Blanke C, et al. - This study was planned to assess results of Oregon physician-aided dying (PAD) , the longest running US program; to disseminate results; and to investigate promising PAD research areas. Researchers observed that since legislation enactment the number of PAD prescriptions written in Oregon has increased annually. Reasons for choosing PAD were related to quality of life, autonomy, and dignity, and rarely for uncontrolled pain. Making this area suitable for cancer care delivery research, many questions remain regarding usage and results.

Methods

• Researchers performed a retrospective observational cohort study of 991 Oregon residents who had prescriptions written as part of the state’s Death with Dignity Act.
• From Oregon Health Authority reports from 1998 to 2015, publicly available data was reviewed.
• in addition, they made a supplemental information request to the Oregon Health Authority

Results

• A total of 1,545 written prescriptions were identified; 991 patients died by using legally prescribed lethal medication.
• 509 (51.4%) of the 991 patients were men and 482 (48.6%) were women; median age was 71 years (range, 25-102 years).
• Researchers noticed an annual increase in the number of prescriptions written (from 24 in 1998 to 218 in 2015).
• The percentage of prescription recipients dying by this method per year averaged 64%.
• Seven hundred sixty two(77%) recipients among the 991 patients using lethal self-medication had cancer, 79 (8%) had amyotrophic lateral sclerosis, 44 (4.5%) had lung disease, 26 (2.6%) had heart disease, and 9 (0.9%) had HIV.
• Psychiatric evaluation was performed in 52 (5.3%) of 991 patients to assess competence.
• Among these 991, most (953; 96.6%) patients were white and 865 (90.5%) were in hospice care; most (118, 92.2%) patients had insurance and 708 (71.9%) had at least some college education.
• Most (94%) of these died at home.
• As per observations, median time between medication intake and coma was 5 minutes (range, 1-38 minutes); to death it was 25 minutes (range, 1-6240 minutes).
• Known complications were observed in 33 (3.3%) patients.
• For desiring PAD, the most common reasons cited were activities of daily living were not enjoyable (89.7%) and losses of autonomy (91.6%) and dignity (78.7%); inadequate pain control contributed in 25.2% of cases.