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Oregon death with dignity act adults residents of

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Oregon Death with Dignity Act • Adults Residents of Oregon • Capable Terminal illness that will lead to death in 6 months
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Oregon Safeguards Thee must be two oral requests There must one written request signed in the presence of two witnesses A physician and a consulting physician must confirm the diagnosis There must be a psychological evaluation if one physician considers underlying disorders The person must be informed of feasible alternatives The physician may request, but not require next- of-kin notification
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Oregon Statistics 1050 prescriptions have been written and 673 deaths (64%) 1997-2012 115 prescriptions were written in 2012; 2.5%(n=2) referred for psychological or psychiatric evaluation 57% (n=66) ingested the medications and died 68% > 65years; 97% White; 43% College graduates, 75% cancer, 98% died at home; 100% had health insurance (51% private & 49% Medicare or Medicaid) 20% (n=23) did not ingest, but died of other causes Status of the others is not known 77 known deaths—11 from a prior prescription 0.8% (n=1) ingested and regained consciousness and died 6 days later Overall Death Rate from Death with Dignity is ~23.5/10,000 deaths
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Washington Initiative 1000 RCW 70.245 First attempt failed in 1991 – Provision for physician administration Passed in November 2008 Became effective in March 2009
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Washington Residents A patient requesting a lethal dose of medication to end his life must: • Be a terminally ill, mentally competent, adult resident of Washington who is expected to die within six months. • Be free of depression and able to make sound judgments. • Request the prescription verbally and in writing, and again verbally after a 15-day waiting period. • Have two witnesses to his or her request. One must not be an heir, related or employed by the health-care facility caring for the patient. No witness is required to be present when the patient takes the drugs.
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Washington Physicians Determine that the patient is competent and acting voluntarily. • Inform the patient of the medical diagnosis, prognosis and the risks and probable result of taking the lethal dose. • Offer alternatives, including pain control, comfort care and hospice services. • Inform the patient of the right to rescind the request at any time. • Refer the patient to a second, consulting doctor who must verify that the patient has a terminal disease, is competent, acting voluntarily and making an "informed decision." • Refer the patient for counseling if the patient is depressed or otherwise not competent. • Recommend that the patient notify next-of-kin. • Document in the medical record all the required steps that were taken.
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Washington Statistics 103 prescriptions written by 80 different physicians and filled at 46 pharmacies; 91% (n=94) deaths; Age range 41-101 years 68% (n=70) ingested medication and died 68% > 65years; 97% white, non-Hispanic; 46% married; 75% some college; 95% west of Cascades; 78% cancer, 12% ALS, 10% other progressive illness; 93% died at home; 83% hospice; 87% had health insurance
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