Friday, March 11, 2011

Washington State’s Assisted Suicide Report: No Information About Consent

By Margaret K Dore Esq(1)

On March 10, 2011, Washington State issued a formal report about its physician-assisted suicide act.(2) The report does not address whether the people who died under the act did so on a voluntary basis. The information provided is inherently unreliable.

A. Washington’s Act

Washington’s assisted suicide act was enacted via a ballot initiative in 2008 and went into effect in March 2009.(3)

During the election, proponents claimed that the act’s passage would assure individuals control over their deaths. The act, however, has significant gaps so that such control is not assured. For example, the act allows a person’s heir, who will benefit financially from the death, to assist in signing the person up for the lethal dose.(4)

There are also no witnesses required at the death.(5) Without disinterested witnesses, the opportunity is created for someone else to administer the lethal dose to the person without his consent. Even if he struggled, who would know?

B. The Assisted Suicide Report

1. Statistical information

Washington's assisted suicide report focuses on statistical information.(6) This information includes that lethal doses were reportedly dispensed to 87 people during 2010.(7) Of these 87 people, 51 are listed as having died after ingesting a lethal dose.(8)

2. Hearsay

The report also includes information about the circumstances of the deaths. For example, the report provides statistics regarding how long it took people to die after ingesting the lethal dose.(9) According to the report, the data for these statistics was obtained from an "After Death Reporting Form" completed by the prescribing physician after each death.(10)

According to the report, however, the prescribing physician is rarely present at the death.(11) He or she is necessarily relying on other persons for the data reported (or even making it up). The information provided is, regardless, hearsay.

3. Patient "concerns" are check-the-box responses on a pre-printed form

The report purports to document the "concerns" of the people who died, which led to their requesting the lethal dose.(12) The data for these concerns comes from a "check-the-box" question on the "After Death Reporting Form."(13)

The check-the-box question gives the prescribing doctor seven choices.(14) These choices do not include the possibility of abuse by an heir.(15)

4. No information regarding consent at the time of death

The Washington report provides no information as to whether the people who died consented when the lethal dose was administered.(16) In other words, there is no information regarding the voluntariness of the deaths.(17)

C. Conclusion

Washington's act has significant gaps, which render it a recipe for abuse. Washington's report, which does not even address whether administration of the lethal dose was voluntary, does nothing to alleviate this concern. The information provided is inherently unreliable.

(1) Margaret K. Dore is an elder law/appellate attorney in Washington state. She is a former Law Clerk to the Washington State Supreme Court. She is a former Chair of the Elder Law Committee of the American Bar Association Family Law Section. Her publications include "Death with Dignity”: A Recipe for Elder Abuse and Homicide (Albeit not by Name), Marquette Elder's Advisor, Vol. 11, No. 2, Spring 2010, available at: For more information, see
(2) Washington State Department of Health 2010 Death with Dignity Act Report, issued March 10, 2011, available at:
(3) Washington’s assisted suicide law was passed as Initiative 1000 on November 4, 2008 and went into effect on March 5, 2009. See Wash. Rev. Code Ann. § 70.245.903.
(4) Wash. Rev. Code Ann. §§ 70.245.030 and .220 state that one of two required witnesses to the lethal dose request form cannot be the patient's heir or other person who will benefit from the patient's death; the other witness may be an heir or other person who will benefit from the death.
(5) See Washington’s Act in its entirety, at Wash. Rev. Code Ann. §§ 70.245.010 et. seq.
(6) Report, supra, at note 2.
(7) Id., Executive Summary, at p.1.
(8) Id.
(9) Report, supra, at note 2, page 9, Table 5 (“Circumstances and complications relating to ingestion of medication prescribed under the Death with Dignity Act of the participants who have died”).
(10) Id. (“Data are collected from the After Death Reporting form”). A blank “After Death Reporting Form” can be viewed at: (Last viewed March 10, 2011).
(11) According to the report, the prescribing physician was present when the lethal dose was ingested in just 4% of the deaths occurring in 2010; the prescribing physician was present at 8% of such deaths in 2009. See Report, supra, at note 2, Table 5, at page 9.
(12) See Report, supra at note 2, page 7, Table 3.
(13) See the After Death Reporting Form, supra, at note 10, Question 7.
(14) Id.
(15) Id.
(16) See Report, supra, at note 2.
(17) Washington's act provides for self-administration of the lethal dose. "Self-administer" is, however, a specially defined term that allows someone else to administer the lethal dose to the person at issue. For more information, see Margaret K. Dore, Death with Dignity: What Do We Tell Our Clients?, Washington State Bar Association, Bar News, July 2009, available at:

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