Oregon Death with Dignity Law: Eligibility, Requests, and Costs

The Oregon Death with Dignity Act (ORS 127.800–127.897) lets a terminally ill adult ask a physician for a prescription they can take themselves to end their life. To use it, you must be at least 18, capable of making your own healthcare decisions, and diagnosed with an illness expected to cause death within six months.¹ The process is built around two oral requests, one written request, two physician confirmations, and a waiting period, with the right to change your mind at any point.

Who Qualifies

Three conditions must all be met. You must be 18 or older, capable of making and communicating healthcare decisions, and diagnosed with a terminal illness that a physician expects will cause death within six months.¹ “Capable” means you understand your diagnosis, your prognosis, the risks of the medication, and the alternatives available to you, such as hospice or comfort care.²

You do not have to live in Oregon. The state settled a lawsuit challenging its residency requirement, and House Bill 2279 formally repealed the residency language in 2023. Out-of-state patients can now participate if they meet the other criteria.¹

How to Make the Request

Start by making an oral request to your attending physician. At least 15 days later, make a second oral request. In between, submit a written request, signed and dated in front of two witnesses.²

Both witnesses have to attest that, to the best of their knowledge, you are capable, acting voluntarily, and not being pressured. At least one witness must be someone who is not related to you by blood, marriage, or adoption, would not inherit from you, and does not own or work at the facility where you receive care. Your attending physician cannot serve as a witness. If you live in a long-term care facility, one witness must be someone the facility designates.²

What the Doctors Must Do

Your attending physician confirms the terminal diagnosis, determines that you are capable and acting voluntarily, and makes sure you understand your diagnosis, prognosis, the risks of the medication, the probable result of taking it, and the alternatives.² They must refer you to a consulting physician, who independently confirms the diagnosis, the prognosis, and your capacity.

If either physician suspects that depression or another mental health condition is affecting your judgment, they must refer you to a psychologist or psychiatrist for evaluation before the process can move forward.¹ Your attending physician is also expected to recommend that you tell your next of kin, and to counsel you about having someone present when you take the medication and not taking it in a public place. Immediately before writing the prescription, they must verify one last time that you are making an informed decision.²

Waiting Periods

Under the standard timeline, at least 15 days must pass between your first oral request and the writing of the prescription. A separate 48-hour waiting period runs between your written request and the prescription.²

Since January 1, 2020, a patient whose death is imminent can bypass these waits. If the attending physician determines, in reasonable medical judgment, that you will die within 15 days of the first oral request, you can make the second oral request at any time. If you have fewer than 48 hours to live, the 48-hour gap between the written request and the prescription is also waived. When either waiting period is shortened, the physician must file a certified statement of imminent death in the medical record.¹

Taking the Medication

You must take the medication yourself. The Act explicitly prohibits lethal injection, mercy killing, and euthanasia; no physician or other person can administer it to you.¹ Your attending physician can dispense the medication directly (if licensed to do so) or send the prescription to a pharmacist, who must be told the intended use.² Receiving a prescription does not obligate you to use it, and many patients who fill the prescription never ingest it.

Changing Your Mind

You can withdraw your request at any time and in any manner. Your attending physician must tell you about this right and give you an explicit opportunity to rescind when you make your second oral request.²

Legal Status and Insurance

Actions taken under the Act do not constitute suicide, assisted suicide, mercy killing, or homicide under Oregon law.² The Oregon Health Authority recommends that physicians list the underlying terminal illness as the cause of death and mark the manner of death as “natural.”¹

An insurance company cannot require you to use the Act, and it cannot penalize you for choosing to do so. Because participation is not classified as suicide, it should not affect life insurance or health insurance benefits.³ Physicians, pharmacists, and anyone present when you take the medication are protected from civil liability, criminal prosecution, and professional discipline for participating in good faith.²

Forging a request, altering a completed request to change its meaning, or pressuring someone into requesting medication is a Class A felony,³ which carries a maximum sentence of 20 years in prison.⁴

What It Costs

The Act itself does not address who pays. Individual insurers decide whether to cover the process, as they would for any other medical procedure.¹

Federal coverage is a different story. The Assisted Suicide Funding Restriction Act of 1997 prohibits the use of federal funds for any healthcare service intended to cause or assist in causing death. That restriction reaches Medicare, Medicaid, Veterans Affairs medical care, the military health system, federal employee health benefits, and several other programs.⁵ If your coverage runs primarily through one of those programs, expect to pay out of pocket for the prescription itself, even when the rest of your end-of-life care is covered.

When a Provider or Facility Declines

No physician, pharmacist, or other healthcare provider is required to participate. A provider who is unwilling or unable to carry out your request must transfer your relevant medical records to a new provider on request.⁶

Healthcare facilities can go further and bar providers from participating on their premises, so long as they give notice of the policy in advance. A facility that has given notice can revoke privileges, terminate a lease, or end a contract if a provider participates on facility grounds anyway. Those sanctions are limited to the facility’s premises and do not reach a physician’s private office.⁶ If your primary physician or hospital will not participate, you have the right to seek out someone who will and to have your records transferred.

1
Oregon Health Authority. Frequently Asked Questions: Death with Dignity Act
2
Oregon State Legislature. Oregon Revised Statutes Chapter 127 – Powers of Attorney; Advance Directives for Health Care; Death With Dignity
3
Oregon State Legislature. Death with Dignity Act Background Brief
4
Public.Law. Oregon Revised Statutes 161.605 – Maximum Terms of Imprisonment for Felonies
5
Office of the Law Revision Counsel. 42 US Code 14402 – Restriction on Use of Federal Funds Under Health Care Programs
6
Oregon.gov. Death with Dignity Act – Oregon Revised Statute