Death with Dignity Laws and the Medical Examiner

Abstract

Currently, three states (Oregon, Washington, and Vermont) have “death with dignity,” physician-assisted suicide laws. Twenty-five other states considered death with dignity (DWD) legislation in 2015. Americans and American physicians have mixed opinions about these laws. Oregon, Washington, and Vermont have similar DWD laws that establish criteria and define roles and responsibilities of the physician, patient, and pharmacist. States require record-keeping and statistical reports administered by public health agencies. Yearly summary reports in Oregon and Washington show that physician assisted suicide (PAS) is uncommon. In Oregon in 2014, 105 PAS deaths were documented, of approximately 34 000 total deaths. The majority of PAS deaths involve patients with terminal cancer or neurodegenerative disease. The laws require that the cause of death be attributed to and certified as the underlying natural disease, making the manner of death natural. The attending physician may sign the death certificate. Because the cause and manner of death are legally mandated, the physician assisted suicide laws have little impact on medical examiner offices.