Washington voters approved the Washington Death with Dignity Act in November 2008, which went into effect on March 5, 2009, and allows Washington residents who are terminally ill to request medication to end their life.
The most recently available Death with Dignity Act Report for the year 2020, published by the Washington Department of Health’s Center for Health Statistics, reports that 340 individuals received life-ending medication under the Act in the year 2020. Of those patients, 334 of them are known to have died, with 252 (about 75%) dying after taking the medication and 41 (about 12%) dying without taking the medication (it’s unknown whether the remaining patients took the medication). The average age of the patients was 73 years old. For context, in 2010 (the first full year that the Act was in effect), the Department of Health reported that 87 individuals received life-ending medication under the Act.
Patient Requirements Under The Act
The Act requires the individual requesting the medication to be a competent person who is at least 18 years old, resides in Washington, and has been diagnosed as terminally ill with less than six months to live. In particular, the patient must be diagnosed with an incurable and irreversible disease that will, within reasonable medical judgment, cause death within 6 months.
A patient can establish themselves as a Washington resident by showing a Washington driver’s license, proof that they are registered to vote in Washington, or evidence that they own or rent property within the state.
Under the Act, the patient must first verbally request the medication, and then make the request in writing. The Washington State Department of Health provides a form “Request for Medication to End My Life in a Humane and Dignified Manner” on its website to make this request. The patient’s written request for the medication must be signed by the patient and witnessed by two people, one of whom cannot be a relative, a beneficiary of the patient’s estate, or an employee of a health care facility where the patient is receiving care. The patient’s physician also cannot serve as one of the witnesses. After at least 15 days have passed since the first verbal request was made, the patient must then again verbally request the medication.
Once the required requests are made, the Act requires the prescribing doctor to offer the patient an opportunity to rescind the request. If the patient does not rescind their request, so long as it has been at least 48 hours since the written request was made, then the prescription for the life-ending medication can be written. The prescription can only be written by a doctor of medicine or osteopathy who is licensed to practice medicine in Washington.
However, doctors and pharmacists are not required to participate in prescribing or filling a life-ending medication, since participation in the Act is voluntary. Doctors and pharmacists (or the facilities they work for) can refuse to provide a prescription and/or the medication to a terminally ill patient. Doctors who do write a prescription for life-ending medication under the Act and pharmacists who fill such a prescription are required to submit several forms to Washington’s Center for Health Statistics. The Act provides that health care providers who participate in the Act in good faith are protected from civil and criminal liability and professional disciplinary action.
While the Act requires the patient’s physician to recommend that the patient notify their family of their choice to request the life-ending medication, the patient is not required to do so.
The patient’s doctor must recommend that the patient take the life-ending medication with another person present and not take it in a public place. The patient must self-administer the medication, and after death, the patient’s Death Certificate will list their underlying condition as the cause of death. There are also specific rules for disposing of any unused life-ending medication.
If you have any questions about the Washington Death with Dignity Act, the Department of Health recommends reaching out to your health care provider or contacting an end-of-life resource, a few options for which are provided on the Department of Health’s website, here.
Other end-of-life planning options, like Durable Powers of Attorney, Health Care Directives, and Instructions Regarding Disposition of Remains, may also be something to consider, depending on your personal circumstances and wishes. If you are interested in having any of these end-of-life documents in place, reach out to an attorney in our estate planning practice group, including Ryan Montgomery or Allison Int-Hout.