Oregon Health Authority (OHA) has released its annual report on physician assisted suicide under the so called “Death with dignity Act (DWDA)”, which shows an almost 30% increase in the number of prescriptions written for lethal doses of medication under the Act in 2023.

The DWDA was a citizens’ initiative passed twice by Oregon voters. The first time was in a general election in November 1994 when it passed by a margin of 51% to 49%. An injunction delayed implementation of the Act until it was lifted on October 27, 1997. In November 1997, a measure was placed on the general election ballot to repeal the DWDA. Voters chose to retain the DWDA by a margin of 60% to 40%.

Prescriptions rose about 29%, from 433 in 2022 to 560 in 2023, according to the report. Deaths from ingesting the DWDA medications increased by about 20%, from 304 in 2022 to 367 in 2023.

The increase in DWDA prescriptions and deaths is believed to be driven in part by an amendment to the DWDA, passed in 2023, that removed the state residency requirement. The law no longer requires patients to be Oregon residents. All other criteria for participation remain.

OHA collects residence data from death records but does not receive records from other states unless the decedent was an Oregon resident. This means if an Oregon DWDA patient dies out of state and was not a resident of Oregon, OHA is unlikely to obtain notice of the death.

As a result, the 23 non-resident deaths reported may not represent all DWDA deaths of out-of-state residents who obtained a DWDA prescription from an Oregon health care provider. It is not known how many prescriptions were written to non-Oregonians. OHA plans to begin collecting patient residency status on the attending physician’s compliance form in 2024.

“The full impact of allowing out-of-state residents to access the law is unclear, as information about where the patient lives has not been collected during the DWDA prescription process,” said Tom Jeanne, M.D., M.P.H.., deputy state health officer and epidemiologist.

The full report is available here

As in prior reports, participates who died after ingesting DWDA medication were more likely to be 65 and older (82%) and have cancer (66%). Other findings for the year include:

Prescriptions for lethal doses of medication were written by 167 different physicians.
The youngest patient who took lethal medication was 29 years old. The oldest was 102.
Seventeen patients (5%) outlived their six-month prognosis.
A physician, other health care provider or trained volunteer was present at 54% of ingestions.
At least 10 patients experienced complications, most of which involved difficulty ingesting the medication, such as a burning sensation in the throat or partial regurgitation of medication. No patients regained consciousness after ingesting the DWDA prescription medication.
The median time from ingestion to death was 53 minutes.

OHA is legally required to collect information on compliance with the Death with Dignity Act and to make that information available on a yearly basis.

“OHA’s role is that of a steward of data about the use of the law,” Jeanne said. “This is a law, not an OHA program, and our principal role is to report accurate aggregate data about the use of the law. It is critical that we have accurate data so that informed ethical, legal and medical decisions can be made.”