At least 36 die using state's new Death with Dignity law

A report issued Thursday showing that 36 patients have used Washington's Death with Dignity Act to hasten their deaths added momentum to the ongoing fight between advocates and opponents of the year-old law, which allows doctors to prescribe lethal medication for terminally ill patients.

The law was passed by voters by a healthy margin in 2008, but that hasn't meant an end to the controversy surrounding it. Even as the state was releasing its first statistical look at the results of the new law, opposing sides were gathering their troops to make sure their views were heard.

In the first 10 months of the law, 63 people obtained lethal medication, with at least 36 of those eventually taking it to end their lives, according to the report by the state Department of Health.

The state data cover the period from March 5, 2009, when the law took effect, through the rest of 2009. It includes all patients who filled lethal-medication prescriptions in 2009; some of those died in 2010.

The report showed that 63 patients were prescribed the medication. Of those, 47 died, but not all of them from the medication. Thirty-six took the lethal dose, and seven died without it. It's not known whether the four others who died had taken the medication.

Information is not yet available about the remaining 16 who were prescribed the drug.

Some 53 doctors prescribed the medication, and 29 pharmacists dispensed it, the state reported. Nearly 90 percent of the patients who filled the prescriptions and later died — with or without taking the medication — had private, Medicare or Medicaid insurance.

Medicaid in this state does not pay for the medication, which ranges from $400 to $600 in capsule form and up to $3,000 for the liquid version. Most Medicare plans and private insurance plans that cover prescription drugs do pay.

The report gave these statistics about the patients who filled those prescriptions and later died:

• All were between 48 and 95 years of age; 59 percent were between 65 and 84.

• 79 percent had terminal cancer. Nine percent had a neurodegenerative disease and another 9 percent had a respiratory disease.

• 90 percent lived in Western Washington.

Also on Thursday, Compassion & Choices, which supports the law, held a media event featuring two doctors and a terminally ill patient, who said the law is necessary so that people near death can die peacefully and in the presence of loved ones.

And the group's chapter in Oregon, where a similar law became legal in late-1997, reiterated its view that the law is benefiting terminally ill patients and their families.

A concern noted by Compassion's medical director in Washington, Dr. Tom Preston, is that patients and doctors are waiting too long in some cases to start the process required by law. Sometimes, physicians delay telling patients they're dying, Preston said, and patients run out of time.

Meanwhile, True Compassion Advocates, a group opposed to the law, was planning to picket the University of Washington Medical Center at noon Friday to "stand in solidarity with seniors, people with disabilities" and others hurt by "legalized assisted suicide," according to a statement.

The group believes that the law's "flimsy reporting standards" and "potentially coercive provisions" may lead to pressure on seniors to use the law.

The state released the data in aggregate form only. Because of privacy concerns, no complete case files can be released. The names of patients, doctors and pharmacies are hidden from view, as are details of individual cases.

Of the 47 people who died:

• 98 percent were white.

• 46 percent were married, 27 percent widowed.

• 61 percent had some college education.

• 55 percent were men; 45 percent were women.

• 89 percent told their family of their decision.

• 27 percent had known the prescribing doctor for less than a year.

• 41 percent died within 24 weeks of making their first request.

Of the 36 who died after taking the medication:

• 94 percent died at home.

• 72 percent were enrolled in hospice care.

• The prescribing doctor was with 8 percent of the patients as they took the medication; 47 percent were attended by another type of health-care provider.

• Three patients had complications, including two who woke up after taking the medication and another who regurgitated.

• Most were unconscious within 10 minutes, and most died within 90 minutes, though at least one remained alive for 28 hours.

Doctors said loss of autonomy was an end-of-life concern for all 47 patients.

Ninety-one percent were also concerned about losing the ability to participate in activities that made life enjoyable, and 82 percent were worried about "loss of dignity," their doctors said.

The report also said that more than 40 percent were worried about losing control of bodily functions, 23 percent about being a burden on family, friends or caregivers, and 25 percent were concerned about inadequate pain control. Only one person was concerned about the financial implications of treatment, according to the doctors' reports.

Paperwork from two patients and their doctors was not received by the Department of Health, although the two patients received lethal doses of medication. Department spokesman Donn Moyer said officials were attempting to track down the forms.

Carol M. Ostrom: 206-464-2249 or costrom@seattletimes.com