Sunday, June 23, 2013

Washington State's Annual Assisted Suicide Report: What it Doesn't Say

Margaret Dore
By Margaret K. Dore, Esq.

The Washington State Department of Health has released its annual Death with Dignity Act Report for 2012.[1] The report is most interesting for what it doesn't say, as follows:

The Act

The report states that Washington's assisted suicide act "allows adult residents in the state with six months or less to live to request lethal doses of medication from physicians."[2] This is an oversimplification. The act applies to persons estimated to have less than six months to live, which as explained below, can include those with many years to live. Moreover, the act's significance is not that people can request a lethal dose, they could always do that, but that physicians and other persons can provide that dose for the purpose of causing a patient deaths without getting into trouble.[3] 

A Small Number of Deaths

Per the report, there were 121 "participants" of the act, meaning persons who were dispensed a lethal dose under the act during 2012.[4]  Of these persons, 104 are known to have died, of which 83 died after ingesting the lethal dose.[5]  These deaths are but a small fraction of all deaths occurring in Washington state, which totaled 49,386 in 2011, the most recent year for which an overall total is available.[6]


The report states that 48% of participants had a baccalaureate degree or higher.[7]  Such persons with a college education are often people with money, i.e., the middle class and above.

The report also states that most participants were age 55 and older.[8] According to a 2009 study by Met Life Mature Market Institute, "The older population owns the largest proportion of wealth in the U.S."[9] Moreover, "older people with money" are a prime demographic for abuse. The study states: 
"Victims may even be murdered by perpetrators who just want their funds and see them as an easy mark."[10]
No Information on Patient Consent

The report gives no information as to whether administration of the lethal dose was voluntary on the part of the 83 people who died after ingesting the lethal dose. The report merely describes the fact of ingestion.[11]

The word "ingest" means "to take (food, drugs, etc.) into the body, as by swallowing, inhaling, or absorbing."[12] This can be on a non-voluntary basis. Consider, for example, a patch placed on the patient's arm, allowing the lethal dose to be absorbed into the patient's body while he is sleeping. The patient would not necessarily even know that the patch was in place.

By using the word, "ingestion," the report provides no information on patient consent one way or the other.

Patients May Have Years to Live

Washington's act, which is based on a similar act in Oregon, applies to "terminal" patients defined in terms of less than six months to live.[13] Oregon's act has the same definition.[14]

Such persons are not necessarily dying. This is because medical predictions of life expectancy can be wrong.[15] Moreover, treatment can lead to recovery. Consider Oregon resident, Jeanette Hall, who was diagnosed with cancer and told that she had six months to a year to live. In a 2012 affidavit, she states: 
I wanted to do our law and I wanted [my doctor] to help me.  Instead, he encouraged me to not give up and ultimately I decided to fight the cancer.  I had both chemotherapy and radiation. . . .
This July, it was 12 years since my diagnosis. If [my doctor] had believed in assisted suicide, I would be dead.[16].


The Department of Health Report, if accurate, documents a small number of people using Washington's assisted suicide act. The reported persons are, however, in a vulnerable demographic for abuse including murder. The report's lack of information about consent to administration of the lethal dose is disturbing. The act, regardless, encourages people with many years to live to throw away their lives.

Margaret Dore is an attorney in Washington State where assisted suicide is legal. She is also President of Choice is an Illusion, a nonprofit corporation opposed to assisted suicide and euthanasia. See: and

1.  See Washington State Department of Health 2012 Death with Dignity Act Report, June 20, 2013, available at: 
2.  Report page 1 ("Executive Summary")
3.  See Margaret K. Dore, "'Death with Dignity': What Do We Advise Our Clients?," King County Bar Association, Bar Bulletin, May 2009 and Washington's Act, RCW 70.245.190(1)(a), available at: ("A person shall not be subject to civil or criminal liability or professional disciplinary action for participating in good faith compliance with this chapter")  
4. Report page 1 at note1.
5. Report page 1 ("104 are known to have died; 83 died after ingesting the medication; 18 died without ingesting the medication").
6.  Washington State Department of Health, Vital Statistics Data, Death Tables by Year, for 2011 
7.  Report, page 5
8.  Report, page 5, table 2 (regarding age)
9. The MetLife Study: "Broken Trust:  Elders, Family and Finances," 2009, page 19, available at: 
10. Id, page 24.
11. See entire report
12. (transitive verb)
13. RCW 70.245.010(13)
14. ORS 127.800 s.1.01(12)
15. See Nina Shapiro, "Terminal Uncertainty," Washington's new "Death with Dignity" law allows doctors to help people commit suicide - once they've determined that the patient has only six months to live. But what if they're wrong? The Seattle Weekly, January 14, 2009.
16.  Affidavit of Jeanette Hall, Leblanc v. Canada, available at: .


Winston said...

If Jeanette had refused treatment, she would also be dead today.

Your arguments have no merit.

Alex Schadenberg said...

Read Margaret Dore's comments again. She is saying that people who qualify for the "Act" are not necessarily dying or terminal.

She was not commenting on refusing treatment.

Further to that, Jeannette was not asking for no treatment, she was asking for assisted suicide. In the end she accepted treatment and got better.

Winston said...

Why do you insist that people like Tony Nicklinson must suffer (unless they are "lucky" enough to require a respirator to breathe for them) until they die naturally?

If I could relieve your pain with analgesics, but instead destroyed the pills, would you or would you not hold me accountable for your suffering?

Nevertheless, if Jeanette had refused treatment, she would be dead years ago.

Alex Schadenberg said...

The point is that once she had accepted treatment and began getting better, that she was happy to be alive.

She remains happy to be alive.

Winston said...

By that logic (and your paternalistic stance), no one should be permitted to refuse treatment.

Alex Schadenberg said...

Margaret Dore makes no comments on refusing treatment.

Dore is far from being paternalistic.

Winston said...

If she isn't willing to advocate vitalism, she's a hypocrite. After all, refusing respirators will lead to death in many cases.

Alex Schadenberg said...

The Euthanasia Prevention Coalition are not vitalists, nor is Margaret Dore or any of the other leaders who are working to stop the killing.

We do not oppose withholding or withdrawing of medical treatment. We do not oppose palliative sedation, when done for reasons of palliation, we recognize that death is a normal part of living, etc.

We oppose intentionally killing people.

Winston said...

You're not vitalists. And that's my point - that makes you hypocrites.

By opposing end-of-life compassion (except for those who need feeding tubes and/or respirators, and who can make their wishes known), you are selectively dictating who can and cannot access the right to die.

Alex Schadenberg said...

There is a clear difference between killing a person and letting them die.

We are not opposed to death, we are opposed to killing people.

Compassion is to eliminate suffering, not the sufferer.

Compassion is achieved through palliative means but also by being with and caring for the other.

Winston said...

You're still hypocritical. No one asks for a respirator to be removed unless they want to die.

Your attitude of "suffering with" others is the antithesis of compassion.