Initiative 1000 (I-1000) of 2008 established the
U.S. state
In the United States, a state is a constituent political entity, of which there are 50. Bound together in a political union, each state holds governmental jurisdiction over a separate and defined geographic territory where it shares its sover ...
of
Washington
Washington commonly refers to:
* Washington (state), United States
* Washington, D.C., the capital of the United States
** A metonym for the federal government of the United States
** Washington metropolitan area, the metropolitan area centered o ...
's Death with Dignity Act (
RCW 70.245), which legalizes
medical aid in dying with certain restrictions. Passage of this
initiative
In political science, an initiative (also known as a popular initiative or citizens' initiative) is a means by which a petition signed by a certain number of registered voters can force a government to choose either to enact a law or hold a pu ...
made Washington the second U.S. state to permit some
terminally ill
Terminal illness or end-stage disease is a disease that cannot be cured or adequately treated and is expected to result in the death of the patient. This term is more commonly used for progressive diseases such as cancer, dementia or advanced he ...
patients to determine the time of their own death. The effort was headed by former Governor
Booth Gardner
William Booth Gardner (August 21, 1936 – March 15, 2013) was an American politician who served as the 19th governor of Washington from 1985 to 1993. He also served as the ambassador of the GATT. A member of the Democratic Party, Gardner previ ...
.
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
In political science, an initiative (also known as a popular initiative or citizens' initiative) is a means by which a petition signed by a certain number of registered voters can force a government to choose either to enact a law or hold a pu ...
119 was rejected by Washington
voters
Voting is a method by which a group, such as a meeting or an electorate, can engage for the purpose of making a collective decision or expressing an opinion usually following discussions, debates or election campaigns. Democracies elect holder ...
by a margin of 54 percent to 46 percent. I-119 would have allowed doctors to prescribe a
lethal
Lethality (also called deadliness or perniciousness) is how capable something is of causing death. Most often it is used when referring to diseases, chemical weapons, biological weapons, or their toxic chemical components. The use of this ter ...
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
Oregon () is a U.S. state, state in the Pacific Northwest region of the Western United States. The Columbia River delineates much of Oregon's northern boundary with Washington (state), Washington, while the Snake River delineates much of it ...
voters passed in 1994 but was not implemented until 1997. At that time, Oregon was the only other state to have enacted similar legislation. In 2013, Vermont became the third state to enact similar legislation. In 2016, California became the fourth state to enact similar legislation. All states on the West Coast now have similar legislation.
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
Terminal illness or end-stage disease is a disease that cannot be cured or adequately treated and is expected to result in the death of the patient. This term is more commonly used for progressive diseases such as cancer, dementia or advanced he ...
,
competent, 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
Resident may refer to:
People and functions
* Resident minister, a representative of a government in a foreign country
* Resident (medicine), a stage of postgraduate medical training
* Resident (pharmacy), a stage of postgraduate pharmaceuti ...
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
coercion
Coercion () is compelling a party to act in an involuntary manner by the use of threats, including threats to use force against a party. It involves a set of forceful actions which violate the free will of an individual in order to induce a desi ...
, verified by two physicians
* The patient must be informed of all other options including
palliative
Palliative care (derived from the Latin root , or 'to cloak') is an interdisciplinary medical caregiving approach aimed at optimizing quality of life and mitigating suffering among people with serious, complex, and often terminal illnesses. Wit ...
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 Gardner
William Booth Gardner (August 21, 1936 – March 15, 2013) was an American politician who served as the 19th governor of Washington from 1985 to 1993. He also served as the ambassador of the GATT. A member of the Democratic Party, Gardner previ ...
. aid-in-dying advocates from Oregon, the
Death with Dignity National Center
Death with Dignity National Center is a 501(c)(3) nonpartisan nonprofit organization, headquartered in Portland, Oregon, that has led the legal defense of and education about Death with Dignity laws throughout the United States for more than ...
,
Compassion & Choices
Compassion & Choices is a nonprofit organization in the United States working to improve patient autonomy and individual choice at the end of life, including access to medical aid in dying. Its primary function is advocating for and ensuring acc ...
, 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 Cook Fairley (born 1943) was a member of the Washington State Senate
The Washington State Senate is the upper house of the Washington State Legislature. The body consists of 49 members, each representing a district with a population o ...
, 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 D. Pedersen (born September 9, 1968) is an American lawyer and politician serving as a member of the Washington State Senate, representing the 43rd district since 2013.[American Medical Student Association
The American Medical Student Association (AMSA), founded in 1950 and based in Washington, D.C., is an independent association of physicians-in-training in the United States. AMSA is a student-governed national organization.They have a membership ...]
, the American Medical Women's Association, the Lifelong AIDS Association, the
ACLU
The American Civil Liberties Union (ACLU) is a nonprofit organization founded in 1920 "to defend and preserve the individual rights and liberties guaranteed to every person in this country by the Constitution and laws of the United States". T ...
