Chapter 5.B: Physician Aid in Dying

Note 2

Through December 31, 2021 (per data collected through January 21, 2022), physicians had written 3,280 prescriptions under Oregon's Death with Dignity Act.  Of the 3,280 patients, 2,159 died after ingesting the prescribed medication (66%), a small number were still alive, and the rest died of their illnesses. During 2021, three-fifths of one percent of deaths in Oregon resulted from aid in dying. Seventy-two.five percent of the 2,159 had cancer, and 91.5 percent were enrolled in hospice care. For more information about the patients, click here.

The annual reports for 1998-2020 are archived here.

Note 3

In 2021, New Mexico became the most recent state to legalize aid in dying with its Elizabeth Whitefield End-of-Life Options Act. Notably, New Mexico allows nurse practitioners or physician assistants to write the prescription for the aid-in-dying medication, and the waiting time is 48 hours instead of 15 days. Now more than 22% of Americans live in a jurisdiction where aid in dying has been legalized.

Maine and New Jersey legalized aid in dying in 2019 with their Death with Dignity Act and Aid in Dying for the Terminally Ill Act.

In 2018, Hawai'i enacted its "Our Care, Our Choice Act," and it took effect on January 1, 2019. Hawai's requires a 22-day waiting period rather than the usual 15-day wait, and mental health evaluation is required for all patients.

For the annual Washington reports, click here.

In February 2012, the Georgia Supreme Court struck Georgia's aid in dying ban down. Since 1994, Georgia's law prohibited the public promotion and provision of aid in dying services, but did not reach the private decision of patient and physician to choose physician aid in dying. The court rejected the law on first amendment grounds--since it targeted those who publicly advertised or offered services but not others. Interestingly, even while the law was in force, there were not any reports that physicians misused their freedom to provide physician aid in dying privately. In May 2012, the Georgia governor signed new legislation banning aid in dying.

For discussion of the increasing legal recognition of aid in dying, see Orentlicher, Pope and Rich, "The Changing Legal Climate for Physician Aid in Dying," 311 JAMA 1961 (2014).

Note 11

While every U.S. jurisdiction that has legalized aid in dying requires the patient to self-administer the lethal dose of medication, other countries permit administration by health care providers, usually physicians, but sometimes nurse practitioners. And data from those countries indicate that health provider administration is much preferred. In the Canadian government’s most recent report on the country’s experience with aid in dying, health practitioners administered the medication in virtually all cases. Self-administration occurred in only 5 out of the 1,382 cases that were included in the report. The Netherlands reports similar data—in 2015, physician-administration outnumbered self-administration by 829 to 22. We don't know exactly why this is so, but the Canadian government reported that many physicians and nurses “are less comfortable with self-administration due to concerns around the ability of the patient to effectively self-administer the series of medications, and the complications that may ensue.” For more detail, click here.