The Legalities of Physician-Assisted Death
Physician-assisted death is legal in the U.S. in several states. Often confused with euthanasia, physician-assisted death is very different, both legally and procedurally. In euthanasia, the doctor administers medication that brings death to the patient, whereas with physician-assisted death, the doctor writes the patient a prescription for a lethal dose and the patient administers the dose to him or herself. Oregon was the first state to legalize physician-assisted death, with other states following suit. To date, Vermont, California, District of Columbia, Washington State, Oregon and Colorado have legalized physician-assisted death, which is called the Death with Dignity Act. Montana allows physician-assisted death, but it must be done through the court system and the patient must have less than six months to live.
This act allows terminally ill individuals to end their own lives by administering lethal doses of medication to themselves after they are prescribed by licensed doctors. In the U. S., support for physician-assisted death has risen by 50 percent since 1970. Last year in California, over 100 residents exercised the “right to die” option.
If you or a loved one is considering this option, you should make sure to become fully informed before making the decision. Review the following sections for more information on Physician-assisted death.
The End of Life Option
In the states where physician-assisted death is legal, laws regarding the specifics have been developed. For example, in California the laws surrounding physician-assisted death are called the End of Life Option Act. Each state spells out when a patient is legally able to request this option and under what circumstances. Most Acts in all states where it is legal first make sure the patient is moved through a process rather than being allowed to make a rash and quick decision. These Acts will often specify the age of the individual, the procedures involved and the rules regarding receiving and administering the lethal medication. Most who utilize this law are suffering from terminal forms of cancer, with the median age of those requesting the right to die at 73 years of age. Many of the requestors were already in hospice but were still of sound mind.
Many residents are concerned about an abuse of the practice in the states where it is legal. A report was completed in the period between 1947 and 2016 that included a review of doctors’ polling data and surveys. There is no evidence that the use of physician-assisted death has been abused by either patients or doctors. In all states, the patient must personally request physician-assisted death and it cannot be performed or requested by anyone other than the patient. Doctors who prescribe life-ending medications in the states where physician-assisted death is legal cannot be prosecuted for prescribing the medications, as long as all of the rules and procedures have been followed. Physician-assisted death is an optional choice for doctors and not all doctors will agree to perform or write prescriptions.
Who Qualifies for Physician-Assisted Death?
Each state is a little different when it comes to qualifications, but all of them require the patient to be a resident of the specific state, be capable of making his or her own health care decisions, have a terminal illness that will most likely take his or her life in six months or less and be at least 18 years of age.
In Oregon, the doctor who prescribes the lethal dose must be licensed to practice medicine in the state and willing to participate in the procedure. Patients must be over the age of 18 and consenting. The doctor cannot legally administer the lethal dose.
Only doctors who have agreed to participate in the Act can write the prescription. No other health care personnel can do so, such as a pharmacist or a nurse. No one but the patient is legally allowed to administer the lethal dose.
Patients must be judged and found to be “qualified” first. Family doctors or doctors of osteopathy who are licensed in the state are the only individuals allowed to write the prescriptions. In the event that a patient is incapacitated, the power of attorney does not apply. The individual must be cognizant, functional and make the request personally.
California’s laws are some of the most stringent. A person must request the prescription verbally twice. These requests must be made at least 15 days apart, and then a written request must be made to the doctor. Both the oral and written requests must be made directly to the attending physician and cannot be received through a third party.
Colorado follows Oregon’s procedures and a terminally ill patient with six months or less to live must make a request to his or her doctor for the assistance. The patient must be a resident of the state and the request for the aid-in-dying medication must not be tampered with or altered by anyone. If a doctor or another person coerces a terminally ill patient to request the medication, he or she will face severe penalties.
As with California, the patient must make two verbal requests at least 15 days apart and there must be a written letter sent after the first oral request and before the second oral request. The letter must be signed and hand delivered by the patient to the doctor. After this, there is at least a 48-hour waiting period before a prescription is provided to the patient.