Washington

Washington State issues 7th official report on doctor-prescribed suicide.  (August 2016)

Scroll down for official reports and for latest news articles.

Background

In 1991, by a vote of 54 to 46 percent, Washington State voters defeated Initiative 119, a measure that would have permitted doctors to provide euthanasia by lethal injection or assisted suicide by a prescription for an intentional lethal overdose of drugs.

After that, three attempts were made in the Washington State legislature to transform assisted suicide, which was a crime in Washington, into a “medical treatment.”  All three attempts failed.

In 2008, assisted-suicide proponents targeted the state for a massive effort to make Washington only the second state to approve assisted suicide.  With a voter initiative (I-1000)on the 2008 ballot, they succeeded, by a vote of 57.91 to 42.09 percent, in making it legal for doctors to help their patients commit suicide. The Washington initiative, patterned on Oregon’s assisted-suicide law, was spearheaded by Compassion and Choices (the former Hemlock Society).

The Washington law (RCW 70.245) went into effect in March 2009.

Washington’s Law Requires Physicians to Falsity Death Certificates. The law does not allow deaths resulting from doctor-prescribed suicide to be listed as assisted suicide.

Physicians are required to list the underlying terminal disease as the cause of death RCW 70.245.040 (2).

The Instructions for Physicians and other Medical Certifiers are explicit:
“If you know that the decedent used the Death with Dignity Act, you must comply with the strict requirements of the law when completing the death record:

  1. The underlying terminal disease must be listed as the cause of death.
  2. The manner of death must be marked as ‘Natural.’
  3. The cause of death section may not contain any language the indicates that the Death with Dignity Act was used.”

Words that are not permitted on the death certificate include: suicide, assisted suicide, physician-assisted suicide, death with dignity, Secobarbital, Seconal, Pentobarbital or Nembutal.

The instructions warn: “The Washington State Registrar will reject any death certificate that does not properly adhere to the requirements of the Death with Dignity Act.” Thus, unless the death certificate falsifies the real cause of death, it will not be accepted and the physician will be required to submit a new death certificate that hides the facts.

In 2011, Senate Bill 5378 was introduced.  It would have required death certificates to contain accurate information.  The bill did not pass.

……….

Seventh Annual Report on Doctor-Prescribed Suicide (8/16)

  • Top reasons reported for requesting doctor-prescribed suicide:
    Losing autonomy, less able to engage in activities making life enjoyable, loss of dignity, and burden on family, friends or caregivers. (p. 7)
  • 71% of patients who received the lethal prescription had only Medicare or Medicaid coverage. (p. 5)
  • Only 4% of patients receiving the prescription were referred for psychiatric or psychological evaluation. (p. 8)
  • The prescriptions were for an overdose of Seconal for 52% of patients,  Pentobarbital for 1% and Phenobarbital for 46% of patients. (p. 8)
  • The duration of the physician-patient relationship ranged from less than 1 week to 2 years. (p. 8)
  • Patients who died of doctor-prescribed suicide ranged in age from 20 to 97 years old (p. 1).

Sixth Annual Report on Doctor-Prescribed Suicide (8/6/15)

  • Top reasons reported for requesting doctor-prescribed suicide:
    Losing autonomy, less able to engage in activities making life enjoyable, loss of dignity, and burden on family, friends or caregivers. (p. 7)
  • 70% of patients who received the lethal prescription had only Medicare and/or Medicaid coverage. (p. 5)
  • Only 4% of patients receiving the prescription were referred for psychiatric or psychological evaluation. (p. 8)
  • The prescriptions were for an overdose of Seconal for 64% of patients and Pentobarbital for 36% of patients. (p. 8)
  • The length of the doctor-patient relationship was less than one week in one or more cases. (p. 8)

Fifth Annual Report on Doctor-Prescribed Suicide (6/4/14)

  • Top reasons reported for doctor-prescribed suicide:
    Concern about loss of autonomy, concern about loss of dignity, concern about loss of the ability to participate in activities that make life enjoyable. (p. 1)
  • More than half of deaths were of individuals who had only Medicare or Medicaid health insurance coverage. (p. 5)
  • Pentobarbital was the drug that caused 89% of doctor-prescribed suicide deaths. (p. 8)
    [Note: Pentobarbital has been the primary drug used for capital punishment]
  • The doctor who prescribed the drugs was present in only 2 of the 159 reported deaths. (p. 9)

Fourth Annual Report on Doctor-Prescribed Suicide (6/20/13)

  • The number of suicide prescriptions has increased each year since the law went into effect
  • 63% of patients who died reported concerns about being a burden
  • Only 3% of patients who received prescriptions for suicide were referred for psychiatric or psychological evaluation
  • In 4% of deaths, no information is available about whether complications occurred after taking the suicide prescription

Third Annual Report on Doctor-prescribed Suicide (5/2/12)

……….

