WASHINGTON

Assisted Suicide is Legal; Safeguards removed in 2023

2025—HB 1876This bill would further destroy safeguards for obtaining lethal drugs. After a public hearing, the bill is awaiting action in the House Early Learning and Human Services Committee. A brief summary of what the bill does and its problems are below. See Dr. Sharon Quick’s testimony in opposition to HB 1876 here.

What HB 1876 does:

  • The attending medical practitioner has an additional duty to inform the patient of “irremediable pain or suffering” defined as “pain or other physical symptoms related to a patient’s terminal disease that cannot be reasonably managed or significantly alleviated by available treatment.”

  • The 7-day waiting period may be waived if the attending practitioner determines:

    1.) Patient won’t survive seven (7) days

    2.) Patient is experiencing “irremediable pain or suffering”

    3.) Patient won’t retain the ability to self-administer lethal drugs in seven (7) days 

Problems with this bill:

  • This bill preys on those with disabilities, implying that loss of ability to self-ingest or loss of functions that cause “suffering” make that person’s life worthless, and not deserving of a trial of palliative care with psychological/emotional/medical/spiritual support that often results in people changing their minds about hastening death.

  • Only one practitioner (who could be a non-physician, e.g., a physician assistant), without a second opinion or defined expertise, is required to make these difficult determinations.

  • Patients close to death likely have compromised mental capacity and inability to ingest liquids (about 90% have these disfunctions within 3 days of death), making ethically-obtained consent unlikely and ingestion dangerous. There are good medical and ethical reasons to DISALLOW lethal drugs the closer a patient gets to death, but this bill authorizes the opposite.

  • Point (2) is false, as there is no irremediable pain for terminally ill patients—palliative/hospice care should be sufficient, and only rarely is sedation needed as a last resort. Unbearable pain in terminally ill patients is a problem with lack of practitioner knowledge; lethal drugs are not the solution.

  • Point (3) appears to be directed toward people with progressive neurological diseases like ALS, Huntington’s, etc., but deterioration progresses differently for each person, making it impossible to predict when the capacity for self-administration would be lost. This provision could be a way to get lethal drugs to patients with chronic diseases who are farther from death than 6 months, as there is no quality review to confirm the prognosis. (Patients with nonterminal conditions, like anorexia, have been given lethal drugs in some states, without doctors being sanctioned.) Alternatively, others with non-neurological terminal diseases may also lose the ability to self-administer medications, but this would probably align with the loss of mental capacity and the ability to ingest liquids—making it unethical to obtain consent and dangerous to attempt ingesting lethal drug concoctions.

2023—ESSB 5179 was passed by the legislature and signed into law by Gov. Inslee. It shortens the waiting period for lethal drugs from 15 to 7 days and allows: nurse practitioners and physician assistants to determine eligibility and write lethal prescriptions in addition to physicians; less qualified practitioners to perform mental health evaluations; consent form completion before two practitioners have agreed; mailing lethal drugs; and an indirect supervisory role between the two evaluating practitioners that compromises the integrity of the second opinion. The waiting period may start before either practitioner has evaluated the patient, making same-day death possible. The definition of “participation” and other clauses create conscience violations for both individual practitioners and health care employers. See the following for more information:

2022—Doerflinger, Richard. “Lethal Noncompliance with Washington’s Death With Dignity Act.” Issue 92, On Point Series (2022)

2008—Washington voters pass the “Death With Dignity Act” via initiative (I-1000) which legalized physician-assisted suicide.

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