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The Death With Dignity Act: History & Origin

Instructor: Kristen Irey
The Death with Dignity Act is a law that permits terminally ill residents of certain states who meet specific criteria to request a lethal dose of a prescription drug to accelerate their death. This is also referred to as physician-assisted suicide.

What is The Death with Dignity Act?

Imagine that either you or a loved one has been diagnosed with an aggressive terminal illness. Now imagine that this disease will so drastically impact your quality of life as it progresses that you decide you do not want to endure the pain it will cause toward the end of your life. You are a mentally competent adult, and if you live in Washington State, Oregon or Vermont you may request a prescription for a lethal dose of medicine from your doctor that will end your life. This option is offered through a law called the Death with Dignity Act, and is only available to those who have an estimated less than six months to live, according to their diagnosis.

The detailed requirements of the law vary by state but the guidelines are similar for all. The Oregon law, which is the oldest, sets out multiple conditions, including the following:

  • The patient must wait at least 15 days between making a first verbal request and a second verbal and written request.
  • The patient's written request must be confirmed by two separate witnesses:
    • The witness is not entitled to any portion of the patient's estate.
    • The witness is not the patient's physician.
    • The witness is not employed by a health care facility caring for the patient.
  • After the request is made, a second physician must examine the patient's medical records and confirm the diagnosis.
  • The patient's mental condition must be medically evaluated and judged to be competent.
  • The patient has the right to change their mind and rescind the request at any time.
  • The physician can refer to the patient for psychological evaluation.
  • The physician must tell the patient about alternative options for end of life care.

History and Origin of the Law

Oregon was the first of the three states to enact this law. The law was passed in Oregon in 1994 and went into effect into 1997. The Oregon Public Health Authority, as required by the law, maintains information on how often the law is used. The delay in Oregon between passing and enacting the law was caused by many legal challenges, the most famous of which was the United States Supreme Court case of Gonzales vs. Oregon.

At issue was whether or not the U.S. attorney general, Alberto Gonzales, under the authority of the federal Controlled Substances Act, could prohibit the use of controlled substances (prescription drugs) for the specific use of physician-assisted suicide. The United States Supreme Court decided that the attorney general did not have the power to prevent the states from enacting and implementing physician-assisted suicide laws using lethal medication doses. This case determined that Oregon's Death with Dignity Law was permitted as an individual's constitutional right and a state's right to be free from government intrusion, referred to as states' sovereignty. This decision and subsequent validation of the law led the way for other states to follow.

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