Articles

“Suicide Groups Control Assisted Suicide in WA/OR”
(National Review — September 15, 2016)
In Washington, a suicide facilitating group boasts its volunteers “assisted 93% of all assisted suicides in the state.”

“‘Right to die’ drug in short supply”
(KIRO TV – Seattle — June 27, 2014)
“The pentobarbital supply has dried up”….[T]he drug’s European manufacturer has stopped exporting it to the U.S. because of opposition to the drug’s use in at least two botched executions in the Southwest.

“Terminally-ill patients face shortage of right-to-die drug amid controversy over capital punishment”
(Real Change News — June 18, 2014)
Compounding pharmacies began using the same drug, pentobarbital, for executions and for aid-in-dying.  This is where the trouble fore aid-in-dying began.

“Death with Dignity Act annual report shows a 43 percent rise in participation”
(Washington State Deptartment of Health press release — June 4, 2014)

“Assisted suicide is a soft sell in this affluent but aging Washington State community”
(National Post — November 26, 2013)
Dick Baker no longer practices family medicine, but he still makes house calls. The retired physician attends planned suicides….There is also a requirement that a patient must reside in Washington to obtain a lethal prescription. “I’ve heard there are ways around that,” said Dr. Baker, but he did not elaborate. “I’ve probably already said too much.”

“Hospice workers struggle on front lines of physician-assisted death laws”
(Medical Xpress — July 22, 2013)
A recent study of 33 hospice programs in Washington state found that laws that allow physician-assisted suicide in the Pacific Northwest have provisions to protect the rights of patients, doctors and even the state, but don’t consider the professionals most often on the front lines of this divisive issue — hospice workers who provide end-of-life care.

“Washington now leads in assisted suicides”
(Baptist Press — July 8, 2013)
Washington has become the No. 1 state for physician-assisted suicide.  Bioethicist C. Ben Mitchell took issue with the language in the report, describing it as “surreal.” Describing patients as “participants” in a law and lethal drugs as “medication” is “something right out of Aldous Huxley’s ‘Brave New World’ said Mitchell.

“83 died from assisted suicide in WA in 2012”
(KGW TV — June 20, 2013)
The state’s annual assisted suicide report shows a 17 percent jump in the number of people requesting lethal prescriptions in 2012 when compared to the previous year.

“Islanders question health center merger”
(Vashon-Maury Island Beachcomber — April 17, 2013)
The merger between the Highline Medical Center and Franciscan Health System has drawn controversy.  Advocates for end-of-life choice say they’re concerned that Catholic health systems interfere with the Death with Dignity Act, which Washington voters passed in 2008.

“Leading cancer centre in Washington state sets up assisted suicide program”
(Bioedge — April 13, 2013)
The leading cancer centre in Washington state has published in the New England Journal of Medicine a blueprint of how to implement a dying-with-dignity program, now that assisted suicide has been leglised…[The article] followed 40 patients….One took more than a day to die, an outcome which distressed his family and the doctor.

“PeaceHealth calls off partnership talks with Catholic Health Initiatives”
(News Tribune — April 3, 2013)
Of concern was how each followed the Ethical and Religious Directives for Catholic Health Care Services.  They said that could tighten access to provisions of the Death with Dignity law that allows the terminally ill to obtain a lethal dose of medication to hasten their dying. “PeaceHealth is not quite so strict,” said Robb Miller, executive director of Compassion and Choices of Washington.

“Bothell man gets 2 years for slaying terminally ill wife”
(Everett Herald — February 1, 2013)
Donald McNeely sat on the couch next to his sleeping wife.  For two hours he held a gun in his hand, contemplating what she’d asked of him….[Snohomish County Superior Court Judge Thomas] Wynne found that the defendant doesn’t pose a significant risk to the community and that his intentions were thought to be humanitarian, not criminal.  Additionally, the victim to a significant degree was a willing participant in the incident, the judge concluded.

