Highlights
- •What is the primary question addressed by this study?This study compares physician-assisted/Death-with-Dignity death and suicide patterns in women and men age 65 and older in Oregon, the first U.S. state to legalize physician-assisted death under the 1997 Death-with-Dignity-Act (DWDA)--as a way to assess the impact of the DWDA on older adult women, a group considered vulnerable to being pressured into a DWDA death.
- •What is the main finding of this study?Between 1998 and 2018 women age 65 and older represented 46% of DWDA deaths and 16.3% of suicides in their age group. DWDA deaths were the most common form (52.7%) of self-initiated death for older adult women, and firearm suicides (65.7%) for older adult men.
- •What is the meaning of the finding?This study's findings, consistent with those of studies conducted in Switzerland, raise questions about the role of medicalization and legalization in increasing women's interest in, and mortality by self-initiated death.
ABSTRACT
Objective
To examine Oregon's Death-with-Dignity-Act (DWDA) death and suicide patterns among
women age 65 and older, relative to patterns among same-age men, as a way to assess
DWDA's impact on older adult women, a group considered vulnerable.
Design
Oregon's 1998–2018 DWDA- and suicide-mortality rates and confidence intervals were
calculated.
Results
Between 1998 and 2018 women age 65 and older represented 46% of DWDA deaths and 16.3%
of suicides in their age group. Among women age 65 and older DWDA and suicide mortality
increased whereas among same-age men DWDA deaths increased and suicides declined.
DWDA deaths were the most common form (52.7%) of self-initiated death for older adult
women, and firearm suicides (65.7%) for older adult men.
Conclusion
Legalization has a substantial impact on older adult women's engagement in self-initiated
death. In Switzerland and in Oregon, where assisted suicide/medical-aid-in-dying (MAID)
is legal and where assisted-suicide/MAID and suicide comparative-studies have been
conducted, older adult women avoid self-initiated death except when physician-approved.
Older adult women's substantial representation among assisted-suicide/MAID decedents,
relative to suicide, may be a clue of their empowerment to determine the time of their
death, when hastened-death assistance is permitted; or of their vulnerability to seeking
a medicalized self-initiated death, when in need of care.
Key Words
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Article info
Publication history
Published online: June 11, 2021
Accepted:
June 5,
2021
Received in revised form:
May 30,
2021
Received:
March 21,
2021
Identification
Copyright
© 2021 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.
