Oregon’s Death with Dignity Act: An Evidenced-Based Approach to Improving End-of-Life Healthcare in Tennessee
Erin E. Mauck, MA
Community and Behavioral Health, College of Public Health
East Tennessee State University
Johnson City, TN
The legalization of physician-assisted death has been shown to improve the quality of end-of-life healthcare in the states that have passed Death with Dignity or End-of-Life Care Acts. The state of Oregon passed its Death with Dignity Act in 1994, and it is a model that has been replicated in Washington, Vermont, California, Colorado, and Washington D.C. In a national ranking of states in the areas of long-term services and supports for end-of-life care, five of the top nine were states with either a Death with Dignity or End-of-Life Care Act. This is not merely a coincidence. This data is a clear reflection that having legislation which clarifies the rights of a dying individual, impacts end-of-life healthcare in a positive way. Tennessee is currently ranked 47th nationally based on the following criteria: affordability and access, choice of settings and provider, quality of life and quality of care, support for family caregivers, and effective transitions. There are three major determinants that impact Tennessee’s poorly rated end-of-life health care. The first determinant is the limited use of advanced directives, living wills and patient-physician discussions about death, dying, and end-of-life healthcare choices. The second determinant is lack of coverage for the uninsured and less affluent. End-of-life healthcare is not strictly for individuals over the age of 65, terminal illness can impact the life of someone, regardless of age, income, or health insurance status. The third major determinant that is negatively impacting Tennessee’s end-of-life health care, is the lack of a Death with Dignity or End-of-Life Care Act. Data has been collected over the past 36 months, including data from secondary sources and field research data collected in Oregon, including 14 in-depth interviews with volunteers, employees, and the directors of two advocacy organizations at the center of Oregon’s Death with Dignity Act. The analysis of this data shows that states which have enacted Death with Dignity Acts, have better end-of-life care than states that have not. This includes the use of hospice and palliative care at the end of life, and the percentage of people who die at home. When a law that legalizes physician-assisted death is being considered, everyone, including citizens of the state, state policy makers, and healthcare professionals take notice. This encourages the public education of end-of-life healthcare options, as well as promotes further education in end-of-life care for all health professionals. In Tennessee, efficient and regulated end-of-life care is becoming more essential as the population increases, and life expectancy is extended.
| Identifer | oai:union.ndltd.org:ETSU/oai:dc.etsu.edu:asrf-1154 |
| Date | 04 April 2018 |
| Creators | Mauck, Erin E |
| Publisher | Digital Commons @ East Tennessee State University |
| Source Sets | East Tennessee State University |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | Appalachian Student Research Forum |
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