“Group Health Teams With Hospital System In Pacific Northwest”
(Kaiser Health News — August 1, 2012)
Seattle-based Group Health Cooperative and the 32-hospital Providence Health & Services, a Catholic hospital system, are merging.  Robb Miller, executive director of Compassion & Choices of Washington said he hopes Group Health will take steps to protect patient choice regarding end-of-life options in the new network.
Note:  Compassion & Choices (the former Hemlock Society) promotes doctor-prescribed suicide as an end-of-life option.

“State Medicaid program to stop paying for unneeded ER visits”
(Seattle Times — February 7, 2012)
Starting April 1, Washington State medicaid will no longer pay for such visits, even when patients or parents have reason to believe they’re having an emergency.  Hospitals and doctors are pressing lawmakers to undo the policy.

“Perhaps it’s time to expand Washington’s Death with Dignity Act”
(The Olympian — November 16, 2011)
According to a Washington attorney, “To improve the chances of passage, the Death with Dignity Act was written to apply only to the choices of the terminally ill who are competent at the time of their death.”  He now suggests that consideration be given to expanding the law to “persons who are not terminally ill but suffering a severely debilitating medical condition” and to “persons who are not competent at the time of their death.”

“A Panel Decides Washington State’s Health Care Costs”
(New York Times – March 21, 2011)
Deryk Lamb who was crushed between two trucks in 1996 pleaded with a state health care board to continue paying for the spinal injections he receives to dull the pain from a workplace injury. “I don’t deserve to be sentenced by a committee to a life of agony,” he said.  The committee chair denies that its actions amount to rationing.

Washington State Releases Second Annual Report on Assisted Suicide (3/11/11) (PDF)
Of the doctor-prescribed suicide deaths reported, only 2 patients were referred for psychiatric/psychological evaluation. Most patients (90%) reported that losing autonomy was their main end of life concern.

Reported Assisted-Suicide Deaths in Oregon & Washington State – April, 2010 – Chart (PDF)

Washington State Releases First Annual Report on Assisted Suicide (3/4/10)

When Washington released its first annual report, one editorial favorably noted that the deaths saved money for families.    Another“celebrated” the deaths.  Certainly, it’s true. Dead family members don’t cost money.  But celebrating their deaths costs us all our humanity. (3/6/10)

Text of Washington Death with Dignity Act

Analysis of Initiative 1000, Washington’s assisted-suicide initiative.

Ads against Initiative 1000 feature actor Martin Sheen.

Funding Watch: Assisted-suicide advocacy groups provide major funding for I 1000.

Audio – Rita Marker on I-1000 (The New Atlantis 10/22/08)

Washington Not Dead Yet blog

Disability Rights Education & Defense Fund (DREDF)

Debate about I-1000 (video)
Debate, sponsored by the University of Washington Evans School of Public Affairs, features Duane French and Booth Gardner.   

Articles
“Physician-Assisted Suicide in Oregon and Washington”
(Living and Dying Well — UK — December 13, 2012)
A report published today in Living and Dying Well updates its 2010 survey of Oregon’s assisted suicide law and extends this to include official data on the working of Washington State’s similar law.  The report concludes that “there are lessons to be learned from Oregon’s and Washington’s experience of licensing physician-assisted suicide” and that “these are too important to be bushed under the carpet with assurances that all is well.”  Full text of report

“MV nursing home accused of abuse”
(Skagit Valley Herald, Mt. Vernon, WA — April 7, 2011)
A state agency has placed a hold on admissions at Life Care Center of Mount Vernon after an annual survey found “serious deficiencies” in care and cases of abuse at the facility….. The statement says the facility’s staff failed to ensure residents’ well-being by allowing two employees with records of abuse to continue working with residents while not fully investigating some claims of abuse.
Note: On May 3, 2011 the state agency placed an additional “stop placement” hold on another Skagit Valley Life Care Center, this one in Sedro Wooley.

