An Overview of the Policy
Death with Dignity Act in the United States was initially implemented by the state of Oregon more than eighteen years ago. Essentially, the Act was implemented to allow terminally ill patients above the age of 18 years to cut short their lives via a voluntary means. This by giving consent to a qualified physician to administer lethal medication otherwise termed as euthanasia or assisted death. In the same breath, other states such as California, Columbia District, Vermont, Colorado, Washington, and Hawaii have adopted similar laws but in different titles. This law provides a myriad of requirements. That before one invokes physician-aided death; the person should be above eight years of age, has a mindset to communicate and make sound decisions. Similarly, is diagnosed with a terminal illness with six months and that two separate physicians should ascertain the decisions. Notably, this Act has created unending debates for over a decade on the safety of this law. However, it has continually been receiving state funding as data collected by the Patients’ Rights Council indicates (Kimsma, 2016). Considerably, this Act has significantly proved to be effective in addressing the policy on pleas and rights of terminally ill patients to die with dignity and with less pain.
Evidence-based in Support for the Policy
Previously, the Death with Dignity Act especially in Oregon was extensively faced with challenges both religiously, political and legal. This was epitomized by court cases in pursuit to affirm the legal position of this Act before it was made efficiently law in 1994 before taking effect in the year 1997. In sustaining these laws, there was a formulated entity; Death with Dignity Political Fund whose main purpose was to defend this law politically (Hedberg and New, 2017). The argument behind the opposing forces was that the process was not ethical, not in line with people’s culture or beliefs and illegal to hasten or induce death to a patient. The opponents equally view this law as legalizing murder, a violation of the Hippocratic Oath and that the procedure is susceptible to abuse by the rogue physicians, nurses and medical practitioners. However, it is noteworthy that Death with Dignity Act essentially helped curb this perception. The act provides that before one is administered with euthanasia; there should be informed consent procured where two or more competent physicians ascertain the consent that the patient is terminally ill. Significantly, this has comprehensively addressed the problem of violations thereby making the laws effective.
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Interestingly, research and data collected from Oregon Health Authority in the year 2015 indicate that over a thousand prescribed for aide euthanasia in accordance with the Death with Dignity Act. Cumulative this was a rough estimate with a slightly above 60% patients who accepted and were actually ‘killed’ by administration of lethal medication to terminate their life. Further statistics indicate that there is a significant increase in percentage especially to cancer patients seeking lethal medication by invoking the provisions of Death with Dignity Act (Finlay, 2018). With such trends and credible statistics available, it is not arguable that the Act has significantly become most effective despite the initial opposition and legality challenges. Illustratively, it is also important to note that since the implementation of the Oregon state laws on death with dignity. Several other states as mentioned above have simultaneously followed suit in legislating and implementing own laws on physician-aided death borrowing a leaf on the successful effect of the Death with Dignity Act. This is indeed evident that the act effectiveness has received public acceptance and support.
In the same breath, it is notable that this policy under the Act essentially gives a patient a right to die or chose when and how to die. Prior to the implementation of this policy, it was illegal, uncouth and in violation of the tenets of the Hippocratic Oath to end a person’s life. Fundamentally, the implementation of this policy has conclusively created this as a right for the terminally ill person that should not be prohibited or restricted. The policy enables to save the patient for the costs, the overwhelming pain he/she is going through (Kimsma, 2016). In other words, the policy majorly puts an end or terminates a patient’s unending suffering and miseries; an aspect that never existed and would have been a criminal act.
On the other hand, the Death with Dignity Act is accompanied by a myriad of safeguarding measures. Among this safeguards is that there should informed consent is given, the patient is supposed to be mentally stable and of maturity age. Similarly, there should be a determination that the said patient has less than six months to survive. These safeguarding measures are the crucial part of this Act that makes it more effective. Considerably, the safeguards ensure that principally, the consent procured was voluntary and not coerced. Majorly, the physician or medical practitioner should have given the patient enough information and options available. Similarly, the physician should have exhausted all the options available; this includes the palliative care or hospital hospice care. Accordingly, the patient must make three statements in the affirmative both written and oral as witnessed. The effectiveness of the policy exhibits itself through this protective measures that aim at protecting the patient and the physician at the same time. Since its implementation and according to research, there have been no reported cases of abuse or violation of this policy (Ganzini, 2017). Significantly, these occurrences imply effectiveness and success.
