Among the many hoary predictions of MAID opponents is the notion that enacting Death with Dignity legislation will usher in a culture of suicide. During the debate in the late 1990s in Oregon and Washington, one often read dire predictions that passage of the legislation would make those states suicide meccas and that soon the local medical communities would be swamped by folks availing themselves. One prognosticator suggested that as many as 10% of all deaths in Oregon would be under the framework of the Oregon Death with Dignity Act.
Twenty years on, the data reveal outcomes vastly different. Death with Dignity is very rarely used– in Oregon of the 25,000 annual deaths by cancer, for example, less than 200 individuals use the statute, or less than 1%. And of course this exclude the thousands of others who die of terminal illnesses in the calculation.
The reality is that Death with Dignity is working just as its proponents suggested: it is very rarely used, few doctors are called upon to participate, even fewer end up writing prescriptions, it has not engendered an increase in suicide among physically healthy individuals; it has increased recourse to hospice and palliative care; it has helped to take End of Life decision-making out of the closet and empowered people to exercise a modicum of autonomy when a disease is otherwise limiting outcomes.
A recent article in JAMA and UPenn Medical School make clear that Death with Dignity legislation does not lead to the nefarious consequences which its detractors predict, even today.