Washington state lawmakers want to fast-track ways for the terminally ill to 'die with dignity'

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A bill in the Washington Legislature is revisiting the question of whether Washingtonians deserve more say in choosing their own deaths.

Washington law allows terminally-ill adults with six months or less to live to self-administer lethal medication provided by a physician to end their life on request once a diagnosis is made by an attending and consulting physician.

Passed by voters in 2008, the state’s “Death with Dignity Act” requires patients to submit two oral requests to a physician over a 15-day waiting period. A minimum of 48 hours must pass between the patient’s written request and a physician writing the prescription. Once a prescription is written, patients choose when and whether to fill it or take it. Requests can be rescinded at any time.

The state law, one of eight around the country, was intended to allow people the freedom to die on their own terms in lieu of cures or viable treatments.

For thousands like Brittany Maynard, the choice between life and death is all too clear. Having exhausted all her options after being diagnosed with a deadly brain tumor in 2014, Maynard and her family moved from the San Francisco Bay Area to Oregon where she died using the state’s death with dignity law, one of five laws to exist nationwide at the time and the first to be passed in 1997. California passed its current death with dignity act in October 2015.

Her husband, Dan Diaz, founded the Brittany Fund in her memory, a nonprofit devoted to supporting end of life care for families and health care reform.

In 2014, 172 Washingtonians died using the state’s death with dignity law, the Washington Department of Health reports. In 2018, that number rose to 251 Washingtonians. Medical practitioners and state lawmakers argue the law needs to be more flexible still.

House Bill 1141 would cut the law’s 15-day waiting period down to 72 hours which may be further reduced if the patient is not anticipated to survive for that long of a time. It also waives the prior 48-hour waiting period for prescriptions.

Testifying to the House Health Care and Wellness Committee this month, Diaz said HB 1141 would ensure the terminally ill find relief when they need it.

“Brittany was determined to live as long as possible,” Diaz said. “Had we stayed in California, the brain tumor would have continued to torture her to death. This program allowed her to truly live the time she had left, and then experience a gentle death. The improvements in HB 1141 will not result in more people dying, those improvements will result in fewer people suffering.”

Others testifying on the bill in January argued otherwise. Waiting periods may be bottlenecks for some patients, but for others, they are protections from coercion and biased diagnoses the disabled experience most of all. Moreover, critics of the bill claim there is no clear metric for how effectively patients are consulted.

“Able-bodied people and health care providers often assume that people with disabilities have a poor quality of life or that they are a burden to those closest to them,” said Darya Farivar, a lobbyist with Disability Rights Washington. “HB 1141 creates major changes to a law about which we have very little information on how it is currently working.”

The bill, which passed the House by a vote of 60-37 in February, also adds more than 1,000 registered nurse practitioners and physician assistants to the list of those allowed to authorize such deaths. As written, the bill’s Senate version would cost the state $451,000 in more medical consultation services.

Some testifying against HB 1141 argue the bill will mean more patients receiving advice from less qualified professionals. Medical professionals testifying disagree.

“I have patients for whom I’m the primary care provider who are at the end of life, who are not able to appropriately access this law because they have chosen me to be their primary care provider,” said Darren Owens, a hospice and palliative care nurse. “I am one of the most experienced palliative care providers in the state of Washington and I’m more than capable of taking care of someone who is at the end of life.”

Under one amendment, HB 1141 allows end of life prescriptions to be mailed directly to patients’ homes where Auxiliary Bishop Daniel Henry Mueggenborg of Seattle believes people are in no state of mind to be making unalterable choices while enduring the stresses of the pandemic.

“Social distancing has dramatically increased the number of people experiencing extreme isolation and depression,” Mueggenborg said. “We do our neighbors battling terminal illness and severe depression no favor by making it easier when they are under the greatest distress imaginable to rush into an unalterable decision to end their lives.”

SB 1141 is scheduled to see executive action on Friday in the Senate Health and Long Term Care Committee at 8:00 a.m.

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