, 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
Neutral or neutrality may refer to:
Mathematics and natural science Biology
* Neutral organisms, in ecology, those that obey the unified neutral theory of biodiversity
Chemistry and physics
* Neutralization (chemistry), a chemical reaction in ...
on I-1000, but found that "patients choose aid in dying because of a desire for
autonomy
In developmental psychology and moral, political, and bioethical philosophy, autonomy, from , ''autonomos'', from αὐτο- ''auto-'' "self" and νόμος ''nomos'', "law", hence when combined understood to mean "one who gives oneself one's ...
and the wish to avoid loss of
dignity
Dignity is the right of a person to be valued and respected for their own sake, and to be treated ethically. It is of significance in morality, ethics, law and politics as an extension of the Enlightenment-era concepts of inherent, inalienable ...
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 an October 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,
hospice
Hospice care is a type of health care that focuses on the palliation of a terminally ill patient's pain and symptoms and attending to their emotional and spiritual needs at the end of life. Hospice care prioritizes comfort and quality of life by ...
workers,
minorities,
right-to-life organizations, the
Catholic Church
The Catholic Church, also known as the Roman Catholic Church, is the largest Christian church, with 1.3 billion baptized Catholics worldwide . It is among the world's oldest and largest international institutions, and has played a ...
and other
Christian
Christians () are people who follow or adhere to Christianity, a monotheistic Abrahamic religion based on the life and teachings of Jesus Christ. The words ''Christ'' and ''Christian'' derive from the Koine Greek title ''Christós'' (Χρι ...
organizations, and politicians.
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
Ramón Antonio Gerardo Estévez (born August 3, 1940), known professionally as Martin Sheen, is an American actor. He first became known for his roles in the films ''The Subject Was Roses'' (1968) and ''Badlands'' (1973), and later achieved wid ...
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.
Results
See also
*
Act 39 Act 39 of 2013 established the U.S. state of Vermont's Patient Choice and Control at End of Life Act ( Vermont Statutes Annotated Sec. 1. 18 V.S.A. chapter 113), which legalizes medical aid in dying (commonly referred to as physician-assisted suici ...
in
Vermont
Vermont () is a state in the northeast New England region of the United States. Vermont is bordered by the states of Massachusetts to the south, New Hampshire to the east, and New York to the west, and the Canadian province of Quebec to ...
, the first state to pass a death with dignity law by legislative action
*
California End of Life Option Act
California End of Life Option Act is a law enacted in June 2016 by the California State Legislature which allows terminally ill adult residents in the state of California to access medical aid in dying by self-administering lethal drugs, provide ...
*
Oregon Death with Dignity Act
Measure 16 of 1994 established the U.S. state of Oregon's Death with Dignity Act (ORS 127.800–995), which legalizes medical aid in dying (commonly referred to as physician-assisted suicide) with certain restrictions. Passage of this initiativ ...
, a ballot initiative passed in 1994 in the neighboring state of
Oregon
Oregon () is a U.S. state, state in the Pacific Northwest region of the Western United States. The Columbia River delineates much of Oregon's northern boundary with Washington (state), Washington, while the Snake River delineates much of it ...
* ''
Baxter v. Montana
''Baxter v. Montana'', is 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 prescript ...
'', a court decision legalizing aid in dying in Montana.
* ''
Washington v. Glucksberg
''Washington v. Glucksberg'', 521 U.S. 702 (1997), was a landmark decision of the U.S. Supreme Court, which unanimously held that a right to assisted suicide in the United States was not protected by the Due Process Clause.
Background
Dr. Harold ...
'', a 1997 Supreme Court decision upholding the State of Washington's
Natural Death Act of 1979
*
Assisted suicide in the United States
Assisted suicide is suicide with the aid of another person. In the United States, the term "assisted suicide" is typically used to describe what proponents refer to as medical aid in dying, in which terminally ill adults are prescribed and self- ...
*
Compassion and Choices
*
Voluntary Assisted Dying Act 2017 (Victoria)
{{use Australian English, date=December 2017
{{Use dmy dates, date=August 2017
{{Infobox legislation
, short_title = Voluntary Assisted Dying
, legislature = Parliament of Victoria
, image =
, imagesize =
, ...
References
{{reflist, 2
External links
Official Washington State Department of Health page on the DWDAwith Annual Reports
Ballotpedia entry on Washington Initiative 1000
In support
Yes! on I-1000 CommitteeDeath With Dignity National Center
In opposition
Coalition Against Assisted Suicide
Further 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*
ttp://www.newsroomamerica.com/usa/story.php?id=421573 ''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
Assisted suicide
Death in Washington (state)
2008 Washington (state) ballot measures
Initiatives in the United States
Assisted suicide in the United States
Euthanasia legislation