Comparatively, it is also worth noting that this policy has contributed significantly to health care, nursing, and health outcomes generally. Firstly it is notable that before the implementation of this policy and the principal Act itself, assisted or aided suicide was banned and illegal. However, the policy in place has essentially offered protection for physicians and health medical practitioners. The policy has fundamentally made it legal to conduct physician-aided death without being held responsible or charged with the offense of negligence. This being the case, the policy has contributed to the increase of willing nurse practitioners and physicians in proportion to willing patients with intend to procure the euthanasia. The policy protects practitioners, rules, and steps that ought to be followed. This measure being in place, the health outcome is almost certain. Secondly, it is also notable that the policy has majorly contributed to the widespread or increases in the number of deaths or life termination (Kimsma, 2016). This is by euthanasia or lethal medication both by self-administration and others prescribed by qualified nurse practitioner or physicians.
Opposing Opinion to the Act
Critically thinking, it is realizable that the Death with Dignity Act has received broad public acceptance in Oregon and other states such as Montana, Washington, Vermont, and California. However, despite this position of being widely accepted and being useful, it is also evident that there are still cases of ethics, culture, moral and ethical dilemmas. There is the view that the policy does not provide for patients pleas and rights to have a say, a decision in choosing their death, self-determination and dying with dignity. Significantly this has hindered the progress of the policy. Majorly the objection and opposing opinion are based on the grounds that religion does not allow killing/murder, in the same breath, the concern is leveled upon the Hippocratic Oath. The oath posits that patients have to receive required treatment, not be harmed and something has to be done to alleviate their suffering condition. Further, the argument is that euthanasia is a violation and abuse of this Oath (Oakman et al. 2015). Illustratively, the oath restricts a physician from administering poison to patients.
A Final Position on the Policy
Importantly, it is comprehensive that Death with Dignity Act is mostly effective in all its aspects to save for few challenges noted above. Blanke et al. (2017) conducted research with fellow researchers and scholars analyzed data collected at Oregon Health Authority. According to their research results, it is estimated that patients with terminal illness felt that they have lost their autonomy, dignity or any reason to enjoy life opted to for this process. All the data analyzed indicated that all the patients who decided to undergo euthanasia were grateful that an effective law was in place to allow them to die in peace, less painful and with their dignity. Significantly, it is discoverable that this research indicated important evidence of the policy's effectiveness.
In conclusion, it is notable that the Death with Dignity Act has proven to be a most effective policy in addressing the pleas and rights of terminally ill patients and equally the rights and obligations by nurse practitioners and physicians. However, it is also appreciated and noteworthy that the existence of challenges and divergent opinion against the policy does not hamper its efficacy. As a recommendation and an action plan towards achieving higher efficiency of this policy; several steps have to be followed. Firstly, the relevant stakeholders and the government should step in basically for funding, campaigning in favor and primarily focus on creating awareness to the public on the availability and functionality of the policy. Notably, the effectiveness of this policy mostly is limited by lack of knowledge by the patients, practitioners and the physicians equally. Once patients and physicians are informed on the policy, unending debates will simultaneously end and constructively pave the way for the smooth efficiency of the procedure.
References
Blanke, C., LeBlanc, M., Hershman, D., Ellis, L., & Meyskens, F. (2017). Characterizing 18 years of the death with dignity act in Oregon. JAMA oncology, 3 (10), 1403-1406.
Finlay, B. I. (2018). 97 Review of data from the 2016 official reports of the Dutch termination of life on request and assisted suicide act and Oregon’s death with dignity act. BMJ Supportive & Palliative Care, 8 (1), A45-A46.
Ganzini, L. (2017). Legalized physician-assisted death in Oregon- Eighteen years' experience. In Assistierter Suizid: Der Stand der Wissenschaft (pp. 7-20). Berlin, Heidelberg: Springer.
Hedberg, K., & New, C. (2017). Oregon's death with dignity act: 20 years of experience to inform the debate. Annals of internal medicine , 167 (8), 579-583.
Kimsma, G. (2016). Euthanasia: Active. In Encyclopedia of Global Bioethics (pp. 1178-1188) Springer International Publishing
Oakman, B. N., Campbell, H. E., & Runk, L. M. (2015). Death with dignity: The developing debate among health care professionals. The Consultant Pharmacist® , 30 (6), 352-355.
