End of Life Choices
Death With Dignity (DWD)
What are Oregon’s eligibility requirements?
- 18 years or older
- Resident of Oregon
- Diagnosed with a terminal illness by two doctors, i.e., illness is more than likely to end your life within 6 months
- Mentally capable of making your own healthcare decisions when requesting and taking the medication
- Physically capable of ingesting the medication without assistance.
Two Oregon physicians must meet with you and evaluate your medical eligibility. One physician prescribes the medication, and the other physician provides a supporting consulting opinion. If either physician questions your judgment, they can require that a psychiatrist or psychologist evaluate your mental capacity.
If I’m eligible for hospice, do I qualify for the DWD law?
Eligibility to use the law is not always the same as eligibility for hospice.
What if I change my mind about using the law?
You may change your mind anytime. This option is always your choice.
What is the process for aid in dying?
- You must make two verbal and one written request to your physician
- The written request is the “Request for Medication” and must be dated after you have seen both doctors
- Only you can make these requests.
What about the medication?
There are several medications that your volunteer and your prescribing physician will discuss with you.
- You must be able to self-administer the medication, either by swallowing or by self-administering a feeding tube
- Your physician must mail or hand-carry the prescription to the pharmacy
- A person you designate may pick up the medications
- Depending on your insurance policy, the cost of the medication and/or physician visits may or may not be covered
- There is NO obligation to fill the prescription or take the medication if you have it in your possession.
How is End of Life Choices Oregon involved?
Experienced volunteers are available to meet with you or talk with you by phone. Our volunteers can answer questions and address concerns about DWD. Although it is your choice, we also recommend that your volunteer be present at the time you take the medication.
Our EOLCOR medical director is available to talk with physicians to explain the requirements of the law. If your physician is not able or willing to participate in the law, let us know.
How do I talk with my physician about using the DWD?
Many people feel anxious about talking to their physician about aid-in-dying. By discussing your choices early in your illness, you are more likely to have time to ensure that your end-of-life wishes are honored.
Suggestions for discussions with your physicians:
“I would like to have the option of using Oregon’s DWD Act.
Am I eligible?”
“Will you be one of the two participating physicians? Will you record that I asked on this date to use the DWD Act and that I’m eligible?
“Will you record that I asked to use the DWD Act and that I’m eligible? Will you refer me to a doctor who will participate?
Voluntarily Stopping Eating and Drinking (VSED)
In order to hasten death, a person can voluntarily stop eating and drinking (VSED). By refusing any food or liquid, the body dehydrates, causing it to cease functioning.
Unlike Death With Dignity, VSED is a process that does not require a doctor, nor does it need to be restricted to terminally ill people. There are people who choose VSED for various reasons, e.g.:
- They are suffering and do not want to wait until they are terminal;
- They are terminal, but do not have two doctors who support DWD;
- The DWD medication is too costly.
VSED requires determination and supportive caregivers. If someone is seriously ill, it is common to have lost their appetite. However, refusal of liquid demands more discipline and can be difficult. Even the slightest amount of liquid can prolong the dying process.
Certain medications can help with VSED, and sometimes hospice supports the process. Talk with your doctor or hospice regarding which of your regular medications you should continue or discontinue taking.
After a few days of refusing food and liquid, a person normally becomes frail and is likely to sleep more. They will eventually fall into a coma before dying. The time until death cannot be predicted; depending on each person’s condition, death can occur within days or a few weeks.
Your EOLCOR volunteer can provide you with more detailed information regarding VSED.
There is the choice of remaining comfortable with hospice services.
Hospice teams specialize in symptom management. In-home care is provided by nurses, social workers, volunteers, etc. It benefits the patient and the caregivers.
There is no charge for hospice services.
If you are not on hospice, we recommend that you ask your doctor for a referral.