“Man’s letter to Cowlitz County sheriff on the day he died shows the burdens we carry to the bitter end”
( The Oregonian – – October 23, 2010 )
Prior to his doctor-prescribed death under Washington State’s assisted suicide law, William B. F. Price wrote a letter to the Cowlitz County sheriff. “I will die in accord with Washington’s Death with Dignity Act at 9 a.m. today,” he wrote. His letter focused on what he deemed to be a poor investigation of the damage done to his car in March.

“ObamaCare High School: Reading, Writing, and Suicide Assistance?”
( American Thinker – WA, USA- April 14, 2010 )
In Washington State, an 18-year-old high school senior could be “qualified” for assisted suicide at a school-based health clinic. Within two weeks, she could be referred to an assisted suicide advocacy group and provided with a prescription for a lethal drug overdose. She could take it. And die – without her parents even knowing she was ill. It would all be perfectly legal. More

“Support Group Speaker Promotes Assisted Suicide”
When the pulmonary rehab therapist suggested a support group, a Washington State couple didn’t expect a speaker from an assisted-suicide advocacy group who would promote assisted suicide.

“Dial 911 for Suicide Assistance?”
( American Thinker – WA, USA – September 28, 2009 )
If a suicidal cancer patient calls 911 in Washington State, will she be provided with all “end-of-life options,” including a referral to the assisted-suicide advocacy group, Compassion & Choices? More

“‘Death with Dignity’: What Do We Advise Our Clients?”
( King County Bar Association – Seattle, WA USA – May, 2009 )
If a client wants to know about the Death with Dignity Act (Washington’s new assisted-suicide law), should an attorney take the politically correct path? Or should she do her job as a lawyer and tell the client that the Act has problems and that he may want to take steps to protect himself? More

“Letter noting assisted suicide raises questions”

( KATU – Springfield, Oregon USA – November 20, 2008 )
Her doctor offered hope in the new chemotherapy drug Tarceva, but the Oregon Health Plan sent her a letter telling her the cancer treatment was not approved. Instead, the letter said, the plan would pay for comfort care, including ”physician aid in dying,” better known as assisted suicide.  Video More

“Terminal Uncertainty”
(Seattle Weekly – January 14, 2009)
In Oregon, of the 341 people who put themselves to death as of 2007, 17 did so between six months and two years after getting their prescription….It’s one thing o make a six-month prognosis that will allow patients access to hospice services and quite another to do so for the purpose of enabling patients to kill themselves. The consequences of being wrong are pretty different.

“Washington’s New Suicide Law Reflects Unfair Prejudices”
( The Hastings Center – Bioethics Forum – Jan/Feb, 2009 )
The problem with physician-assisted suicide is that it presumes euthanasia is a rational choice for someone in dire straits, based solely on that person’s diagnosis. If, on the other hand, a healthy, able-bodied person requests a doctor’s aid in death, what happens? Antidepressant medication or psychological counseling will likely by prescribed. More

“Washington State Voters Legalize Physician-Assisted Suicide” (NWV, 11/24/08)
“We’re tired of being the sprouts-chewing liberals out in Oregon…We need another state.”

“I-1000 could remove personal choice,” writes former Washington Governor John Spellman.
(Seattle Post-Intelligencer, Oct. 21, 2008)

“An Open Letter to Baroness Warnock on Assisted Suicide” (American Thinker; Oct. 4, 2008)
When she said people with Alzheimer’s should be able to appoint someone to request euthanasia for them, Britain’s leading medical ethicist, Baroness Mary Warnock, caused a firestorm of controversy. A similar, but little known, proposal was made by those in the forefront of Oregon’s assisted-suicide law and the current Washington State initiative to legalize assisted suicide.

“Oregon’s Suicidal Approach to Health Care” (American Thinker; Sept. 14, 2008)
Oregon seems to have found a surefire way to lower health care costs:  Tell the patient you’ll pay for drugs that will end her life, but not those that would extend her life.”  Now, Oregon assisted-suicide activists are trying to bring the Oregon experience to Washington.

“Proposal is reckless, unnecessary” (Seattle Post-Intelligencer, 8/25/08)
In the past, Rheba De Tornyay, dean and professor emeritus of the University Washington School of Nursing, “robustly supported” assisted suicide and euthanasia.  Now she opposes Washington’s assisted-suicide initiative because “a profit-preoccupied medical establishment, combined with emotionally and financially stressed families, would press them to accept death, regardless of the heralded safeguards laws would contain.”

