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Public Health's Role
 

On October 27, 1997 Oregon enacted the Death with Dignity Act (the Act) which allows terminally-ill Oregonians to end their lives through the voluntary self-administration of lethal medications, expressly prescribed by a physician for that purpose. The Act requires the Oregon Health Authority, Public Health Division, to collect information about the patients and physicians who participate in the Act and publish an annual statistical report. While the Oregon Health Authority is neutral about the Act itself, we believe these data are important to parties on both sides of the debate.

To monitor compliance with the Act, the Oregon Health Authority has incorporated a basic reporting process into our administrative rules. When a prescription is written under the Act, the prescribing doctor must either submit Death with Dignity forms to the Oregon Health Authority or make available relevant portions of the medical record. Either method must clearly show that the doctor and patient have followed the requirements of the Act. After the patient has died, the death certificate will be matched with their Death with Dignity forms or copies of the medical record and then reviewed by Oregon Health Authority staff. We then contact the physician and ask him/her to confirm whether their patient died from a lethal prescription or from their terminal illness.

To identify possible reasons for the request, and assess circumstances surrounding the time of death, we have developed a follow-up questionnaire to be filled out by the physician or licensed health care provider who was present at the time of death. The interview questions were developed with help from the Oregon Task Force to Improve the Care of Terminally Ill Oregonians. Information collected includes: characteristics of the patients and their motivations for requesting a prescription; patient's underlying medical condition; end-of-life care issues (for example: whether the patient was enrolled in hospice); compliance with the Act; events surrounding the patient's death (f. ex.: the types of medications used and the time it took for the patient to die after taking the lethal medications); and characteristics of physicians who participate in the Act.

The Oregon Health Authority is responsible for providing the public with accurate information about the Death with Dignity Act. We believe that our reporting system, follow-up questionnaires filled out by providers, and information policy will protect the privacy of patients who choose DWDA, their families, and their providers. At the same time, it will provide important information on the impact of Oregon's Death with Dignity Act.