Clients sometimes ask me whether they can authorize their healthcare agent (named in their advance directives or medical powers of attorney) to, essentially, euthanize them if their quality of life becomes intolerable.  The answer is no, that would be considered murder, at least the way the laws are written today.  They ask if they can pre-authorize a doctor to do so.  No, murder again. 

They then ask about the so-called Death With Dignity laws in the states that have them (California, Colorado, Hawaii, New Jersey, Oregon, Vermont, Washington and the District of Colombia), which allow residents to end their lives under certain circumstances. Generally, the person must be (1) diagnosed with a terminal illness that will lead to death within six months (as determined by an attending physician), (2) at least eighteen (18) years old, (3) a resident of the state, (4) capable of communicating health care decisions for him or herself.  To invoke the law, the person must make two oral requests, at least fifteen days apart, plus he or she must provide a written request to the attending physician; and a consulting physician must confirm the attending physician's diagnosis, among other detailed requirements.

While some people are strongly opposed to such laws, other feel they do not go far enough.  Keep in mind, the patient must be able to take the medication, orally, on his or her own accord.  Some people with degenerative diseases, such as Alzheimer's, ALS, Huntington's disease, oral and laryngeal cancers, strokes, or Parkinson's disease, may never be able to use it because they are not considered "terminally ill", having post-diagnosis life expectancies of more than six months.  By the time their life expectancy is less than six months, they may no longer be able to verbalize their wishes or may not be able to physically manage swallowing the prescription.

Some states are pushing to allow an agent to elect for Death With Dignity for the terminally ill patient who is no longer able to make his/her wishes known verbally. 

Canada has Death With Dignity laws which allow physicians to administer the medication to those patients who are unable to do so on their own and does not require the request to be made within a certain time frame.

For the time being, because the laws require the terminally ill individual to make a verbal request, an advance directive/medical power of attorney cannot legally authorize a Health Care Agent to make a request under the DWDA for the terminally ill individual.