A paper in the New England Journal of Medicine is the first of its kind to describe how a large cancer center implements a Death with Dignity law.
Researchers from the Seattle Cancer Care Alliance explored the implementation of the Death with Dignity law in Washington state, becoming the first major comprehensive cancer center to do so.
The law itself took effect in March of 2009. It works by granting patients who have been given fewer than six months to live the ability to request a prescription for life-ending medication from their doctor.
The Seattle Cancer Care Alliance is the site of care for the Fred Hutchinson–University of Washington Cancer Consortium, a national comprehensive cancer center serving the Pacific Northwest.
Between March 5, 2009, and December 31, 2011, investigators reported that 114 patients asked about the Death with Dignity program. Of them, 44 (38.6%) chose not to pursue it while 30 (26.3%) began the process but did not complete it (meaning they either changed their minds or they died before they could complete it).
Forty patients asked for and ultimately received a prescription for a lethal dose of secobarbital and all died, but only 24 of them died after taking the medication.
In Washington state in that time frame, 255 people participated in the program, with 15.7 percent of them being from the Cancer Care Alliance. The most commonly cited reasons for participating were as follows:
- -- Loss of autonomy (97.2 percent)
- -- Inability to engage in enjoyable activities (88.9 percent)
- -- Loss of dignity (75 percent)
According to the authors, "Qualitatively, patients and families were grateful to receive the lethal prescription, whether it was used or not."
Source: NEJM
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