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By Max Erikson

Death With Dignity Act reviewed


January 31, 2018

On Jan. 24 Klickitat Valley Health (KVH) hosted a presentation by End of Life Washington to gain a better understanding of the issues surrounding the Death with Dignity Act. End of Life Washington is a company that provides assistance to people who choose to end life early due to a terminal illness. The voter approved Death with Dignity Act was passed in 2008 and became law in March of 2009.

End of Life Washington is a nonprofit organization that, according to their mission statement, is a statewide organization supporting people in their final days. It advocates for the right to a peaceful death, and there is no fee for their services. The company is trying to expand its awareness to all parts of Washington State to make sure that every terminally ill person has all the information needed to make an informed choice about ending their life.

After 10 years of the Death with Dignity Act, many rural community hospitals are not well informed about the law, and many do not have services in place for patients who make that request. Currently KVH and its employees do not participate in the Act. The hospital is looking at the information provided by End of Life Washington and how it would affect the services of KVH hospice programs. KVH plans to weigh all options and considerations to see if the hospital wants to consider expanding its approach to the Death with Dignity Act.

KVH Chief Executive Officer Leslie Hiebert says that knowing the information is important to get a better understanding of the law, and KVH will look at all sides of the argument to know how best to address it.

“We have had some patients ask our staff in our hospice program about the death with dignity act,” Hiebert says. “It is at least good to know what we can tell them and what their options are, and since it is the law, our staff should know how to answer.”

Hiebert says that KVH is not planning to change its current policy, but it is important to be aware of what the Death with Dignity Act is and to have a discussion about it.

“We want the feedback from our physicians and medical staff about the subject,” she adds. “And we encourage members of the community to express their opinions as well so our ethics committee and our board can make an informed decision about our approach to the future and what steps we are willing to take.”

Since 2009 there have been 909 confirmed assisted suicides according to Washington Department of Health statistics, and there has been a yearly rise since its inception. In 2009, 36 patients ingested medication to end their life. By 2016 it increased to 196, and that number is expected to grow.

Other states that have death with dignity laws include Oregon, California, Vermont, and Colorado. Montana has a similar law for end of life requests that prevents prosecution of doctors who perform the procedure.

For a terminally ill patient who is considering an end of life option, there is a process that must take place before being legally able to participate. To be eligible, a person must be a Washington State resident, be diagnosed by a physician as terminal ill with a condition that will cause death within six months, be capable of making an informed decision—not impaired by mental illness, dementia, or depression—and able to self-administer the prescribed dose of life-ending medication.

The procedures for requesting life-ending medication starts when a patient asks a physician if they would support the decision to obtain a prescription. An oral request is then made and documented in the patient’s medical file.

Two physicians are required to proceed with the end of life request. The attending physician is the one who will prescribe the life-ending prescription and one consulting physician confirms the diagnosis and mental capacity of the patient. The patient then makes a written request that is signed by two witnesses and a second oral request 15 days after the first one. Forty-eight hours after providing the written request to the attending physician, the patient may obtain their life-ending medication.

Not all patients who acquire the life-ending medication actually use it. Some patients choose not to, and others die before it is needed.

KVH will continue to gather information on the topic and will ask for input from medical staff, and the public, before any proposals are made about what areas of the Death with Dignity Act KVH would participate in, if any at all.

“Our next step at KVH is to get information from the other side of the argument, those opposed to the death with dignity act,” Hiebert says. “It is a topic that people have strong convictions about, and we want to make sure we hear everyone’s point of view.”


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