Physician Assisted Suicide (PAS)

Year 2008: I-1000: Background,
text, support and opposition

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Background:

All previous attempts to legalize PAS in Washington via an initiative, court action and legislation all failed. The Washington death with dignity act allows a patient to request aid in dying from their physician, subject to many restrictive requirements and precautions. It was presented to the voters in the form of an Initiative on election day in 2008-NOV. ₁

The act requires that the patient must initiate the process. There are procedures set up to make certain that the patient is not seeking an end to life because they are simply depressed. They must be terminally ill with a very short life expectancy before qualifying to receive a fatal dose of medication.

Text of the Initiative:

The following is an abbreviated form of the Act. If you are affected directly by the Act, we recommend that you consult its precise wording rather than the following interpretation:

	They must be competent and over the age of 18.
	They must be capable of ingesting the medication without assistance.
	Their attending physician and a consulting physician determine that the patient is suffering from a terminal illness and has voluntarily expressed a wish to die.
	Their life expectancy must be less than 6 months.
	The patient must have made an oral request for assistance in dying.
	The patient must sign and date a written request for assistance in dying. It must be witnessed by at least two individuals who must meet specific requirements.
	The patient must prove their residency in the state.
	The patient must be fully informed of their diagnosis, prognosis, potential risks and probable results of taking the medication.
	The patient must be informed of alternatives: e.g. comfort care, hospice care, pain control.
	The patient may cancel their request at any time.
	The patient must wait for 15 days.
	If either the consulting or attending physician suspect that the patient is suffering from depression or other disorder causing impaired judgment, either physician shall refer them for counseling instead of granting their request for assistance in dying.
	Only a fatal dose of oral medications can be prescribed. Ending a patient's life by lethal injection is not allowed.
	Physicians are free to refuse their patient's request for assistance in dying. 7

Groups that supported the Initiative:

The official group promoting Initiative 1000 was originally called "It's My Decision." Their name was later changed to "YES on 1000."

Compassion and Choices, formerly called the Hemlock Society, was the group mainly responsible for promoting the initiative. It was patterned after the successful Oregon law. ₂

Former governor Booth Gardner, and the National Death with Dignity Center were also heavily involved, as were other state and national organizations: the American Medical Student Association, the American Medical Women's Association, the Lifelong AIDS Association, the ACLU, the National Women's Law Center, the Washington Chapter of the National Association of Social Workers, and the Washington State Public Health Association. ₃

According to Wikipedia, some comments in support of the initiative were:

	State Senator Darlene Fairley, chairperson of the Death with Dignity Disabilities Caucus, said: "As a matter of personal control and autonomy, it makes sense to let patients themselves decide what kind of medical care they want to receive and how long they want to suffer with a terminal illness."
	State Representative Jamie Pedersen, chair of LGBT for 1000, said that: "People facing terminal illnesses gain peace of mind from knowing that their end-of-life choices will be respected. Everyone deserves that respect and can appreciate its importance."
	The Washington State Psychology Association was neutral on I-1000, but found that:  "... patients choose aid in dying because of a desire for autonomy and the wish to avoid loss of dignity and control, not because of a poor mental state, lack of resources or social support." They also concluded that: "The law has had a positive effect in terms of significant improvements in palliative care."
	The Newcastle News endorsed the measure in a 2008-OCT-07 editorial. It said: "Some opponents of I-1000 will refer to the life-death option as assisted suicide, but this has no resemblance to suicide. It is a humane end to a life that is already ending." 3

Groups that opposed the Initiative:

The Coalition Against Assisted Suicide opposed Initiative 1000. It consisted of individuals and groups including the Roman Catholic Church, various pro-life groups, conservative Protestant groups, and those who advocate for minorities, the disabled, and the poor. They oppose allowing terminally ill people to chose to hasten their death. A main objection is that the Initiative would put lethal pressure on the disabled, poor and other minorities to end their lives early. The Coalition stated that:

"Assisted suicide directly threatens the lives of the most vulnerable people in our culture. People with disabilities, the dependent elderly, those who live with depression and mental illness and the poor are all directly threatened by assisted suicide in Washington State and elsewhere." ₄

Many national disability organizations opposed Initiative 1000 as well, including the National Council on Disability (NCD), National Council on Independent Living (NCIL), National Spinal Cord Injury Association, Not Dead Yet (NDY) and American Association of People with Disabilities (AAPD).

The Washington State Medical Association was also opposed. Its president, Brian P. Wicks, MD, said:

"We believe physician-assisted suicide is fundamentally incompatible with the role of physicians as healers. Patients put their trust in physicians and that bond of trust would be irrevocably harmed by the provisions of this dangerous initiative. ...The initiative is a dangerous distraction from symptom-directed end-of-life care that provides comfort for dying patients and their families. Our focus should remain on caring for terminally ill patients and should never shift toward helping them kill themselves." ₅

Hollywood actor Martin Sheen expressed his opposition to Initiative 1000. He said:

"I try to work when I'm not on the screen to help improve conditions for the most vulnerable people in our country -- low-wage workers, immigrants, the disabled and the poor. We have a health care system where the more money you have, the better medical care you receive. Initiative 1000 is a dangerous idea --- because so many people do not have the money necessary to get the care they need. When I heard about Initiative 1000, I wanted to help stop it before it harms people who are at risk.

This topic continues in another essay

References used:

The following information sources were used to prepare and update the above essay. The hyperlinks are not necessarily still active today.

1. Text of "The Washington Death with Dignity Act: Initiative Measure No. 1000," Washington Secretary of State, at: http://www.secstate.wa.gov/ This is a PDF file.
2. "Washington State," International Task Force on Euthanasia and Assisted Suicide, 2009, at: http://www.internationaltaskforce.org/
3. "Washington Initiative 1000 (2008). Wikipedia, 2009-MAR-04, at: http://en.wikipedia.org/
4. Home page of The Coalition Against Assisted Suicide, at: http://www.noassistedsuicide.com/
5. "True compassion advocates: The Coalition Against Assisted Suicide; Supporters," at: http://www.noassistedsuicide.com/

Up-to-date information:

The Death with Dignity National Center tracks bill activity at the state, national and international level. See:  http://www.deathwithdignity.org/

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Last updated 2009-AUG-17
Author: Bruce A Robinson

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