June 29, 2022

Oregon’s ‘death with dignity’ stats need to be examined

Oregon was the first American state to pass a right-to-die, back in 1996. Since then, its legislation has become a template for assisted suicide legislation in the US, Australia and elsewhere. One significant difference, however, is that Oregon publishes an annual report with a number of statistics about the background of people who ask for death, the handling of the lethal medication, the role of the doctor, and the moment of death.

Other jurisdictions collect and publish very little, which makes it very difficult to critique their laws. This makes the annual yearly release of Oregon’s data all the more important, as it has to serve as a lens to assess the weaknesses of laws elsewhere. It must be a sign of the normalisation of assisted suicide that the media overlook it.

The 2021 data summary for Oregon’s Death with Dignity Act is not remarkably different from 2020. As of January 21, 238 people had died in 2021 from ingesting the prescribed medications. This was a drop from 2020, when 259 people died. Most patients were 65 years or older (81%), college educated (45%) and white (95%). The most common underlying condition was cancer (61%), followed by neurological disease (15%) and heart disease (12%).

As in past years, the main reasons that people requested death were “losing autonomy” (93%), and “less able to engage in activities making life enjoyable” (92%). “Inadequate pain control, or concern about it” was only cited by 27%.

However, there were some surprises – minor, but still significant.

  • The number of complications increased slightly. Five people (3 in 2020) had “Difficulty ingesting/regurgitated” and one person “Regained consciousness after ingesting DWDA medications” (a nasty surprise!). But, as usual, for more than half of the patients no information is available about complications. Are they much higher? It’s impossible to say.
  • For the first time, anorexia was listed as a cause of death. In other states, this appears to be illegal.
  • Over the last 20 years about 7% took more than 6 hours to die.
  • No one was present in 49.6% of the deaths – so it is difficult to know anything about the last moments of these patients.
  • Although depression and demoralisation are known to be associated with requests to die, only 2 patients were referred to psychiatrists in 2021 – 0.8%. This may be declining, as from 1998 to 2019, 4% were referred. Are patients seeking death becoming less depressed? Or are doctors treating requests like prescriptions for toenail anti-fungals?