Every year in America, about 1% of the population dies of all causes, i.e. a little over 3 mio. with West Viriginia the state with the highest annual death rate of 1.46%. 100,000 people die from drug overdoses, mostly fentanyl. Every year, more than 42,000 people die from car or truck accidents, about 1/3 of which involves alcohol; 1600 of whom now die from marijuana impairment. Forty-three thousand (43,000) die from falls, of which the vast majority are aged. Annually, some 50,000 Americans commit suicide, half of which involve firearms. The US suicide rate is now at an 80-year high, at 14.3 suicides per 100,000 people, with men over 75 at 44 per 100,000, the most vulnerable age bracket. Some 24,000 people are murdered every year in the United States. And every year, over 2 million people will receive a cancer diagnosis, leading to about 610,000 deaths. In total, over 3.5 mio Americans die every year, of which 21% are from heart disease and 18% from cancers. And let's not ignore that in the most recent year, there were 1 mio abortions in America, which rankles the pro-life movement to no end, as it put paid to the notion that abortions would decline with the overturning of Roe v Wade; instead abortions have now risen 11% since 2000.
Why am I highlighting these gruesome statistics? To listen to the opponents of MAID, the country is embarking on an existential threat to the sanctity of life by advancing the right of self-determination when faced with a terminal illness. They pronounce the very fabric of an ordered society at risk with an ever-imminent explosion of the number of people opting for an Assisted Death. They would have you believe the proliferation of easy access to MAID represents a turning point in American civilization for the worse, if not a return to some barbaric, medieval trivialization of the value of life.
And yet the numbers involved in MAID are so miniscule, if not inconsequential, compared with the staggering numbers of common-place deaths which society laments but accepts with no more than a collective shrug of its shoulders, so inured have we all become to their frequency. And compared with the now increasing annual number of abortions, which the ever active pro-life community views as tantamount to murder, one would think that the infinitesimally minor number of people who opt for MAID when it is legally available would not be deemed a factor in the scheme of the annual number of deaths in America.
Let us examine the reality of MAID in the 27 years of its availability in the United States. As a reminder, there are currently 11 US jurisdictions where MAID is legally accessible (a possible 12th awaits the Governor of Delaware's signature). Every year, each of those jurisdictions, except Montana, publishes detailed, granular statistics of the number of patients who have recieved a prescription per the stautory guidelines and/or used the medicine to hasten death. So we can calculate with scientific precision just how widespread MAID usage is in the United States, and more importantly the longitudinal evolution of its frequency.
Each state which has enacted MAID legislation files an annual report detailing how many people received Aid in Dying prescriptions, how many ingested and died from the medication, demographic details of the persons using the law, the number of prescribing physicans, the medicines prescribed, their dosages and their time to efficacy. Because the statutes are extremely prescriptive, the data base is rich.
Oregon was the first state to enact a MAID law, so there is now available 25 annual reports from 1998 through 2023. In that time the annual number of deaths through MAID rose from 15 in 1997 to 367 in 2023; the number of prescriptions rose from 24 in 1998 to 567 last year. What is fascinating is to note that in those two bookend years and in every intervening year, consistenlty about 1/3 of patients who went through the trouble of procuring the medicine decided not to take it, but rather let nature take its course. And equally curiously, this percentage has been fairly consistent in each of the other 10 reporting states. The most recent cumulative data for which we have published reports (some states have not yet published their 2023 reports) shows that since 1997 a total of 9.506 people used MAID prescriptions to hasten an inevitable death out of a total of 15,652 presscriptions written. That works out to an average of 380 deaths per year and 626 presxriptions written annually. Compare that with the global death numbers listed at the beginning of this essay, with annual deaths of 3 mio; with annual suicides of 49,000; with annual drug overdoses of 100,000. You would think the good people so worried about the effrontery of anyone contemplating abbreviating suffering when diagnosed with a terminal illness might better spend their time looking into the other causes of death in America, many preventable, if their real concern was the sanctity of life.
Let us put these numbers in context. In no state, does the annual deaths from MAID prescriptions exceed 1% of that state's annual deaths from a terminal illness like cancer. In fact, in Oregon, by example, in the most recent year of available data, less than 0.40% of natural deaths for which the patient could potentially have invoked the Death with Dignity Act, were caused by ingestion of MAID medicine. Thus of the circa 9,000 deaths in the most recently recorded year from disease like cancer, heart disease, ALS which very frequenlty enter a terminal phase in which the patient goes on hospice care for the final six months, only 567 invoked Oregon's Death with Dignity law, and only 367 did in fact ingest the Terminal Comfort Care medicine. In fact, in Oregon, more than twice as many people died from suicide (880) than from MAID (367), which statutorily is not deemed suicide. And it is worth noting that in the 25 years of its existence, there has never been a single recorded instance of an individual inappropriately prescribed the medicine either through coercion, lack of capacity, inability to self adminster or a faulty diagnosis. The law has worked exactly as it was intended-- permitting the very few who wish to hasten their end and avoid what they perceive as futile suffering, a dignified, respectful and self determined end of life narrative.
But that is far what opponents in their hyperbolic mischaracterization of Assisted Dying's expansion in the US would have you believe. They have bootstrapped themselves to the rounding error of deaths brought about by MAID in the overall scheme of US annual loss of life as if making life unbearable for the very few who would even contemplate accessing MAID is a great Pyrrhic victory: never mind that while they scream from the rooftops of the perils of MAID to US society, hundreds of thousands die from drug ODs, murder, car accidents, and fatal diseases. You would think a more productive use of their time would be to help prevent the millions who die in these fashions, rather than the several hundred a year who choose to use MAID when they are faced with the grim diagnosis of a life expectancy of less than six months and a terminal illness.