Washington Initiative 1000 (2008)
Encyclopedia
Initiative 1000 of 2008 established the U.S. state
of Washington's Death with Dignity Act (RCW
70.245), which legalizes physician-assisted dying with certain restrictions. Passage of this initiative
made Washington the second U.S. state to permit some terminally ill
patients to determine the time of their own death. The effort was headed by former Governor Booth Gardner
.
The measure was approved in the November 4, 2008 general election. 1,715,219 votes (57.82%) were cast in favor, 1,251,255 votes (42.18%) against. There were 2,966,474 votes total. 30 of the state's 39 counties voted in favor of the initiative.
In 1991, the similar initiative
119 was rejected by Washington voters by a margin of 54 percent to 46 percent. I-119 would have allowed doctors to prescribe a lethal
dosage of medication, and also to administer it if the terminally ill patient could not self-administer.
Unlike that initiative, I-1000 requires the patient to ingest the medication unassisted.
The initiative is based on Oregon Measure 16
, which Oregon
voters passed in 1994. Oregon is the only state to have enacted similar legislation, and overwhelmingly re-approved it after the Oregon State Legislature referred a repeal of it to voters in 1997.
, adult Washington residents medically predicted to die within six months to request and self-administer lethal medication prescribed by a physician. The measure requires two oral and one written request, two physicians to diagnose the patient and determine the patient is competent, a waiting period, and physician verification of an informed patient decision. Physicians, patients and others acting in good faith compliance would have criminal and civil immunity."
Provisions in the law include:
. aid-in-dying advocates from Oregon, the Death with Dignity National Center
, Compassion & Choices (national), Compassion & Choices of Washington, Compassion & Choices of Oregon. The name of the official political advocacy group working on the campaign was changed from "It's My Decision" to "YES on 1000".
State Senator Darlene Fairley
, who chairs the Death with Dignity Disabilities Caucus, said that "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, "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." Organizations that supported I-1000 include 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.
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," and "the law has had a positive effect in terms of significant improvements in palliative care."
The Newcastle News endorsed the measure in a Oct. 7, 2008, editorial. "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," the editorial said.
workers, minorities, right-to-life organizations, Christian
organizations, the Catholic Church, and politicians from both sides of the aisle. A more comprehensive look at the opposition to I-1000 can be found at the Coalition's website.
The organization held that the danger of making doctors the agents of a patient's death far outweighed any advantages to assisted suicide, or safeguards in the initiative's text. They felt that legalization of assisted suicide would put pressure on minorities, the disabled, and the poor.
Actor Martin Sheen
appeared in television ads opposing Initiative 1000. There has been some debate over one of Sheen's statements: persons with depression can be given a lethal dose without prior professional assessment. According to the Washington Death with Dignity act, "Medication to end a patient’s life
in a humane and dignified manner shall not be prescribed until the person performing the counseling determines
that the patient is not suffering from a psychiatric or psychological disorder or depression causing impaired
judgment." This issue has been explored in the field of medical ethics.
Not Dead Yet, a disabilities advocacy group which joined with the Coalition Against Assisted Suicide, objected to the measure, arguing that it discriminates against and targets the disabled. They believe that disabled people who are worried they will become a burden to their families need help and pain relief for their conditions, not encouragement to die.
U.S. state
A U.S. state is any one of the 50 federated states of the United States of America that share sovereignty with the federal government. Because of this shared sovereignty, an American is a citizen both of the federal entity and of his or her state of domicile. Four states use the official title of...
of Washington's Death with Dignity Act (RCW
Revised Code of Washington
The Revised Code of Washington is the compilation of all permanent laws currently in force in the U.S. state of Washington. Temporary laws such as appropriations acts are excluded....
70.245), which legalizes physician-assisted dying with certain restrictions. Passage of this initiative
Initiative
In political science, an initiative is a means by which a petition signed by a certain minimum number of registered voters can force a public vote...
made Washington the second U.S. state to permit some terminally ill
Terminal illness
Terminal illness is a medical term popularized in the 20th century to describe a disease that cannot be cured or adequately treated and that is reasonably expected to result in the death of the patient within a short period of time. This term is more commonly used for progressive diseases such as...
patients to determine the time of their own death. The effort was headed by former Governor Booth Gardner
Booth Gardner
Booth Gardner , an heir to the Weyerhaeuser fortune, was the 19th Governor of the U.S state of Washington between 1985 and 1993. He also served as the ambassador of the GATT. He is a Democrat. Before serving as governor, Gardner was Pierce County Executive...
.
The measure was approved in the November 4, 2008 general election. 1,715,219 votes (57.82%) were cast in favor, 1,251,255 votes (42.18%) against. There were 2,966,474 votes total. 30 of the state's 39 counties voted in favor of the initiative.
In 1991, the similar initiative
Initiative
In political science, an initiative is a means by which a petition signed by a certain minimum number of registered voters can force a public vote...
