Wash. completes final rules on physician-assisted suicide

The Washington State Dept. of Health has finalized rules implementing Initiative 1000, the Death With Dignity Act.

Voters approved the measure in November 2008, and the law took effect March 5. The rules are virtually the same as Oregon's, where more than 340 patients have died with physicians' help since 1998.

The health department proposed the rules in January and got more than 200 comments. The final version consisted of "minor changes to clarify language and make technical corrections," said an agency news release. The department did not grant American Medical News interview requests.

The final rules disappointed Eileen Geller, a Seattle hospice nurse active with the Coalition Against Assisted Suicide. "The Dept. of Health did nothing. There are effectively zero changes."

Her group called for more robust record-keeping requirements and more public access to information about how the law is used. Supporters of the law said such requirements would impede access to aid in dying and violate patients' confidentiality.

The law makes physician-assisted suicide available only to patients who have been judged terminally ill by two doctors. Patients must make an oral request and a witnessed written request. Another oral request must be made 15 days later.

Physicians must tell patients about options such as hospice and palliative care. The data doctors report will not be made publicly available, but the health department is required to release an annual statistical report. Doctors may refuse to participate and are not obligated to refer patients elsewhere.

The Washington State Medical Assn., which opposes the law, suggested changes to bolster the informed-consent process and give the agency more documentation of patients' illnesses and decision-making capacity. Most suggestions did not make it into the final rules. The American Medical Association opposes physician-assisted suicide, calling it incompatible with the doctor's role as healer.

Paul V. O'Donnell, MD, PhD, is a medical adviser to Compassion & Choices of Washington, which supports the Death With Dignity Act and will counsel patients seeking to use it. "People shouldn't get hung up" on the new law, he said. "It's another option that just happens to be available. It's not something anyone would want to encourage people to take that option, but it's just there."