Monday, April 26, 2010

Some data from the Washington State Death with Dignity Act

I have previously blogged about a hastened death that I witnessed.

I thought some might be interested to know what we have learned in Washington State during the first year with our new law. The Washington State Death with Dignity Act was passed by voter initiative on November 4, 2008 and became law on March 5, 2009. In the language of the Act,

"The law allows terminally ill adults seeking to end their lives in a humane and dignified manner to request lethal doses of medication from physicians."

All of the data cited here can be viewed on Washington State Department of Health Web Site where statistics for the first year are reported.

The number of requests for medication is not known, although I personally know that many persons seeking to use the law never made it through the process which requires having two physicians agree, making three requests (2 oral and one written), and a waiting period. In some parts of the state, there are no participating physicians, meaning the law is meaningless to many who would like to use it.

The health department only receives and collects data for persons who complete the complex process and actually receive the medication for use in hastening their death. In the first year of reporting, 63 persons received lethal doses of medication (either secobarbital or pentobarbital) and 47 of these died during this time period. Of those who died, 36 died following ingesting the medication and 7 died without taking their medication. Status for 4 of the deaths is unknown at this time (whether or not they took the medication or died without it).

Of the 47 participants who received medication and died during the twelve months from March 5 2009- March 5 2010:

  • their ages ranged from 48-95 years
  • 79% had cancer; 9% had neurological conditions such as ALS (Lou Gehrig's disease) and 12% had other chronic illnesses such as lung and heart disease.
  • 98% were white, non-Hispanic
  • 46% were married
  • 100% cited loss of autonomy among the reasons for requesting medications; 91% cited loss of ability to enjoy life; 82% cited loss of dignity
  • 94% of the deaths occurred at home
  • 72% were enrolled in hospice at the time of death

The time to unconsciousness following taking the medication ranged from 1-20 minutes and the time from ingestion to death ranged from 9 minutes to 28 hours. Most died in less than 90 minutes. Three persons vomited after taking the medication and five awakened after ingestion, although all persons ingesting the medication died.

As an aside, I am aware that not all of the participants were given pre-medications to prevent nausea and vomiting, and some were unable to ingest all of the medication. Of the deaths that have been attended by volunteers of Compassion and Choices (accounting for about 80% of them) all took pre-medications and most died within 20 minutes.


  1. What could be done to extend the privilege of making informed decisions about this to dying people who are NOT white, I wonder? (If it's the case that non-whites are not sufficiently informed, that is.)

    Their lack of access may have to do with needing to jump through the hoops, as you mentioned, and with lack of access to decent care in the first place.

    I wonder if there is something in white culture that makes some white people more willing to consider taking the step?

    It would be interesting to collect and analyze statistics pertaining to income level or class, too.

  2. having just attended our hospice teams first death with dignity it is a powerful experience. My practice as a hospice nurse is forever deepened