Washington State’s Death With Dignity Act, based on Oregon’s, came into operation on 9 March 2009.
The latest annual report with data from 2016 was published in September 2017.
This latest data confirms that once assisted suicide is legalised use of it increases from year to year, seemingly without limit.
In 2010, the first full calendar year of operation, some 87 prescriptions for lethal drugs were provided under the Act. By 2016 this had nearly tripled (285%) to 248.
Prescriptions for lethal drugs increased by 15% from 2015 to 2016.
Deaths from lethal drugs prescribed under the Act have nearly quadrupled (376%) from 51 in 2010 to 192 in 2016, increasing by 13.6% from 2015 to 2016 alone.
Not all of those who are prescribed lethal drugs end up taking them. Some die of natural causes. There is no tracking of lethal drugs that are not used by those for whom they are prescribed so these lethal drugs are available in the community and could be used accidentally or intentionally to cause death. Of the 1184 prescriptions for lethal drugs issued since 2009 only 846 (71%) have been reported as used leaving some 338 doses of lethal drugs unaccounted for in the community.
Some 59% of those for whom a prescription for lethal drugs was provided did not cite any concern about pain control as a reason for asking for the prescription.
However, 87% cited concerns about loss of autonomy and 51% cited concerns about being a burden on family, friends or caregivers.
Significantly, 8% cited concerns about the financial implications of treatment.
Only 5% of those given a lethal prescription were referred to a psychiatrist or psychological for evaluation.
In some cases the prescribing doctor knew the patient for less than a week before writing the prescription, and in more than half the cases (53%) the doctor knew the patient for less than 25 weeks.
Although the Act specifies that only persons with “six months or less to live” may request lethal doses of medication from a physician, the data shows that in each year between 5% and 17% of those who die after requesting a lethal dose do so more than 25 weeks later, with one person in 2012 dying nearly 3 years (150 weeks) later, one person in 2015 dying nearly two years later (95 weeks) and one person in 2016 dying more than two years (112 weeks) later.
In 2016, one person took 11 hours to lose consciousness after ingesting the lethal dose and one person took 22 hours to die after ingesting the lethal dose. In 2013, one person took 3 hours to lose consciousness after ingesting the lethal dose and one person took 41 hours (1 day and 17 hours) to die after ingesting the dose. In 2015, one person took 72 minutes (1 hour and 12 minutes) hours to lose consciousness after ingesting the lethal dose, and one person took 30 hours (1 day and 6 hours) to die after ingesting the dose. In 2009, two people awakened after initially losing consciousness. In 2014, one person suffered seizures after ingesting the lethal medication.
At least 16 patients have regurgitated the lethal medication. Seven of these cases occurred in 2016 alone.
This may be related to the use of new experimental cocktails of lethal drugs being used since the price of the previously used drugs, secobarbital and pentobarbital (Nembutal), escalated.
The first of the new cocktails is a mix of phenobarbital, chloral hydrate and morphine sulfate. It was used in 88 cases in 2015 and 44 cases in 2016.
The second experimental cocktail includes morphine sulfate, propranolol, diazepam, digoxin and a buffer suspension. It has been used in 2 cases in 2015 and 22 cases in 2016.
There is no requirement under the Act for a physician or any other person to be present when the lethal dose is ingested.
Since 2009, there have been 200 cases where no health-care provider was present when the lethal dose was ingested and a further 104 cases where it is not known if a health-care provider was present.
In other words, in some 304 cases, people have died ingesting a dose of lethal medication, legally prescribed under Washington law, and nobody knows whether the person freely ingested the lethal dose or they were cajoled, coerced or forced to do so by another person.