“The indignity of I-1000:  Backers’ claims misleading” (Seattle Times, 8/20/08)
“Up until two months ago, I had no strong opinion on the proposed Death with Dignity Act, which is on the ballot as Initiative 1000.  That was, until I read its actual language.”

“Booth Gardner:  Tribute or fundraiser?” (Seattle Post-Intelligencer, 8/20/08)
A September “Dinner of Appreciation” for former Governor Booth Gardner, with tickets starting at $20,000, may be a thinly veiled fundraiser for Washington’s assisted-suicide initiative.

“Letter noting assisted suicide raises questions” (KATU TV; Portland, OR; July 31, 2008)
Interview with Barbara Wagner who was denied chemotherapy, but offered assisted suicide, by the Oregon Health Plan.  Includes link to video interview.
More on assisted suicide in Oregon.

“Assisted suicide gets push from out of state”
Portland Oregon based Death with Dignity National Center’s annual report tells the tale of its behind the scenes manipulation of Washington State’s assisted-suicide initiative.
(Seattle Post-Intelligencer, 7/28/08)

“‘Assisted suicide’ describes initiative correctly”
Washington state supporters of I-1000 complained that the measure should not be described as an assisted-suicide proposal.  However, the Associated Press and newspapers will continue to refer to it as “assisted suicide.”
According The Olympian’s executive editor, “the phrase [assisted suicide] is a simple, accurate description of the proposal.  We recognize there are negative connotations attached to the word suicide, but its definition is clear – the act of taking one’s own life voluntarily and intentionally.”
(The Olympian, 7/15/08)

“A matter of life and death for state’s voters” (Seattle PI, 5/27/08)
Kathryn Tucker, an advocate of the Oregon law described those in the assisted-suicide movement as people of “affluence” and “high education.”

“Oregon’s Trojan Horse”
“If other states refused to pass laws patterned on Oregon’s current, seemingly restrictive law, it was a sure bet that they’d be even less inclined to follow Oregon’s lead if it were to be expanded.”

“Suicide as a Medical Treatment”
Assisted-suicide campaign spokesperson admits it’s only intended to be the “first step.”

“I-1000 campaign seeks to sell voters on death” (Seattle P-I, 3/30/08)
“If you are campaigning for the ‘right’ of people to kill themselves, the first challenge is finding a nonlethal definition: Soft reassuring terms must be substituted for the off-putting phrase ‘assisted suicide.'”

“Gardner crusade is a selfish last act” (Seattle P-I, 1/11/08)
Why Booth Gardner’s “last campaign is harmful to the sick, the disabled, the vulnerable…and society.

“Unlike father, unlike son” The Gardners are split on ‘death with dignity” (Crosscut, 1/11/08)

“Just don’t call it suicide, initiative’s backers say” (Seattle Times, 1/9/08)
Assisted-suicide activists want to avoid the word “suicide” when discussing their proposal.

“Former Gov. Gardner becomes assisted suicide’s advocate” (Herald, Everett, WA, 1/6/08)
Filing of the assisted-suicide measure is expected to take place on Wednesday, January 9.  Supporters set up a campaign committee last year and had raised $253,000 by Dec. 1.

“Death in the Family” by Daniel Bergner (The New York Times Magazine, 12/2/07)
“Booth Gardner, a former governor of Washington State who has Parkinson’s, is urgently lobbying for a doctor-assisted-suicide law.” “Gardner’s campaign is a compromise; he sees it as a first step.  If he can sway Washington to embrace a restrictive law, then other states will follow.  And gradually, he says, the nation’s resistance will subside, the culture will shift and laws with more latitude will be passed…”

“Physician-assisted suicide symptom of broken system
(The Olympian, Olympia, Washington, 9/28/07)
Washington State disability rights activist Joelle Brouner explains why Washington is no place for Oregon-style assisted suicide. “Is it so great a leap to think that a system with a record of perpetuating bias could abuse its power to promote death as a management strategy to achieve cost savings?”

“Ex-governor seeking death with dignity” (Seattle Post-Intelligencer, 5/18/07)
Ex-governor Booth Gardner pledges to fight to legalize assisted-suicide.

“Gardner: I’ve thought about the end” (Seattle Times, 2/10/06)
Former governor wants to legalize assisted suicide but doesn’t want the word “suicide” used to describe it.