119 was rejected by Washington voters by a margin of 54 percent to 46 percent. I-119 would have allowed doctors to prescribe a lethal
Death
Death is the permanent termination of the biological functions that sustain a living organism. Phenomena which commonly bring about death include old age, predation, malnutrition, disease, and accidents or trauma resulting in terminal injury....
dosage of medication, and also to administer it if the terminally ill patient could not self-administer.
Unlike that initiative, I-1000 requires the patient to ingest the medication unassisted.
The initiative is based on Oregon Measure 16
Oregon Ballot Measure 16 (1994)
Measure 16 of 1994 established the U.S. state of Oregon's Death with Dignity Act , which legalizes physician-assisted dying with certain restrictions. Passage of this initiative made Oregon the first U.S...
, which Oregon
Oregon
Oregon is a state in the Pacific Northwest region of the United States. It is located on the Pacific coast, with Washington to the north, California to the south, Nevada on the southeast and Idaho to the east. The Columbia and Snake rivers delineate much of Oregon's northern and eastern...
voters passed in 1994. Oregon is the only state to have enacted similar legislation, and overwhelmingly re-approved it after the Oregon State Legislature referred a repeal of it to voters in 1997.
Specific provisions in the initiative
The official ballot summary for the measure, slightly amended following a February 2008 court challenge, is, "This measure would permit terminally ill, competentCompetence (law)
In American law, competence concerns the mental capacity of an individual to participate in legal proceedings. Defendants that do not possess sufficient "competence" are usually excluded from criminal prosecution, while witnesses found not to possess requisite competence cannot testify...
, adult Washington residents medically predicted to die within six months to request and self-administer lethal medication prescribed by a physician. The measure requires two oral and one written request, two physicians to diagnose the patient and determine the patient is competent, a waiting period, and physician verification of an informed patient decision. Physicians, patients and others acting in good faith compliance would have criminal and civil immunity."
Provisions in the law include:
- The patient must be an adult (18 or over) resident of the state of Washington
- The patient must be mentally competent, verified by two physicians (or referred to a mental health evaluation)
- The patient must be terminally ill with less than 6 months to live, verified by two physicians.
- The patient must make voluntary requests, without coercionCoercionCoercion is the practice of forcing another party to behave in an involuntary manner by use of threats or intimidation or some other form of pressure or force. In law, coercion is codified as the duress crime. Such actions are used as leverage, to force the victim to act in the desired way...
, verified by two physicians - The patient must be informed of all other options including palliative and hospice care
- There is a 15 day waiting period between the first oral request and a written request
- There is a 48 hour waiting period between the written request and the writing of the prescription
- The written request must be signed by two independent witnesses, at least one of whom is not related to the patient or employed by the health care facility
- The patient is encouraged to discuss with family (not required because of confidentiality laws)
- The patient may change their mind at any time and rescind the request
- The attending physician may sign the patient's death certificate which must list the underlying terminal disease as the cause of death
Supporters
The campaign was run by a coalition that includes former Washington governor, Booth GardnerBooth Gardner
Booth Gardner , an heir to the Weyerhaeuser fortune, was the 19th Governor of the U.S state of Washington between 1985 and 1993. He also served as the ambassador of the GATT. He is a Democrat. Before serving as governor, Gardner was Pierce County Executive...
. aid-in-dying advocates from Oregon, the Death with Dignity National Center
Death with Dignity National Center
Death with Dignity National Center is a nonprofit organization located in Portland, Oregon which has led the defense of and education about Death with Dignity laws throughout the US...
, Compassion & Choices (national), Compassion & Choices of Washington, Compassion & Choices of Oregon. The name of the official political advocacy group working on the campaign was changed from "It's My Decision" to "YES on 1000".
State Senator Darlene Fairley
Darlene Fairley
Darlene Cook Fairley was a member of the Washington State Senate from 1995 to 2011 representing the 32nd District. In the Senate, she chaired the Government Operations and Elections Committee.Fairly earned in B.S...
, who chairs the Death with Dignity Disabilities Caucus, said that "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
Jamie Pedersen
Jamie Pedersen is an American lawyer and politician from the state of Washington who has served as a member of the Washington House of Representatives since January 2007. During the 2009–10 biennium, he chairs the House Judiciary Committee.A Democrat, he was elected to the House from the reliably...
, chair of LGBT for 1000, said, "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." Organizations that supported I-1000 include the American Medical Student Association
American Medical Student Association
The American Medical Student Association , founded in 1950 and based in Washington, D.C., is the oldest and largest independent association of physicians-in-training in the United States. AMSA is a student-governed, national organization...
, 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
National Association of Social Workers
The National Association of Social Workers is a professional organization of social workers in the United States. It had over 150,000 members as of January 2008 and provides guidance, research, up to date information, advocacy, and other resources for its members and for social workers in general...
, and the Washington State Public Health Association.
