Last November Washington State passed a death with dignity law. The law, which went into effect on March 5, 2009, allows a competent adult and resident of Washington State to end his or her life. The person must be suffering from a terminal disease as determined by the attending physician and a consulting physician, and voluntarily express his or her wish to die.
Here’s the probable order of events:*
- The patient makes an initial oral request for the medication;
- The patient must then wait 15 days;
- Next, the patient makes a written request signed by patient and witnessed;
- The attending physician evaluates the patient to determine the diagnosis is terminal, and that the patient is competent and is making the request voluntarily;
- A consulting physician makes an identical evaluation, if they concur the request can proceed;
- The patient is referred for counseling by a licensed psychiatrist or psychologist if either physician deems appropriate;
- The attending physician must then give the patient the express opportunity to rescind the request;
- The patient must reiterate orally his/her request after he/she is given express opportunity to rescind; and
- The prescription is written, filled and the patient “takes” the prescribed medication.
*The timeline outlined above is anything but clear. The statute could be read to allow an oral request coupled with a simultaneous written request, then a 15-day waiting period, reiteration of the request orally and finally, writing the prescription. Under such a reading, the 48 hour wait period is subsumed into the 15 day period not added to it. This interpretation would give effect to both waiting periods, just not the way most people would probably think.
Washington’s statute is anything but perfect. While there are many safeguards, some problems do exist. One significant problem is the lack of control or guidance as to what happens after the medication is prescribed. There is no prescribed time or location to take the medication, no one has to witness the “self-administration”, and while one must have capacity all through the request process, there is no requirement of capacity at the moment of administering the medication. Moreover, while the language of Washington’s law seems to imply that only the patient can administer the medicine to himself/herself, another party could in fact give the medication due to the definition of “self-administration.”
It is only appropriate that we counsel clients on all ramifications of Washington’s Death with Dignity Law and allow them to decide how to proceed.
