Monday, April 18, 2011

A chat with Death with Dignity

Since saturday April 16th was National Healthcare Decisions Day, I thought I'd speak with Melissa Barber from Death with Dignity.

What is Death with Dignity?

Our organization provides information, education, research and support for the preservation, implementation and promotion of Death with Dignity laws which allow a terminally ill, mentally competent adult the right to request and receive a prescription to hasten death under certain specific safeguards. We promote Death with Dignity laws based on our model legislation, the Oregon Death with Dignity Act, as a stimulus to nationwide improvements in end-of-life care and as an option for dying individuals.

Our most recent success was when the voters of Washington state passed the second such US law in 2008. We led the effort, helped write the law, and laid the groundwork necessary for this successful campaign.

What is the biggest misconception about Death with Dignity?

Probably the biggest misconception about Death with Dignity has to do with terminology and what is and isn't allowed under the Oregon and Washington laws.

What we advocate for:
Death with Dignity/Physician-Assisted Death: Under the Oregon and Washington Death with Dignity Acts, terminally ill patients who are mentally competent to make their own medical care decisions may request a prescription of medication to hasten their deaths. These patients must also be able to self-administer and ingest the medication.

What we don't advocate for:
* "Assisted Suicide" more accurately refers to criminals like William Francis Melchert-Dinkel.
* "Suicide" is also inaccurate. A terminally ill patient making a request under the Oregon or Washington law is doing so to hasten an already inevitable and imminent death; therefore, the act cannot properly be equated with suicide. None of the moral, existential, or religious connotations of "suicide" apply when the patient's primary objective is not to end an otherwise open-ended span of life but to find dignity in an already impending exit from this world. Individuals who use the law may be offended by the use of "assisted suicide," because they are participating in an act to short the agony of their final hours, not killing themselves. It is the cancer (or other underlying condition) which is killing them.
* Euthanasia often refers to the act of painlessly but deliberately causing the death of another who is suffering from an incurable, painful disease or condition. It is commonly thought of as lethal injection.

I know with hospice, or at least the hospice program I volunteered for, a patient has to be given 6 months or less to enter hospice care.  What about Death with Dignity?  At what point is a person legally able to make this decision?

In order to make a request for medication under the Oregon and Washington Death with Dignity Acts, the patient must have received a terminal diagnosis with six months or fewer to live.

Are there any other states considering this legislation?

In December 2009, Montana's Supreme Court ruled there was nothing in the state law which prohibited a physician from honoring his or her terminally ill, mentally competent patient's request by prescribing medication to hasten the patient's death. During this year's legislative session, three bills were introduced in Montana regarding Death with Dignity. One, modeled on the Oregon and Washington laws would have codified the Supreme Court ruling and outlined in which circumstances the medication could be prescribed. The other two were aimed at overturning the court's ruling. All three bills failed to pass. Physician-assisted death is still legal in Montana, but the state doesn't currently have a standard of practice for physicians to follow regarding their patients' requests. I believe they'll try to codify the state's Supreme Court ruling the next chance they get in the legislature.

After careful research and polling, we've found the next likely state to pass a Death with Dignity law will be in New England, and that's where we're currently focusing our efforts. Right now, we're working with a grassroots group in Vermont to enact a law through the state's legislative process.

You can also see other legislative efforts related to end-of-life care on our site:

Okay readers, I would like to hear what you think.  It's never too early to begin this conversation.  As an FYI, HBO will air “How to Die in Oregon” on May 26th at


  1. My salutations, Pam, for taking on the topic of death in our irrationally death-averse culture, and for supporting death with dignity laws. I've been on the same journey vis-a-vis my new novel What You Wish For, which deals with this same topic in a California context. I did tons of research in order to make everything real, because I wanted to show the conflict and anguish of patients and their families when government makes illegal the end-of-life choice any one of us might desperately need some day. If you're interested, it's on Amazon at link:

  2. Thanks so much Bill for stopping by. I was becoming rather paranoid that no one was going to say a peep. I'll definitely check out your book.

  3. After giving this subject some thought, I will have to agree with the passing of the legislature to be a positive move. We live in a free country and laws that provide freedom of ones own action upon themselves is crucial to the original intent and values of our country.
    Some people may not want to subject themselves into the barrage of drugs, procedures, surgeries, medical experiments, etc just to squeeze a few months out of life. The stressful schedule with doctors and nurses with questions, instructions and prescriptions can be mind numbing enough to suck the joy out of anyone. The medical bills for insurance and family may be staggering for those remaining days or months. I would rather spend the money on a weekend long party with everyone I ever knew then a follow up party with my family. Why doesn't the insurance companies pay for this kind of piece of mind? What better way to give back rather than pay off hospitals, pharmaceutical companies and doctors.
    Pamela, you seem to be a person with some guts. You ask questions but what would you do if you were given three months to live? Let's not sugar coat this. Let's say this terminal diagnosis will amplify in pain and misery day by day. Let's say you gain a new friend because he or she changes your diaper several times a day. Let's say, total body hair loss will occur in six weeks. What if you had to be cared for like a premature baby? If it was me, I would rather revert back to my good times. If I had a choice to avoid this kind of care by people I don't really care for - I would take it.
    What about the others? Some people may say this and that and this and that. Should it be concerning? Sure, but to what extent? Who's life is at stake??? At the end, when it's over, nothing else will matter.

  4. I like and agree with AnOnymous Comments
    My Vote is Pass It - For

  5. Thanks for responding to my post. To be honest, I don't know where I stand with this. I believe it should be legal, but if and when I am faced with a terminal diagnosis, I can't say what I would do. I think the will to live is so strong that it must be the most difficult decision that a person would have to make. I mean, at what point does someone surrender? I imagine pain level and quality of life play a huge factor in this decision.
    Anyway, thanks again for posting!

  6. Hi Jason! Welcome to your crazy sis-in-law's blog. I appreciate you stopping by and posting.

  7. It seems in keeping with the philosophies of hospice: a respectful and "comfortable" way to die. Like you, Pam, I wonder how easy it would be to actually make that choice. However, I think it is important that those with a terminal illness and short time to live have the option.
    Sorry, I cannot watch the documentary. No TV stations here. I'll have to check it out another time.

  8. Thanks for posting Susan. I appreciate it.


Comments are welcome and appreciated!