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Initiative 1000 (I-1000) of 2008 established the U.S. state of Washington's Death with Dignity Act (RCW 70.245[1]), which legalizes physician-assisted dying with certain restrictions. Passage of this initiative made Washington the second U.S. state to permit some terminally ill patients to determine the time of their own death. The effort was headed by former Governor Booth Gardner.
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.[2] 30 of the state's 39 counties voted in favor of the initiative.[3]
In 1991, the similar initiative 119 was rejected by Washington voters by a margin of 54 percent to 46 percent. I-119 would have allowed doctors to prescribe a lethal dosage of medication, and also to administer it if the terminally ill patient could not self-administer.[4] Unlike that initiative, I-1000 requires the patient to ingest the medication unassisted.[5]
The initiative is based on Oregon Measure 16, which Oregon voters passed in 1994. Oregon is the only state to have enacted similar legislation,[6] and overwhelmingly re-approved it after the Oregon State Legislature referred a repeal of it to voters in 1997.
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The official ballot summary for the measure, slightly amended following a February 2008 court challenge, is, "This measure would permit terminally ill, 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."[7]
Provisions in the law include:
The campaign was run by a coalition that includes former Washington governor, Booth Gardner.[8][9] aid-in-dying advocates from Oregon, the Death with Dignity National Center, Compassion & Choices (national), 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, 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, chair of LGBT for 1000, said, "people facing terminal illnesses gain peace of mind from knowing that their end-of-life choices will be respected. Everyone deserves that respect and can appreciate its importance." Organizations that supported I-1000 include the American Medical Student Association, the American Medical Women’s Association, the Lifelong AIDS Association, the ACLU, 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 on I-1000, but found that "patients choose aid in dying because of a desire for autonomy and the wish to avoid loss of dignity 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 a Oct. 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.[10]
The Coalition Against Assisted Suicide opposed the measure. It included doctors and nurses, disability rights advocates and organizations, hospice workers, minorities, right-to-life organizations, Christian organizations, the Catholic Church, and politicians from both sides of the aisle. A more comprehensive look at the opposition to I-1000 can be found at the Coalition's website.
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 appeared in television ads opposing Initiative 1000.[11] There has been some debate over one of Sheen's statements: persons with depression can be given a lethal dose without prior professional assessment.[12] 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."[13] This issue has been explored in the field of medical ethics.[14]
Not Dead Yet, a disabilities advocacy group which joined with the Coalition Against Assisted Suicide, objected to the measure, arguing that it discriminates against and targets the disabled. They believe that disabled people who are worried they will become a burden to their families need help and pain relief for their conditions, not encouragement to die.[15]
Washington Initiative 1000 (Approved) [16] | ||
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Choice | Votes | Percentage |
Yes | 1,715,219 | 57.82% |
No | 1,251,255 | 42.18% |
Total votes | 3,071,587 | 100.00% |
Voter turnout | 84.61% | |
Electorate | 3,630,118 |
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