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C&C Magazine

Washington: Physician Aid In Dying Two Years Later

FOR IMMEDIATE RELEASE: Thursday, March 10, 2011
CONTACT: Robb Miller, Executive Director, Compassion & Choices of Washington,
206.669.0902 or [email protected]

The 2010 Washington Death With Dignity Report indicates aid in dying in Washington is safe, legal, and rare, but some terminal patients wait until it’s too late.

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 deaths.

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-of-life 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 death.”

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 adiscussion 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.