Lethal dose waiting, doctor dies after stopping dialysis

Oregon's Dr. Willeford was heralded by some for bringing credibility to assisted suicide; others say personal choice was his real cause.

By Andis Robeznieks, amednews staff. Nov. 17, 2003.

Allison B. Willeford, MD, 79, a former family physician, surgeon and an activist for Oregon's physician-assisted suicide law, died in his home Oct. 23, about six days after deciding to discontinue dialysis.

Dr. Willeford received attention for publicizing his decision to go through his state's physician-assisted suicide process and obtain a lethal prescription for Nembutal. In the end, he decided not to take it. After his death, his son Tom said the lethal drug went down the drain along with his father's supply of Roxanol and oxycodone.

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Although Dr. Willeford's activism put him under the media spotlight, Tom Willeford said his father didn't talk much about assisted suicide. During his final days, the issue was never discussed. "I really did not think of his dose of Nembutal, and he didn't bring it up at all," said Tom Willeford, a registered nurse. "He got a lot of press coverage, but he didn't talk about it much with friends and family. He told me about it after he made the decision" to go through the process.

The process includes being diagnosed by two doctors as having less than six months to live. Physicians can refer patients to a psychiatrist if they judge them to be mentally impaired. Dr. Willeford scoffed at notions that people considering assisted suicide must be clinically depressed.

"If you're dying and with all the suffering you're going through, there'd be something wrong with you if you weren't depressed," Dr. Willeford said earlier this year. "I'm not talking about being clinically depressed but, if you're dying, there's very little that can make you happy."

After obtaining his Nembutal, Dr. Willeford complained about its cost and told people he didn't know if he would ever take it. First, he said, the drug is known for tasting so bitter that he didn't think he'd be able to swallow it, and, second, he said he might be too "chicken" to take it.

"I don't think he had much of a mind to hasten his death," Tom Willeford said. "He just didn't like [U.S. Attorney General John] Ashcroft or the government or anyone else interfering with his personal life."

Willeford said his father, who had kidney cancer, went for dialysis every Tuesday, Thursday and Saturday. It was during his dialysis treatment on Tuesday, Oct. 16, that his pain intensified and his health took a sharp turn for the worse. He skipped his Thursday treatment and was visited by his physician and former partner Frank R. James, MD, the next day.

"While Dad was still oriented, Dr. James asked him, 'What do you think about dialysis tomorrow?' and Dad just said no," Tom Willeford said. "That day he decided to stop."

Dr. James said discontinuing dialysis was something that had been discussed. "I talked to him about a month before he passed away. He said he was still willing to continue dialysis because he didn't want to quit yet."

According to the physician-assisted suicide advocacy group, Compassion in Dying of Oregon, at least five other physicians have obtained a lethal prescription, but Dr. Willeford was the first to do so publicly. He also became the second physician to obtain the prescription and not use it.

According to Oregon Dept. of Human Services statistics, 198 lethal prescriptions have been written and 129 have been taken in the five years assisted suicide has been legal.

"It is common that people who start the process don't complete it, but they want the option," said George Eighmey, executive director of Compassion in Dying of Oregon. "It gives them comfort and peace of mind knowing that, worse comes to worse, they have the option."

Eighmey said Dr. Willeford's position as an educated person and physician helped give "credibility" to the idea that assisted suicide was a needed option for terminally ill patients.

Dr. James said his former partner and mentor was probably more energized over concerns about personal freedom than assisted suicide. "He thought it should be his choice and not the choice of some politician in Washington telling him what to do," Dr. James said. "He wasn't on the bandwagon to get people to do it."