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Originally published March 7, 2010 at 4:00 PM | Page modified March 9, 2010 at 7:37 AM

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Guest columnist

The Washington voter-approved Death With Dignity Act is working

The Washington Department of Health's inaugural report on the new Death With Dignity Act demonstrates that the voter-enacted law is working as it was intended, writes Robb Miller, a leader in the Initiative 1000 campaign in 2008. Thanks to the new law, mentally competent, terminally ill patients now have another end-of-life option.

Special to The Times

FOURTEEN years ago, my partner of eight years had a very bad death. Despite excellent medical and hospice care, his burning fevers, agitation and other symptoms remained intolerable. His suffering from the loss of all dignity and quality of life was even worse. Although he wanted to end his life when he became bedridden, it wasn't possible. His grueling, drawn-out dying process was demeaning, unnecessary and pointless.

Thanks to the compassion and wisdom of nearly 60 percent of Washington's voters in 2008, dying patients like my former partner now have the option to use the Washington Death With Dignity Act. The law gives qualified, terminally ill adults the right to ask their physicians for life-ending medication the patient may choose to self-administer to bring about a peaceful, humane death. The law also gives medical providers the right not to participate.

The Washington Department of Health recently released its first annual report on the new law. Just as we predicted during the Initiative 1000 campaign, only a very small percentage — less than 1/10 of 1 percent — of terminally ill Washingtonians elected to take life-ending medication under the law. Most were suffering from end-stage cancer and were receiving hospice care at the time of death.

Several of those who received life-ending medication died without taking it. All of these patients, whether they took the medication or not, gained peace of mind and comfort from knowing that if their suffering became unbearable, they had a way out.

The act's benefits extend well beyond the terminally ill patients who want to use the law. In Oregon, the law spurred conversation, education and improvements in end-of-life care across the board.

Researchers have also concluded that there is no evidence of harm to the elderly, the uninsured, the poor or the disabled. Forbes Magazine recently ranked Oregon second among states as a good place to die, while Washington ranked 18th. We expect improvement in Washington as the law prompts education, conversation and better end-of-life care.

Anti-choice activists will use the occasion of the Health Department's annual report to make the same fabricated, undocumented claims they made during the campaign. They will excoriate the report and the process. But take their statements with a grain of salt. The real, rarely acknowledged reason for their opposition to the law is, and always will be, moral judgment.

Don't be fooled by their supposed "concern" for the dying. These are the same people who believe that patients in a persistent vegetative state should be kept alive by medically administered artificial nutrition and hydration, even when it is contrary to the patient's legally documented wishes and the wishes of their families.

Opponents will also repeat that hospice and palliative (comfort) care can manage any and all suffering, making Death With Dignity unnecessary. Compassion & Choices of Washington believes that hospice and palliative care are essential components of excellent end-of-life care, but some suffering is beyond their ability to relieve.

The American Academy of Hospice and Palliative Medicine agrees, stating, "Excellent medical care, including state-of-the-art palliative care, can control most symptoms and augment patients' psychosocial and spiritual resources to relieve most suffering near the end of life. On occasion, however, severe suffering persists ... "

No one should have to die the way my partner did. Thanks to the Death With Dignity law, mentally competent, terminally ill patients now have another end-of-life option.

The annual report indicates the new law is working just as it was designed to work. Death With Dignity in Washington has been legal, safe and rare.

Robb Miller has been the executive director of Compassion & Choices of Washington since 2000 and was one of the leaders of the Initiative 1000 campaign, which legalized death with dignity in Washington in 2008. For information, go to

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