End-of-Life Choice, Palliative Care and Counseling

Physician Aid in Dying One Year Laterby Blaine

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Washington Death with Dignity Report for 2009 Shows Death with Dignity is working as expected.

Compassion & Choices of Washington (C&C), a nonprofit organization advocating for better end-of-life care, patient-centered care, and end-of-life choice, today reported on its 2009 experience with the Washington Death With Dignity Act (DWDA).

Listen to the press conference.

Two Washington physicians and a terminally-ill Issaquah woman told a Seattle Public Library news conference marking the one-year anniversary of the Act that patients have benefited from the peace of mind the Act provides.

“Our experience has been that terminally-ill patients and their families are benefiting from physician aid in dying,” said Dr. Tom Preston, Medical Director of C&C of Washington. “With those terminal patients who have qualified to use the Death With Dignity Act, I have observed peaceful dying. There has been overwhelming gratitude from patients and their families. Because the family is with the patient at the end of their life, all can say their goodbyes. As studies of the Oregon experience have found, families are more at peace with the loved-one’s death than families of other patients.”

Kathy Sparks of Issaquah, a former hospice nurse with Stage 4 Melanoma, told the news conference that the Death With Dignity Act provides her with peace of mind. “I have witnessed many deaths working in hospice: some peaceful, some painful. Now, with my own terminal illness, I’m very grateful for our Death With Dignity Act. I don’t want to die; I’m trying very hard to live. I’ve undergone chemotherapy several times. I’m going through experimental treatment now to gain some time,” Kathy said. “The spiritual part of me is hopeful for the very best in my final days. The nurse part wants to be prepared for the worst. I’m very grateful that my own doctor will respect my end-of-life decisions. I intend to acquire a prescription to provide me with peace of mind and some measure of control for a peaceful death. I don’t know if I’ll even take the prescription. But having it and the choice to use it to aid in achieving a peaceful death is of great benefit to me.”

“Aid in dying practice in Washington has been safe, legal and rare,” said Dr. Preston. “Patients can discuss this with their physicians as one of a full spectrum of care options at the end of life. It is never too early to begin a discussion with your doctor about the options you would want to consider if you were diagnosed with a terminal illness.”

The Washington State Department of Health reported that during 2009 more terminal patients received prescriptions than used those prescriptions to help ease their imminent deaths. Based on total Washington mortality for 2008, deaths under the law represent less than 1/10th of one percent.

“The report’s data on the circumstances of death sketch a peaceful picture. Most of the patients were enrolled in hospice and died at home. Almost all those who took their medication achieved unconsciousness within ten minutes and there were virtually no ill side effects,” said Barbara Coombs Lee, President of Compassion & Choices, the national organization that serves terminal patients and their families throughout the U.S. “It is hard to draw too much from statistics, but most of the participants cited loss of autonomy and loss of dignity as concerns, and the data on circumstances suggest they maintained a sense of both at the end.”

Dr. Robert Thompson, MD, is a General Practitioner Internist in Seattle. Three of Dr. Thompson’s terminally-ill patients have asked him for aid in dying and each benefited from the option in different ways. “One is still alive today. One died in her sleep, but was greatly reassured by having her prescribed medications in case she needed them for a peaceful death. The third was himself a physician, with metastatic cancer in his bones. He took the medication and died peacefully according to his own values and choices,” Doctor Thompson said.

“The reports required under Washington’s DWDA confirm the safety of physician aid in dying. The law is working as voters intended,” said Dr. Tom Preston. “Doctors can feel safe responding to requests from their patients for aid in dying. The practice is having a significant, positive impact on Washingtonians’ end-of-life experience, even though being infrequently used. Knowing they can access prescribed medication and take control of their dying if suffering becomes intolerable, improves patients’ quality of life in their final days.”