Week One 1/14-1/21: Introduction to the Health Policy Topic

Health Policy Topic

Legalizing Death with Dignity  in the state of Arizona

Background and Significance of the Death with Dignity Act

The Death with Dignity movement made national headlines in 2014 when Brittany Maynard, a young woman with terminal brain cancer, chose to end her life with the assistance of a physician (through prescribed medications) on November 1, 2014. Brittany moved and established residency in the state of Oregon, which was the first state to pass the Death with Dignity Act in 1997.  To date, their are four other states where patient-directed dying (PDD), also known as physician-assisted dying, is occurring either by mandated state laws (e.g., Vermont and Washington) or court rulings (e.g., Montana; and one county in New Mexico) (CNN.com, 2014); sparking the national debate of should terminally ill patients, deemed mentally competent, be allowed the choice to end their own life?  Proponents for PDD, like the Death with Dignity National Center, want to proliferate the movement for people facing terminal illnesses to have control and options when facing end-of-life decisions, including PDD (Death with Dignity National Center, 2015).  Some interesting statistics since the inception of these mandated laws or court rulings include:

  • In Oregon, there have been 1,173 physician prescriptions written; and 752 deaths since 1997 (Oregon Health Authority, 2014).
  • In Washington, there have been 549 prescriptions written; and 529 deaths since 2009 (Washington State Department of Health, 2014).
  • In Vermont, there has been no deaths reported since the passing of the doctor-prescribed suicide bill in 2013 (CNN, 2014)

For those patients diagnosed with terminal illnesses in states with no Death with Dignity laws, it can be a frustrating journey. Most are dealing with painful and debilitating disease processes like cancer or amyotrophic lateral sclerosis (ALS).  This is the case in the state of Arizona (AZ) where an Aid in Dying Bill (HB 2572) was proposed in 2007; and continues to remain in the Health, Judiciary, and Rules Committees (Life Issues Institute, Inc., 2014).  In 2005, an AZ Opinion Poll conducted by the local new channels, KAET-TV/Channel 8 and the Walter Cronkite School of Journalism and Mass Communication at Arizona State University (ASU), telephoned 442 voters inquiring about a physician-assisted suicide law for people with terminal illnesses.  The results revealed 53% of those polled were in support of a law being passed (Compassion & Choices AZ, 2005).

Establishing Death with Dignity laws can potentially do the following:

  • Lower healthcare costs for those with terminal illnesses. Studies show 1 in 4 Medicare dollars,  over 125 billion dollars, are spent on care at end of life (Time, 2014)
  • Mandate safe and effective means over ending a person’s life.  Stopping potential suicide attempts that are horrific and traumatic for all involved.
Please watch the video of Brittany Maynard’s fight with terminal brain cancer; and her decision to die with dignity.

Significance to Me

My name is Leslie Moses-Grubenhoff; and I have been a registered nurse (RN) for the past 10 years.  Currently, I am a Doctor of Nursing Practice (DNP) student at Arizona State University (ASU) concentrating in adult and geriatric primary care.

Working for a non-profit hospice in Phoenix, AZ for the last 9 years, I have encountered patients who have inquired or requested assistance with dying.  Many had lost their abilities to feed, bathe, or toilet themselves; and all had lost their overall quality of life.  They assumed being admitted to a hospice program would hasten the dying process due to the morphine the agency could provide.  Clarification and education on what a hospice does never includes providing medications to end a person’s life.  Comfort medications, like morphine, are only utilized for symptom management for issues such as pain and/or shortness of breath.  This left some patients feeling hopeless because they were ready to die; and wanted control in when this would happen.  One story that I will always remember is an admissions call I received for a man who attempted suicide with a helium tank and a paper bag, but failed.  This man was suffering from terminal cancer; and had unrelieved pain.  He told me he got all his affairs in order; said his goodbyes to his family and friends; and distributed out all his life savings only to receive an empty helium tank for a botched suicide attempt.  He was angry and frustrated that the state of Arizona did not have laws in place to help him die with dignity.

Please watch the video below of an elderly man who shot his wife of more than 40 years as a “mercy killing.”

Man shoots elderly wife in alleged ‘mercy killing’ – FOX 10 News | fox10phoenix.com

Looking forward to the upcoming weeks to discuss this topic further.  See you in Week Two!


CNN (2014). Physician-assisted suicide fast facts. Retrieved from http://www.cnn.com/2014/11/26/us/physician-assisted-suicide-fast-facts/

Compassion & Choices (2014, October 29). A new video for my friends. Retrieved from http://www.youtube.com/watch?v=1lHXH0Zb2QI

Compassion & Choices AZ (2005). Arizona opinion polls. Retrieved from http://www.choicesarizona.org/azpoll2.htm

Death with Dignity Center (2015). About us. Retrieved from http://www.deathwithdignity.org/aboutus

Fox 10 News (2013, November 13). Man shoots elderly wife in ‘mercy killing.’ Retrieved from man shoots elderly wife in alleged ‘mercy killing’ – FOX 10 News | fox10phoenix.com

Life Issues Institute (2014). Current attempts to legalize assisted suicide in the United States. Retrieved from http://www.lifeissues.org/euthanasia/current_attempts.htm

Time (2014). Cutting the high cost of end-of-life care. Retrieved from http://time.com/money/2793643/cutting-the-high-cost-of-end-of-life-care/


3 thoughts on “Week One 1/14-1/21: Introduction to the Health Policy Topic

  1. marnibailey

    What a heart-breaking video. Asking a person to watch their loved-one suffer and beg for it to end is inhumane. I find doing nothing a greater moral wrong than doing something. Morality seems to be the basis of the discussion on assisted suicide. Society has progressed to a position which a women has a right to chose to abort a pregnancy, but does not have the right to end their own suffering – men, included in this part. I am also troubled by the thought that even in states where assisted suicide is legal, there is an underlying basis attached such as terminal cancer, etc. So many people suffer in an equal capacity to cancer.

    One of the argument to assisted suicide is that prescriptions may be given but end up being used on an innocent person. The reason I bring this up is I don’t understand how 1173 prescriptions were written and result in 752 deaths. I recognize writing a prescrition and filling a prescription are two different things. But the difference in the two figures could possibly give reason supporting the opponents argument.


  2. dignitydiscussion Post author

    I am assuming those patients who never went through with the act died on hospice services? I believe there are some articles that asked the same question you did, but I am not (currently) aware of how that was answered.


  3. nanettewhittington

    I was so touched by the video and your post. I have to be honest…..I have not been a fan of the hospice organization since the death of my grandfather in 2004. My grandfather was in congestive heart failure secondary to a very very small unrepairable hole in his aorta. His life expectancy was approximately 6-12 months. While we arranged for him to come home he went to an East Mesa hospice facility for pain management. The morning that he was transferred to the hospice we got him settled and then we left to make arrangements for some medical equipment to be delivered to my house. We went back to see him that afternoon and he was asleep and he never woke up. We were told that they had given him some oral morphine and nothing else. To this day I don’t really understand or comprehend what and why. Since that time I have not had another experience with hospice and have had a negative attitude about the hospice system. Your post has given me a different perspective and I am anxious to follow your future posts.

    Liked by 1 person


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