numbers
WA’s Death with Dignity Act by the Numbers

Written into Washington’s Death with Dignity law is the requirement the state’s Health Department must issue annual reports of information collected during the medication request and dispensing process.

Washington’s Department of Health recently issued their 4th annual report, and consistent with all previous years, the data continue to show the law works the way it’s intended: rarely used, but providing comfort to individuals who know they have more options at the end of their lives.

Some quick facts about the usage of Washington’s law in 2012:

  • 83 people hastened their deaths under the Washington Death with Dignity Act.
  • Prescriptions were written by 87 different physicians.
  • 73% of the participants had been diagnosed with terminal cancer, an additional 10% with ALS.

The numbers also show people who request the medication under Washington’s law are receiving high quality end-of-life care:

These 4 years of statistics on Washington’s law and 15 years of data from Oregon reiterate the facts: Death with Dignity laws work and refute all of the opponents’ fear-mongering assertions. The data are so consistent over the years, there’s been little media attention once the pattern of use was understood. Annual reports published after particular milestones—five years, then ten years—were met with media attention and some national notice, but the most recent reports from Oregon and Washington have attracted little more than a brief note in regional publications.

The data haven’t changed, and it’s unfortunate more media attention isn’t given to how the consistent statistics show these laws work and work well. Opponents of Death with Dignity laws will continue to pitch the same myths to make their case, but the data which disprove their false assertions simply isn’t newsworthy these days.

View full post on Death with Dignity National Center

Green Cemetery KAKE News Special Report Promo

Thursday, May 17 on KAKE News at 10:00.

Washington 2011 Death with Dignity Report Attracts Little Media Attention

Robb Miller of Compassion & Choices of Washington
Robb Miller of Compassion & Choices of Washington

Robb Miller has been the Executive Director of Compassion & Choices of Washington—an affiliate of Compassion & Choices—since 2000. He was also one of the leaders of the coalition that passed Initiative 1000, the Washington Death with Dignity Act, with nearly 60% of the vote in 2008.

When the Washington Department of Health issued its third annual report on the Washington State Death with Dignity Act in early May, there was little interest from the media and no good news for opponents of patient autonomy at the end-of-life.

The lack of interest from the media tells us there was nothing sensational and no controversies to report. On the other hand, less media coverage means less awareness about the law.

Only 16 more people received prescriptions for life-ending medication as compared to 2010, and only 10 more died after receiving prescriptions. Of the 94 individuals who died, 70 self-administered medication, and 19 didn’t—32% of patients who acquired prescriptions in 2011 elected not to take the medication. This is bad news for opponents who claimed that people who use the law would be anxious to die and would take the medication prematurely. The report indicates just the opposite.

Other claims by opponents, such as “patients wouldn’t need the option if they had good palliative (comfort) care,” or that “patients will be encouraged to use the law to save money,” have been debunked by Washington’s and Oregon’s annual reports which indicate that the vast majority of patients who use the law were enrolled on hospice at the time of death and had health insurance.

Additionally patients’ concerns about pain control or the financial implications of treatment were both at the bottom of the list of end-of-life concerns of those who died after acquiring medication. As in prior years, their major concerns were loss of autonomy and dignity, and the loss of ability to participate in activities that make life enjoyable.

Prescriptions were written by 80 different physicians in 2011 (up from 68 in 2010) and dispensed by 46 different pharmacies. Participating physicians wrote an average of 1.3 prescriptions in 2011, and pharmacies filled an average of 2.2 prescriptions. This contrasts sharply with claims by opponents that only a few physicians would help the majority of patients who used the law.

An issue not fully addressed by the report is the difficulty that some patients face finding participating physicians in certain regions of the state. While considerable support for the law exists throughout Washington (the ballot measure received majority support in 30 of 39 counties), the 2011 report indicates only five out of 94 patients who died after acquiring—but not necessarily using—life-ending medication lived in Central and Eastern Washington.

Another problem is medical providers putting their values before those of their patients, i.e., practicing organization-centered care rather than patient-centered care. Although the Death with Dignity Act permits medical providers to decline to participate, participation is defined in law as performing the duties of a participating physician, pharmacist, or psychiatric/psychological evaluation provider. Participation does not include providing information about the Death with Dignity Act or referring patients to other physicians or organizations, such as Compassion & Choices of Washington, who will.

Nevertheless, some religiously affiliated providers, such as Providence Hospice of Seattle, a Catholic health care provider, have gone so far as to adopt “gag rules” that expressly prohibit its nurses, social workers, and other staff from discussing Death with Dignity or making referrals. Because a key component of hospice philosophy is patient autonomy, these kinds of policies are antithetical to the practice of hospice. They also violate informed consent, one of the most important principles in medicine.

One of the items the report doesn’t directly address is the peace of mind and comfort the law provides. Because most of the patients who use the law are clients of Compassion & Choices of Washington and work with our client support volunteers, we believe the law is a form of palliative care. Our clients frequently say the peace of mind and control they gain makes it easier to live out their remaining days, or once they’ve acquired the medication, they can “start living again.”

Finally, a major benefit of the Death with Dignity Act is that it allows patients to die at home in familiar surroundings surrounded by their loved ones. 93% of patients who self-administered life-ending medication died at home, most often with two Compassion & Choices of Washington client support volunteers present to support the patient and family through the process.

Like the 2009 and 2010 annual reports, the 2011 report confirms the law is safe and working as intended with no unintended consequences.

Compassion & Choices of Washington stewards, protects, and upholds Washington’s Death with Dignity Act and provides free counseling services to incurably and terminally ill patients statewide. Compassion & Choices of Washington also provides information and medical expertise to participating physicians and other medical providers. All services are free of charge, and confidentiality is strictly protected. For more information: 206.256.1636, 877.222.2816 toll free, info@CompassionWA.org, or www.CompassionWA.org.

The Washington State Department of Health’s 2011 Report on the Death with Dignity Act is available on the Washington Department of Heath website.

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natural burialNatural burial ground opens in the Vale

natural burialNatural burial ground opens in the Vale
The first natural burial ground has opened in the Vale of Glamorgan. Native Woodland, the Monmouth-based company, officially opened the site Thursday with the Mayor of the Vale of Glamorgan, Councillor Audrey Preston cutting the ribbon. Report by Media Wales’ James Cuff