The number of people suffering from terminal diseases has increased in the 21 st century, especially due to the emergence of chronic diseases like cancer. It is estimated that about 42% of Americans have had either a friend or relative who is suffering from terminal illness for the last four-five years, which explains the high prevalence of chronic diseases. Due to the social, economic, and physical pain and cost associated with terminal illness, the majority of people support laws or policies that allow patients with terminal diseases to decide when to end their lives. Consequently, the Death with Dignity (DWD) Act was first adopted in Oregon in 1994 to allow people with terminal illness to end their lives. DWD Act has been adopted by many states in the USA, including other parts of the world ( Drum et al ., 2010) . DWD Act is mainly embraced by the majority because it improves safety and quality of care for patients with terminal illness.
DWD Act Address and Outcome or Quality of Care for Patients
DWD Act has many safeguards that are aimed at protecting patient's safety, especially about abuse and coercion. The Act has a stringent requirement that must be met before the life of a patient is terminated. A patient must be an adult, be of sound mind, and has a terminal disease with a confirmed six months prognosis. Only the patient himself or herself is allowed to make an oral request for medication ( Drum et al ., 2010) . The patient must be physically present in person when making the oral request. At the same time, the oral request must be made twice with at least 15 days apart. The oral request must be accompanied by a written request. Also, the Act makes it mandatory for the physician who is familiar with the patient to confirm the diagnosis of the terminal sickness. Besides, the physician is required to meet strict reporting requirements for every request. The requirements are aimed at ensuring that the patient safety is safeguarded before they finally receive medications that end their lives.
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DWD Act also improves the outcome of care for patients with terminal illness. First, the act ensures that only the right hospice or medication is used to care for patients with terminal diseases ( Drum et al ., 2010) . Secondly, it assists caregivers and family of a dying person to offer the best care while at the same preparing psychology for the demise of the patient. Caregivers are likely to give a patient who has requested to be assisted in dying the best medical care to make them feel comfortable and relaxed.
The Effectiveness of the Policy in Addressing the Issue
The DWD Act has been proved to be effective in addressing the safety of patients with terminal illness. Initially, before the policy was enacted, the safety of many patients with a terminal illness was not given a priority because they were expected to die anyway. Besides, physicians could collude with patient's family to end the life of affect sick person against their will, which encourages the use of unsafe medication methods. However, has improved patient's safety, especially due to the many requirements before the medication is administered ( Prokopetz & Lehmann, 2012) . Importantly, the Act has helped in addressing concerns over potential patient abuse and safety.
Also, the Act has effectively improved the quality of care, as physicians are now using the right medication and procedures in ending lives of persons with terminal illnesses. For instance, the overall spending and patient rating have improved in Oregon since the Act was passed into law ( Prokopetz & Lehmann, 2012) . However, some critics of the Act argue that it can worsen the quality of care for patients with terminal sicknesses. At the same time, there are some concerns over patients' safety, especially about potential discrimination and abuse.
Role of Nurses in Addressing Safety and Quality Standard within DWD Act
Initially, it was perceived that nurses have no significant role in the implementation of DWD Act. However, currently, nurses play a significant role, especially in improving quality and safety of patient within the Act ( Stokes, 2017) . Specifically, nurses play the role of ensuring that patients understand their rights before they decide on whether to end their lives not. They are acting as advocates for terminally ill patients who want to end their lives, which is essential to improving the safety and quality of care. They ensure that patients choose the right medication for their physician-assisted deaths (PAD).
My Position on the Effectiveness of DWD Act
The available evidence shows that the Act is effective in sneering patient safety and quality of care. States that first implemented the policy like Oregon have experienced improved care for patients with terminal illness. Therefore, I agree that DWD Act can significantly improve the patient safety and quality of care if appropriately implemented. However, the concerns over the policy should not be ignored to enhance the effectiveness of the policy. Loopholes in the Act that can lead patient discrimination and abuse should be addressed to make the policy more effective.
Conclusion
The number of patients with a terminal illness has significantly increased in the 21 st century. Treatment and management of terminal diseases are always costly. At the same time, terminal illness is linked to social and psychological problems, including severe pain. Therefore, DWD Act is crucial in reducing concerns and problems associated with terminal diseases. However, it is important to enhance the effectiveness of DWD Act to improve patient safety and quality of care.
References
Drum, C. E., White, G., Taitano, G., & Horner-Johnson, W. (2010). The Oregon Death with Dignity Act: results of a literature review and naturalistic inquiry. Disability and health journal , 3 (1), 3-15.
Prokopetz, J. J., & Lehmann, L. S. (2012). Redefining physicians' role in assisted dying. New England Journal of Medicine , 367 (2), 97-99.
Stokes, F. (2017). The emerging role of nurse practitioners in physician-assisted death. The Journal for Nurse Practitioners , 13 (2), 150-155.
