Who is qualified to request physician aid-in-dying?
The law requires the patient to be: 1) 18 years of age or older, 2) a resident of Oregon, 3) capable of making and communicating health care decisions for him/herself, and 4) diagnosed with a terminal illness that at least 2 physicians agree will lead to death within six (6) months. It is up to the patient’s primary (attending) physician to determine whether the patient meets these requirements and the consulting physician to confirm them.
Only persons who have been given a prognosis of six or fewer months to live by two Oregon physicians who agree to sign an Oregon State form to that effect are eligible to use the Oregon physician Aid-in-Dying law (the Act). If a person is enrolled in a hospice program that means he/she has received that prognosis from one physician, but it does not necessarily mean they will receive the same prognosis for using Aid-in-Dying. If a person has a terminal or chronic illness but their life expectancy cannot be predicted within reasonable medical judgment to be fewer than six months, then he/she is not eligible to use the Act.
How does a person ask his or her physician to assist them in using the Act?
The patient must make 2 oral requests and 1 written request. A qualified patient must make 2 oral requests to his/her attending physician (who may be the primary care physician or a specialist). The second oral request may be made no sooner than 15 days after the patient makes the initial oral request. The second request may be made to the patient’s original doctor or to the new doctor who agrees to write the prescription for the lethal dose of medication. The patient’s physician must document both oral requests in the patient’s medical records to confirm the dates of the requests.
The patient is also required to make a written request, which can be done any time during the fifteen-day waiting period, but cannot be made until after two physicians agree to sign the Oregon State form stating the patient has six months or fewer to live. There is a mandatory 48-hour waiting period between the time the written request is made and the time the prescription may be written. So as not to prolong the process, the written request should be made at least 2 days prior to the end of the 15-day waiting period. A standard authorized form must be completed for the written request and may be obtained free of charge from Compassion & Choices of Oregon.
Do I have to be able to take the medication orally, or may I inject it?
The medication may not be injected. It must be self-ingested. The Act does not permit lethal injections. The patient must be able to self ingest the medication. The typical method of self-ingestion is by swallowing.
Is all of the information I provide Compassion & Choices of Oregon kept confidential?
YES. All information, written or oral, provided to Compassion volunteers, physicians, staff and other health care providers is maintained in the strictest confidence and will not be revealed without the patient’s informed consent.
What does it mean to be a “resident” of Oregon?
An Oregon resident is a person who lives in Oregon and intends to permanently live in Oregon. To be an Oregon resident a person must currently be living in the state, but there are not a specified number of days a person must live in Oregon before he/she is considered a legal resident. If a patient can truthfully answer YES to two or more of the following questions, he/she may be considered an Oregon resident:
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Do you live in Oregon? (Location of permanent place of abode.)
Are you employed in Oregon?
Are you registered to vote in Oregon?
Are you receiving relief or assistance requiring residency in Oregon?
Do you pay taxes in Oregon?
Do you have children in school in Oregon? (Are you paying resident or nonresident tuition?)
Do you own or are you purchasing real property in Oregon?
Do you have an Oregon driver’s, fishing or hunting license?
Do you plan to live in Oregon for a long time?
Is it your intent to become a permanent resident of Oregon?
Terminally ill patients should not move to Oregon solely to use the Act. Oregon patients need to establish a long term relationship with their physician.
Compassion & Choices of Oregon suggests non-Oregonians consider all other end-of-life options available to them in the state in which they presently reside. Our national organization, Compassion & Choices, is available to give counsel throughout the country on these matters and may be contacted at 1-800-247-7421.
I am sad because I am dying, but I am not so sad that it is interfering with my decision to hasten my death. Does the fact that I am sad about dying mean I am not eligible to use the Act?
NO. There is a difference between being sad about dying and being “clinically or chronically depressed.” It is normal and common for people to be disheartened and sad about dying. If, however, a patient views hastening death as a preferred option to addressing an unsolved problem or as a means of escape, then further consultation is warranted. A decision to hasten death should not be made as a result of a lack of emotional or physical care, or because one or more of the patient’s needs are not being met. Also, if a patient has a history of clinical depression and has taken anti-depressant medications or attempted or threatened suicide previously, a psychological evaluation to assess the situation may be required. However, having been treated previously for mental illness does not automatically make a patient ineligible to use the Act.
Will my loved ones be entitled to my life insurance policy if I choose to end my life by lethal ingestion of medication under The Act and will my health insurance policy carrier pay for the medical expenses associated with my using The Act?
YES to life insurance. Physician aid in dying is not the same as committing suicide, and is not treated as such by insurance companies. This is clearly explained in the Act. Loved ones (beneficiaries) are entitled to the proceeds of a patient’s life insurance policy, just as they would be if the patient died naturally from their underlying illness.
Maybe to health insurance. Individual health insurance providers determine whether aid-in-dying is covered under their policies. Most carriers to date have covered the expenses associated with using the law, except those health insurance carriers or providers who are connected with religiously owned or operated facilities. In addition, federal funding cannot be used for services rendered under the Act.
Can my loved ones and friends be with me when I take the medication?
YES. Not only may loved ones and friends be present when the medication is taken but also Compassion & Choices of Oregon encourages them to be present. The Act allows a patient to choose the time, manner and place of their death. According to a recent Gallup poll, people wish to die in comfort, dignity and in familiar surroundings with their loved ones. As long as a patient is able to self-administer the medication, loved ones are allowed and encouraged to be with them when it is ingested.
What if my doctor says no to my request to have him/her assist me in using the Act?
Call Compassion & Choices of Oregon – 503-525-1956 – to discuss all of the options and choices about end-of-life care. We will provide a Client Information Pamphlet that explains in detail all of the options and choices, including a script on how to talk to a doctor about one’s wishes. We may be able to recommend another doctor if the patient’s doctor continues to refuse to assist the patient in using the Act as one of their end-of-life options.
I am in a hospital, nursing home or foster home where the owners/operators oppose the Act. If I choose to use the Act will they kick me out?
There is a possibility the owner/operator may ask a patient to leave. A patient should determine a facility’s policy prior to being admitted. The Act permits health care providers to “opt out” of participating in the Act. There are hospitals that prohibit their employees (doctors, nurses, and other health care providers) from assisting in using the Act. However, these hospitals agree not to evict a patient if he/she merely discusses whether he/she is considering using the Act. Facilities, such as hospitals, nursing homes or foster homes that oppose the Act on religious or other grounds may prohibit patients from taking the medication on their property. If a patient is told he/she may not remain in the facility if he/she uses the Act, please call Compassion & Choices of Oregon. We may be able to negotiate with the facility to allow the patient to stay as long as possible or assist in locating a new facility for the patient that supports his/her right to use the Act.
