The Oregon assisted suicide figures for 2015, released this month, are yet another rebuff to those who insist euthanasia and assisted suicide laws 'must be given time to settle in'.

The report advises that since 'the law was passed in 1997, a total of 1,545 people have had prescriptions written under the DWDA, and 991 patients have died from ingesting the medications. From 1998 through 2013, the number of prescriptions written annually increased at an average of 12.1%; however, during 2014 and 2015, the number of prescriptions written increased by an average of 24.4%.'

The 132 assisted suicides so far reported for 2015 would translate to 2,147 for a population the size of the UK. That's a few seats short of filling the Royal Opera House in Covent Garden. More specifically, this would translate to 1,908 for England and Wales (which the Marris and Falconer Bills would have covered) and 177 for Scotland (which the MacDonald/Harvie Bill would have covered, although those proposals went beyond the Oregon model).

(Although the US Census Bureau has released 2015 population estimates for Oregon, the ONS is yet to do so for the UK, so these extrapolations use 2014 population figures.)

We don't know

218 people had prescriptions written during 2015. Of these, we know 125 have taken the medication and died (along with seven from prescriptions made before 2015). Alongside 50 who did not take the medication but died from other causes, the status of 43 patients given prescriptions in 2015 is unknown. Five are known to have died, with ingestion status unknown, but for the remaining 38, both death and ingestion status 'pending'. The state of Oregon allowed 218 prescriptions for lethal drugs to be made out last year, and have no idea of the outcome in a fifth (19.7%) of cases. This is the 'closely safeguarded' system we in the UK have been asked to replicate.

Doctor, doctor

A total of 106 physicians wrote the 218 prescriptions given during 2015 - up to 27 prescriptions per physician. That balances out to at least one a fortnight.

As in 2014, the briefest doctor-patient relationships resulting in a lethal prescription were just a week long, and the median has dropped from 19 weeks in 2014 to 9 weeks in 2015.

Just five patients who are reported to have died through assisted suicide last year were referred for psychiatric evaluation - 3.8%. That this is the highest proportion since 2006 (4%) is far from a ringing endorsement.

How long to live, how long to die

Patients whose 2015 assisted suicides have been reported lived for between 15 and 517 days (about 17 months) after making their first request.

Following ingestion of the prescribed drugs, patients took between five minutes and 34 hours to die. We are reminded that patients in previous years have taken up to 104 hours, but perhaps more significant is the fact that these times are only reported when a healthcare professional is in attendance. This means that we have no idea how long death took in more than 81% of reported cases.

The same goes for complications. We know that four patients suffered complications including regurgitation, and we are told that 23 suffered no complications, but we know nothing of the remaining 105.

Older and more isolated

26% of those who underwent assisted suicide in Oregon in 2015 were widowed - substantially higher than for Oregon's general population (2.6% of men and 8.3% of women) and also higher than for all assisted suicides in the preceding 17 years (23.1%). 27.5% were divorced, again substantially higher than in the population at large (11.8% and 14.6% respectively) and again higher than for assisted suicides across preceding years (22.7%). 78% of assisted suicides last year were for people over 65 years of age; in the 2010 census, they made up 13.8% of Oregon's population.

Even more of a burden

The main argument advanced for assisted suicide is unremitting pain but the Oregon data show that those people citing 'inadequate pain control or [even] concern about it' constitute just 28.7% of cases overall (down on 2014). The three most commonly cited reasons for seeking assisted suicide remain being less able to engage in activities making life enjoyable (96.2%), losing autonomy (92.4%) and loss of dignity (75.4%). These are not physical but existential symptoms. Should lethal drugs be prescribed to people who feel their lives no longer have meaning and purpose? Almost half of patients undergoing assisted suicide last year didn't want to be a burden on family, friends/caregivers (48.1%, up on 40% in 2014).

Diagnoses

While most assisted suicides concern cancer patients, the balance continues to shift. In 2005, 84% of reported deaths concerned patients with cancer; last year, this had fallen to 72%. 6.8% concerned heart disease, up from 2.9% in 2014, and 'other illnesses' last year accounted for 10.6% of assisted suicides, up from 8.6% in 2014. 'Other diseases' include

benign and uncertain neoplasms, other respiratory diseases, diseases of the nervous system (including multiple sclerosis, Parkinson's disease and Huntington's disease), musculoskeletal and connective tissue diseases, cerebrovascular disease, other vascular diseases, diabetes mellitus, gastrointestinal diseases, and liver disease.

The mantra of clear terminal diagnoses with clear prognoses confirming coming death is repeated often by assisted suicide advocates, but this is increasingly hard to justify.

Even on a simple inspection of official figures, it is ever clearer that Oregon is not the example we should wish to emulate. Rising numbers of deaths; disproportionate representation of older and isolated people; applicants with increasingly diverse diagnoses; existential reasons for seeking suicide (which would be countered with care and support were applicants not deemed terminally ill); vast gaps in data. British healthcare professionals want no part in it, disabled people fear it and we know that we can do better (both than people imagine and than we are managing at present) for people approaching the end of life. Oregon is not the way to go.

Read the 2015 report in full; all 18 reports are freely available online.

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