Physician-Assisted Death — From Oregon to Washington State

New England Journal of Medicine Volume 359:2513-2515 December 11, 2008 Number 24 Robert Steinbrook, M.D. In November, residents of the state of Washington voted 58% to 42% to allow physician-assisted suicide. The Washington Death with Dignity Act is modeled on a similar law that has been in effect in Oregon since October 1997 and that was upheld in 2006 by the U.S. Supreme Court. The act permits terminally ill state residents, defined as adults with an illness expected to lead to death within 6 months, to request and receive a prescription for a lethal dose of a medication that they may self-administer in order to end their life. Booth Gardner, a former governor of Washington who has Parkinson's disease — which is not considered a terminal disease under the act — filed the initiative, spearheaded the campaign, and was a major financial contributor. If the Washington act takes effect as scheduled on March 4, 2009, there will be two states in which physician-assisted suicide is legal; no states permit euthanasia. Physician involvement in hastening death is also legal in Belgium, the Netherlands, and Switzerland — the specifics vary by country — and is an underground practice elsewhere. The prescription of lethal doses of medication to terminally ill people who want to hasten their own deaths is inherently controversial. The Washington State Medical Association opposed the initiative, and doctors have divergent views on the matter. In 1991, voters in Washington rejected a broader initiative that would have allowed doctors to administer the lethal drugs. The controversy carries over into disagreements over terminology; designations such as "death with dignity" and "physician-assisted suicide" may be considered emotionally charged and judgmental. Indeed, deaths under the Oregon act are not classified as suicides. Although some prefer terms such as "physician aid in dying" and "physician-assisted death," physician-assisted suicide remains a frequently used descriptor. Link to Full Article