What are Death With Dignity laws?
Brittany Maynard, a 29-year-old woman from California, chose to die on Saturday. She had been diagnosed with terminal brain cancer on Jan. 1, when she was given a prognosis of six months to live.
Wishing to die on her own terms rather than by aggressive cancer, she moved to Oregon, one of only a handful of states with Death With Dignity laws. These are laws that allow terminally ill patients to opt for physician-assisted death — sometimes referred to but not officially recognized as physician-assisted suicide — via ingesting prescribed lethal medications.
Maynard was very vocal about her right to die, and her public story rallied advocates from both sides of the debate on whether assisted suicide should be legal.
However, while a video Maynard made with the nonprofit Compassion & Choices went viral in early October, and while her death made headlines this weekend, many didn’t even know Death With Dignity laws existed, let alone what they entail.
What do the laws stipulate?
Five states allow physician-assisted death: Oregon, Washington, Vermont, Montana and New Mexico. Only Oregon, Washington and Vermont have enacted specific Death With Dignity laws — modeled from Oregon’s first Death With Dignity Act — but the other two states have similar, albeit looser, legislations in place.
Under the laws, mentally competent, terminally ill state residents can request and receive prescription medication to hasten their deaths. This is one of several end-of-life care options in these three states, according to the Portland, Oregon-based Death With Dignity National Center, a nonpartisan, nonprofit organization in charge of legal defense, education and promotion of Death With Dignity laws.
The website further explains that each states’ law is implemented on an individual basis, between eligible candidates and licensed physicians. Here’s what the Death With Dignity National Center says about eligibility:
Terminally-ill patients who wish to obtain a prescription under the Oregon, Washington, or Vermont law must be a resident of one of the three states and follow a series of steps in order to be certified.
Among other requirements, a patient must be:
18 years of age or older;
a resident of Oregon, Washington or Vermont;
capable of making and communicating health care decisions for him/herself;
and diagnosed with a terminal illness that will lead to death within six months.
Two physicians must determine whether these criteria have been met.
The residency portion of the law is why Maynard moved to Oregon; there’s no minimum amount of time a patient needs to live in one of the states — he or she only needs proof of being a current resident. Maynard is a special case, however — Death With Dignity’s website says that very few people have moved to these states expressly to use the law.
The request timeline is as follows:
First oral request to your physician
15-day waiting period
Second oral request to your physician
Written request to your physician
48-hour waiting period before you can pick up your prescribed medications
Patient may pick up prescribed medications from the pharmacy
Each state may have additional provisions, and the laws only protect a person who chooses physician-assisted death from criminal prosecution. No physician or health care system is obligated to participate in Death with Dignity laws.
The Death With Dignity National Center was founded in Portland, Oregon in 1993 to promote and fight for legislation that allows dying people to hasten their deaths. A separate entity, the 501(4)(c) Death With Dignity Political Fund, is tasked with the political defense of the act, and promoting legislation in other states.
Oregon voters passed the Death With Dignity Act in 1994, and after a number of legal challenges, the law officially went into effect on Oct. 27, 1997. It requires the Oregon Health Authority to collect information about participating patients and physicians, and publish an annual statistical report. The 2003 Supreme Court case of Gonzalez v. Oregon further solidified the law’s legality.
Washington voters passed their version of the law on Nov. 4, 2008, and it went into effect on March 5, 2009. According to the Death With Dignity National Center’s website, it did not face any credible opposition.
On Dec. 31, 2009, the Supreme Court of Montana ruled that state law does not prohibit a physician from prescribing a terminally ill patient medication to hasten his or her death. In 2013, a bill modeled on Oregon and Washington’s Death With Dignity Acts was introduced to further establish a law, but it was subsequently tabled. There are still no official standards of care regarding physician-assisted death in Montana, but the state affords individuals the right under the Rights of the Terminally Ill Act.
On May 20, 2013, Vermont enacted the Patient Choice and Control at End of Life Act. It was the first Death With Dignity law to be passed through legislation, rather than through voters.
Will other states adopt Death With Dignity laws?
Since 2013, seven other states have considered or are still considering bills based on the already existing Death With Dignity laws.
As of Oct. 29, according to the Death With Dignity National Center, the bills in Connecticut, Hawaii, Kansas and Massachusetts missed their deadlines and are unlikely to move forward during the current House sessions. In New Hampshire, the House voted against the proposed bill on March 6, 2014. The New Jersey House voted to advance the proposed bill on June 5, 2014. The bill in Pennsylvania remains open for consideration through the 2013-2014 biennium.