A chat with Death with Dignity

Since saturday April 16th was National Healthcare Decisions Day, I thought I'd speak with Melissa Barber from Death with Dignity.

What is Death with Dignity?

Our organization provides information, education, research and support for the preservation, implementation and promotion of Death with Dignity laws which allow a terminally ill, mentally competent adult the right to request and receive a prescription to hasten death under certain specific safeguards. We promote Death with Dignity laws based on our model legislation, the Oregon Death with Dignity Act, as a stimulus to nationwide improvements in end-of-life care and as an option for dying individuals.

Our most recent success was when the voters of Washington state passed the second such US law in 2008. We led the effort, helped write the law, and laid the groundwork necessary for this successful campaign.

What is the biggest misconception about Death with Dignity?

Probably the biggest misconception about Death with Dignity has to do with terminology and what is and isn't allowed under the Oregon and Washington laws.

What we advocate for:
Death with Dignity/Physician-Assisted Death: Under the Oregon and Washington Death with Dignity Acts, terminally ill patients who are mentally competent to make their own medical care decisions may request a prescription of medication to hasten their deaths. These patients must also be able to self-administer and ingest the medication.

What we don't advocate for:
* "Assisted Suicide" more accurately refers to criminals like William Francis Melchert-Dinkel.
* "Suicide" is also inaccurate. A terminally ill patient making a request under the Oregon or Washington law is doing so to hasten an already inevitable and imminent death; therefore, the act cannot properly be equated with suicide. None of the moral, existential, or religious connotations of "suicide" apply when the patient's primary objective is not to end an otherwise open-ended span of life but to find dignity in an already impending exit from this world. Individuals who use the law may be offended by the use of "assisted suicide," because they are participating in an act to short the agony of their final hours, not killing themselves. It is the cancer (or other underlying condition) which is killing them.
* Euthanasia often refers to the act of painlessly but deliberately causing the death of another who is suffering from an incurable, painful disease or condition. It is commonly thought of as lethal injection.

I know with hospice, or at least the hospice program I volunteered for, a patient has to be given 6 months or less to enter hospice care.  What about Death with Dignity?  At what point is a person legally able to make this decision?

In order to make a request for medication under the Oregon and Washington Death with Dignity Acts, the patient must have received a terminal diagnosis with six months or fewer to live.

Are there any other states considering this legislation?

In December 2009, Montana's Supreme Court ruled there was nothing in the state law which prohibited a physician from honoring his or her terminally ill, mentally competent patient's request by prescribing medication to hasten the patient's death. During this year's legislative session, three bills were introduced in Montana regarding Death with Dignity. One, modeled on the Oregon and Washington laws would have codified the Supreme Court ruling and outlined in which circumstances the medication could be prescribed. The other two were aimed at overturning the court's ruling. All three bills failed to pass. Physician-assisted death is still legal in Montana, but the state doesn't currently have a standard of practice for physicians to follow regarding their patients' requests. I believe they'll try to codify the state's Supreme Court ruling the next chance they get in the legislature.

After careful research and polling, we've found the next likely state to pass a Death with Dignity law will be in New England, and that's where we're currently focusing our efforts. Right now, we're working with a grassroots group in Vermont to enact a law through the state's legislative process.

You can also see other legislative efforts related to end-of-life care on our site: http://www.deathwithdignity.org/advocates/national/

Okay readers, I would like to hear what you think.  It's never too early to begin this conversation.  As an FYI, HBO will air “How to Die in Oregon” on May 26th at