The Washington State Psychology Association was neutral
Neutrality (philosophy)
Neutrality is the absence of declared bias. In an argument, a neutral person will not choose a side.A Neutral country maintains political neutrality, a related but distinct concept.-What neutrality is not:...
on I-1000, but found that "patients choose aid in dying because of a desire for autonomy
Autonomy
Autonomy is a concept found in moral, political and bioethical philosophy. Within these contexts, it is the capacity of a rational individual to make an informed, un-coerced decision...
and the wish to avoid loss of dignity
Dignity
Dignity is a term used in moral, ethical, and political discussions to signify that a being has an innate right to respect and ethical treatment. It is an extension of the Enlightenment-era concepts of inherent, inalienable rights...
and control, not because of a poor mental state, lack of resources or social support," and "the law has had a positive effect in terms of significant improvements in palliative care."
The Newcastle News endorsed the measure in a Oct. 7, 2008, editorial. "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," the editorial said.
Opposition
The Coalition Against Assisted Suicide opposed the measure. It included doctors and nurses, disability rights advocates and organizations, hospiceHospice
Hospice is a type of care and a philosophy of care which focuses on the palliation of a terminally ill patient's symptoms.In the United States and Canada:*Gentiva Health Services, national provider of hospice and home health services...
workers, minorities, right-to-life organizations, Christian
Christian
A Christian is a person who adheres to Christianity, an Abrahamic, monotheistic religion based on the life and teachings of Jesus of Nazareth as recorded in the Canonical gospels and the letters of the New Testament...
organizations, the Catholic Church, and politicians from both sides of the aisle. A more comprehensive look at the opposition to I-1000 can be found at the Coalition's website.
The organization held that the danger of making doctors the agents of a patient's death far outweighed any advantages to assisted suicide, or safeguards in the initiative's text. They felt that legalization of assisted suicide would put pressure on minorities, the disabled, and the poor.
Actor Martin Sheen
Martin Sheen
Ramón Gerardo Antonio Estévez , better known by his stage name Martin Sheen, is an American film actor best known for his performances in the films Badlands and Apocalypse Now , and in the television series The West Wing from 1999 to 2006.He is considered one of the best actors never to be...
appeared in television ads opposing Initiative 1000. There has been some debate over one of Sheen's statements: persons with depression can be given a lethal dose without prior professional assessment. According to the Washington Death with Dignity act, "Medication to end a patient’s life
in a humane and dignified manner shall not be prescribed until the person performing the counseling determines
that the patient is not suffering from a psychiatric or psychological disorder or depression causing impaired
judgment." This issue has been explored in the field of medical ethics.
Not Dead Yet, a disabilities advocacy group which joined with the Coalition Against Assisted Suicide, objected to the measure, arguing that it discriminates against and targets the disabled. They believe that disabled people who are worried they will become a burden to their families need help and pain relief for their conditions, not encouragement to die.
Results
See also
- Ballotpedia entry on Washington Initiative 1000
- Oregon Death with Dignity Act, a ballot initiative passed in 1994 in the neighboring state of OregonOregonOregon is a state in the Pacific Northwest region of the United States. It is located on the Pacific coast, with Washington to the north, California to the south, Nevada on the southeast and Idaho to the east. The Columbia and Snake rivers delineate much of Oregon's northern and eastern...
- Baxter v. MontanaBaxter v. MontanaBaxter v. Montana, was a Montana Supreme Court case, argued on September 2, 2009, and decided on December 31, 2009, that addressed the question of whether the state's constitution guaranteed terminally ill patients a right to lethal prescription medication from their physicians.-Background of the...
, a court decision legalizing aid in dying in Montana. - Washington v. GlucksbergWashington v. GlucksbergWashington v. Glucksberg, 521 U.S. 702 , was a case in which the Supreme Court of the United States unanimously held that a right to assistance in committing suicide was not protected by the Due Process Clause.-Facts:Dr...
, a 1997 Supreme Court decision upholding the State of Washington's Natural Death Act of 1979 - Assisted suicide in the United StatesAssisted suicide in the United StatesPhysician-assisted suicide in the United States is legal in the states of Oregon, Montana and Washington.The process is set forth in law, including the requirements that the patient must be of sound mind when requesting assisted suicide, as confirmed by a doctor and other witnesses; and the patient...
External links
In support
Additional reading
- Wall Street Journal: "Social Issues Dominate 2008 Ballot Initiatives," Aug. 7, 2008
- LA Times: "Washington's right to die battle is personal," June 22, 2008
- The News Tribune: "Death with Dignity initiative set for 2008," Dec. 5, 2007
- Associated Press: "Washington state mulls assisted suicide measure," June 16, 2008
- Seattle Times: "Identifying donors becomes issue in right-to-die campaign," June 16, 2008
- NewsroomAmerica.com: "Wash. Considers Assisted Suicide Measure," June 16, 2008
- Seattle Post-Intelligencer: "Playing God or dignified death? Faith-based groups taking crucial role in initiative battle" October 13, 2008