Washington Joins Oregon on Physician-Assisted Suicide. Is California Next?

Jane Gross reports in the New York Times on the passage of “Initiative 1000,” the referendum that makes Washington the second state in the country (after Oregon) where physicians are permitted to prescribe lethal doses of medication to terminally ill people who want to hasten their own deaths. It’s been 11 years since Oregon passed its referendum. The Washington measure requires that the assisted parties be state residents, mentally compentent, have two physicians confirming their terminal (six months or less) condition, to live according to two physicians, and that they wait 15 days after their request and then repeat that request orally and in writing. They must be capable of administering medication themselves and agree to counseling if their physicians request it. The patients also must be informed of alternatives.

Dr. Timothy Quill, a palliative care expert, recommended a palliative care consultation prior to assisting a patient with any of the following “last resorts”:

• aggressive pain management that may, but is not principally intended to, hasten deathPain management (“double effect”);
• permitting a patient to opt out of life-sustaining therapies;
• abiding a patient’s voluntary refusal to eat and drink;
• sedation to the point of unconsciousness (endorsed earlier this year by an AMA panel).

Will California be next, forming a Pacific Coast “bloc” on the issue? In 2007, the California legislature debated but could not pass a measure that would have made California the second state in the country to permit physician-assisted suicide. The failure capped a three-year effort that is almost certain to be renewed in light of the Washington decision. The California Medical Association (CMA), which represents 35,000 doctors, opposed the California bill, arguing that it created a conflict with a physician’s ethical duties. (The California Association of Physician Groups, however, supported it.)