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Self-Administration

Every month, Compassion & Choices Medical Director, Dr. David Grube, answers frequently asked questions about medical aid in dying.

Q: How is self-administration defined and practiced under the Oregon Death with Dignity Act?

A: In all authorized states, medical aid in dying requires that the dying individual be mentally capable, volitional, and self-administer the medication that has been prescribed by the Attending Physician.

The medication is ingested, which simply means it is introduced into the gastrointestinal tract. In most instances this means swallowing, but some individuals have a feeding tube (j-peg, etc.) and the medication can be introduced into the body through it. Preparation of the medication (opening capsules, mixing solutions, filling a reservoir or feeding tube) can be done by a family member, loved one, or nurse; however, volitional ingestion means that it is the dying person who must instigate the action (push a plunger, open a valve or clip, etc.) of ingestion.

Some individuals (e.g. those with ALS) do not have use of their arms so volitional ingestion for them might mean sucking on a straw that is in the liquid medication. In this instance an assistant may hold the medication. Active vomiting is a contraindication to oral ingestion.