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Regarding Oregon's Death with Dignity Act and Oregon State Public Health's Role June 16, 1998 Letter to Editor To monitor compliance with the Act, the Health Services has incorporated a basic reporting process into our administrative rules. When a PAS prescription is written, the prescribing doctor must either submit Death with Dignity forms to the Health Services 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 Health Services staff. We will then call the doctor and ask him/her to confirm whether their patient died from a lethal prescription or from their terminal illness. This reporting process lets us evaluate compliance with the Act but it is not designed to answer many of the important questions surrounding the Act. Clearly, the public deserves more information about the Act's impact than what we can collect from reporting forms and death certificates. Therefore, we will also be conducting special in-depth interviews with doctors about their patients who receive a PAS prescription. The interview questions have been developed with help from the Oregon Task Force to Improve the Care of Terminally Ill Oregonians and address issues raised by many Oregonians. We will collect information about: characteristics of the patients and their motivations for choosing PAS; 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 (for example: 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 Health Services is responsible for providing the public with accurate information about the impact of the Death with Dignity Act. We believe that our reporting system, follow-up interviews with doctors, and information policy will protect the privacy of patients who choose PAS, their families, and their providers. At the same time, it will provide us all with useful information necessary to evaluate the impact of Oregon's Death with Dignity Act. Sincerely, Grant Higginson, MD, MPH, State Health Officer |
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