Assisted Dying Rises Over Time in States With Oldest ‘Medical Aid in Dying’ Laws

The use of medical aid in dying (MAID) in Washington and Oregon has increased per 1,000 deaths since laws were passed in those states permitting the practice, according to a report in JAMA Open Network.

The majority of patients availing themselves of MAID in those states are non-Hispanic, college-educated, white individuals, and 88.5% had public or private insurance. In both states, slightly more than 72% of patients were over 65 years of age, more than 76% had cancer, and 4% received referrals for psychiatric examinations.

Those are among the findings from a study of trends in MAID (also known as medical-assisted death, physician-assisted death, and physician-assisted suicide) in the two states with the longest standing laws permitting patients with a terminal illness to receive a lethal prescription from their physician.

The increased use of MAID over time during a period when laws permitting the practice spread to other jurisdictions suggests it is becoming more acceptable, although the most recent data indicate it could be plateauing. Meanwhile, the demographics of MAID in the two states suggest that the practice has not been directed—as some have feared—at vulnerable populations based on age, race/ethnicity, educational attainment, or insurance status.

“Concerns that MAID would unintentionally target socially disadvantaged patients have not materialized,” wrote Charles D. Blanke, M.D., of the Oregon Health Science University and colleagues. Blanke is also chair of the SWOG (Southwest Oncology Group) Cancer Research Network.

The practice of physician-assisted death is among the most contentious issues in contemporary American medicine; even the term is hotly debated, with opponents of the practice tending to prefer the term “physician-assisted suicide,” while proponents insist that terminally ill patients seeking to end their lives with medical assistance should not be conflated with individuals who are suicidal when they have years of life yet to live.

Last June, the AMA House of Delegates approved a report by its Council on Ethical and Judicial Affairs stating that the AMA’s Code of Medical Ethics supports both opponents and proponents of what the council calls physician-assisted suicide (Psychiatric News).

The Oregon Death With Dignity Act was approved by the state in 1994, permitting terminally ill adults (18 or over) who are residents of the state to voluntarily obtain a physician’s prescription for a lethal medication. In 2008, Washington state approved legislation largely modeled on the Oregon law. Today, MAID (or physician-assisted death or physician-assisted suicide) has been adopted in nine jurisdictions in the United States: California, Colorado, District of Columbia, Hawaii, Montana, New Jersey, Oregon, Vermont, and Washington.

“Trends in Medical Aid in Dying in Washington and Oregon” is posted here.