Oregon – steady annual increase in assisted suicide cases sounds warning to UK

Lord Falconer wants to legalise assisted suicide for adults who are mentally competent and have less than six months to live based on the ‘Oregon model’.

Since assisted suicide was legalised in Oregon there has been a steady annual increase in the number of prescriptions written for lethal drugs and in numbers of people killing themselves.

In 1998 there were 24 prescriptions written and 16 assisted suicide deaths. By 2012 these numbers had risen to 116 and 85 respectively. This is a 380% increase in prescriptions and a 430% increase in assisted suicide deaths in 15 years.

In 2013 there were 71 deaths – an apparent fall. But this was number that had been reported by 22 January 2014 and there were still 31 patients for whom ‘ingestion status’ was unknown.

For 2012 it was initially reported in January 2013 that there were 77 deaths – but also 25 whose ‘ingestion status’ was unknown - this increased to 85 once all figures were in so we can expect the 2013 figures to go up by at least a similar level.     

How would this translate to the UK?

There were 56.6 million people in England and Wales in 2012 but only 3.9 million in Oregon. So 85 assisted suicide deaths in a year in Oregon would equate to 1,232 in England and Wales (14 times that of Oregon).

Overall since the Oregon Death with Dignity Act (DWDA) was passed in 1997, a total of 1,173 people have had DWDA prescriptions written and 752 patients have died from ingesting medications. 

So over a similar time period, all other things being equal, we would expect 10,528 assisted suicide deaths in England and Wales.

This pattern of steady annual increase in number is also evident in other jurisdictions which have legalised either assisted suicide or euthanasia.

The number of assisted suicide deaths in neighbouring Washington State, increased by at least 43% in 2013.

There were 119 known assisted suicide deaths in 2013, up from 83 in 2012, 70 in 2011, and 51 in 2010. Assisted suicide was legalized in March 2009, after a ballot measure.

According to Dutch media reports, euthanasia deaths in the Netherlands in 2012 increased by 13% to 4188.

In fact from 2006 to 2012 there has been a steady increase in numbers each year with successive annual deaths at 1923, 2120, 2331, 2636, 3136, 3695 and 4188 – an overall increase of 118% in just six years. 2013 figures are still awaited but expected to show similar trends.

The number of reported euthanasia deaths in Belgium increased by 26.8% in 2013 to 1816 reported deaths. Figures for 2012, 2011 and 2010 were 1432, 1133 and 954 respectively and the increase since the first full year in 2003 is over 600%.

There is also widespread evidence of under-reporting. The Lancet recently published a long awaited meta-analysis study which indicated that in 2010, 23% of all euthanasia deaths were not reported meaning that the total number of deaths last year may not have been 4,188 but rather 5,151. 

Could similar under-reporting be happening in Oregon? It is a virtual certainty.

Oregon officials in charge of formulating annual reports have conceded ‘there’s no way to know if additional deaths went unreported’ because Oregon DHS ‘has no regulatory authority or resources to ensure compliance with the law’.

The DHS has to rely on the word of doctors who prescribe the lethal drugs. Referring to physicians’ reports, the reporting division admitted: ‘For that matter the entire account [received from a prescribing doctor] could have been a cock-and bull story.  We assume, however, that physicians were their usual careful and accurate selves.’

So with an Oregon law we can expect to see steadily increasing numbers of assisted suicide cases year on year in England and Wales, along with an unknown level of underreporting.

But that’s just one disturbing fact about assisted suicide in Oregon. There’s much much more to come.

Let’s not follow Oregon’s lead.