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C&C Magazine

Physician Aid in Dying Two Years Later

SEATTLE, WA – Compassion & Choices of Washington (C&C), a nonprofit
organization that advocates excellent, patient-centered end-of-life care and
stewards Washington’s Death With Dignity Act (DWDA), today responded to the
Washington State Department of Health’s (DOH) report on the state’s first full
year of experience with the DWDA. A significant number of patients who
received medication died without taking it, showing the benefit of comfort and
control the law provides. “Our experience has been that terminally ill patients and
their families are benefiting from physician aid in dying,” said Dr. Tom Preston,
one of C&C’s medical directors. “The practice of aid in dying in Washington has
been infrequent, and comforts many more patients than just those who use it.
Patients have benefited from the peace of mind and comfort the law provides. The
medical community is integrating aid in dying into the standard of end-of-life
medical care. Additionally none of the claims made by opponents during the I-
1000 campaign have come true.”

The DOH reported that during 2010, 87 prescriptions for life-ending medications
were written under the provisions of the DWDA compared to 63 during 2009. Of
those who received prescriptions in 2010, 51 (59%) self-administered the
medication, and 15 (17%) died of their underlying disease. No complications
were reported for any of the patients who used the law to achieve a peaceful
death. Contrary to opponents’ predictions that only a few doctors would
participate, prescriptions were written by 68 different physicians, indicating that
aid in dying is being integrated into end-of-life medical practice.

Because the law took effect in March of 2009, the 2010 data represents the first
full year of Washington’s experience with the DWDA. When compared to the
total number of deaths from all causes in Washington, patients who died after
self-administering life-ending medication continue to represent a very small
fraction of Washingtonians who died in 2010 – approximately 1/10th of one
percent. This corresponds to approximately 10 DWDA deaths per 10,000 total

Consistent with 2009 report, the primary reasons for electing to use the DWDA
were loss of autonomy, losing the ability to participate in activities that made life
enjoyable and loss of dignity. The vast majority of patients who used the law had
cancer, were on hospice at the time of death and died at home.

Because only patients who pass psychiatric or psychological evaluations may
participate in the DWDA, the number of psych evaluations reported in the DOH’s
annual reports does not represent the total number of psych evaluations that
actually occurred.

Joyce Rizzo, of Puyallup, was one Washington terminal patient who did use the
DWDA. Joyce’s husband, Tony Rizzo, said his wife found great comfort having a
choice when it came to the end of her long, tough battle against lung cancer.
“Joyce had fought lung and neck cancer for three years. She underwent radiation
treatments, chemotherapy and had part of her lung removed,” said Tony, who was
Joyce’s primary caregiver and was with her when she died. “When the tumors
kept growing and the experimental treatment was unsuccessful, the DWDA
provided her with peace of mind. She died at home, surrounded by family. Joyce
was able to have the peaceful, dignified death she desired because she could use
the DWDA.”

Lonnie Maxfield, of Olympia, who is terminally ill with ALS (Lou Gehrig’s
disease), said that the DWDA provides him with peace of mind, “I’m very
grateful for our Death with Dignity Act, and that my doctor respects my end-oflife
choices. I have the support of my family, and this and having the medication
available provides me with some measure of control for a peaceful and dignified

Dr. Preston said, “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. We encourage terminal patients to speak
with their doctor and C&C as soon as they have questions or concerns. Most
people don’t understand that there are two waiting periods, including a 15-day
waiting period between oral requests, and that patients are required to be
evaluated by two physicians. This takes time. Don’t wait until it’s too late.”

“The reports required under the DWDA confirm the safety of physician aid in
dying. The law is working exactly as voters intended,” said Dr. 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
experiences, even though it is rarely 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.”

C&C provides expert consultation, advice, information and emotional support for
patients and families facing the end of life, and if requested, a personal presence
at the time of a Death With Dignity. To request C&C’s client services call 877-
222-2816 toll-free. C&C also provides information, medical expertise to
participating physicians and other medical providers. Physicians are invited to
request C&C’s Physician Guide to the DWDA. All services are free of charge,
and confidentiality is strictly protected.

Compassion & Choices of Washington – an affiliate of Compassion & Choices –
stewards, protects and upholds Washington’s Death with Dignity Act.
877.222.2816, [email protected], www.CompassionWA.org