Women and men who ended their life via Oregon’s Death-with-Dignity-Act and why: a sex by age analysis of 25 years of physician-assisted suicide patterns and motives

OBJECTIVES: Studies of Oregon's Death-with-Dignity-Act decedents-data have reported patterns by single variable. Research by intersecting variables (e.g. motives by sex and age) is missing. METHOD: Analysis, by sex and age, of Oregon-Health-Authority's data on Death-with-Dignity-Act decedents' demographic and medical characteristics, motives, length of petitioner-prescribing physician relationship, psychiatric referrals, and health-care-provider's presence at ingestion and death, in the first Death-with-Dignity-Act 25-years. RESULTS: Two-thirds of decedents were older adults. Women were about half of decedents overall and in the under-65 (<65) age group. Overall and age-65-and-older (65+) Death-with-Dignity-Act deaths-rates were higher for men, particularly among age-75+ decedents. Over time the length of the petitioner-prescribing physician relationship shortened, especially for men and age-65+ individuals, and psychiatric referral-rates dropped, especially for age-65+ individuals, women and men. The top physician-reported petition-reasons (autonomy, life-enjoyment, dignity, and burden concerns) were consistent over time in endorsement-ranking, across sex and age groups. Burden concerns were increasingly reported, especially for men and older adults, with half or more recent decedents with that petition-motive. CONCLUSION: This study reveals sex, age, and time-period Death-with-Dignity-Act patterns, particularly an increase in physician-reported burden-motives among men and older adults; and Death-with-Dignity-Act data-gaps, including that the Death-with-Dignity-Act record has no information about motives directly from petitioners.