Washington "Death with Dignity Act", Initiative 1000 (2008)
|Voting on Assisted Death|
|Not on ballot|
The official ballot measure title referred to the measure as "aid in dying." Supporters of the measure referred to it as the Death with Dignity initiative, and critics referred to it as the Assisted Suicide initiative.
- See also 2008 ballot measure election results
In 1991, Initiative 119, a similar (but broader) measure, failed with 46% of the vote. The 2008 ballot initiative is more restrictive in that it explicitly prohibits euthanasia and lethal injections. The initiative was based on Oregon Measure 16, which Oregon voters passed in 1994. Oregon is the only state to have enacted similar legislation. and overwhelmingly re-approved after a U.S. Supreme Court challenge in 1997.
Specific provisions in the initiative
Initiative 1000 enacted law which allows mentally competent, terminally ill adults the legal choice to request and self-administer a lethal overdose of medication.
The official ballot summary for the measure, slightly amended following a February 2008 court challenge, was, "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."
The measure enacted the following provisions regarding lethal overdoses of medicine:
- The patient must be an adult (18 or over) resident of the state of Washington
- The patient must be mentally competent, verified by two physicians (or referred to a mental health evaluation)
- The patient must be terminally ill with less than 6 months to live, verified by two physicians
- The patient must make voluntary requests, without coercion, verified by two physicians
- The patient must be informed of all other options including palliative and hospice care
- There is a 15 day waiting period between the first oral request and a written request
- There is a 48 hour waiting period between the written request and the writing of the prescription
- The written request must be signed by two independent witnesses, at least one of whom is not related to the patient or employed by the health care facility
- The patient is encouraged to discuss with family (not required because of confidentiality laws)
- The patient may change their mind at any time and rescind the request
The campaign was run by a coalition that included former Washington governor, Booth Gardner,aid-in-dying advocates from Oregon, the National Death with Dignity Center, Compassion & Choices of Washington, and Compassion & Choices of Oregon. Political consultants included Christian Sinderman and Seattle-based Democratic consultant, Blair Butterworth. 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 supporting I-1000 included 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 stayed 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.
TV and radio ads
Yes on I-1000 started airing two new television ads and a radio spot in late October, in an effort to reassure voters who might be hesitant to vote for the initiative.
One of the television ads, called "Get the Facts" featured former Oregon Gov. Barbara Roberts reassuring voters who were worried that some may be taken advantage of if the measure were to be approved.
The other TV ad, "Doctor-Daughter," showed a doctor whose mother used physician assisted suicide in Oregon.
The radio ad said, "There are decisions and private matters in our lives where government and politicians have no place," and suggested that it is an issue of freedom of religion and reproductive rights.
Another television ad, called "Lies," responded directly to an opposition ad featuring actor Martin Sheen, calling his statements lies.
The Oregon Death with Dignity Political Action Fund promised to match all donations to the "Yes on 1000" campaign in Washington State up to $1 million.
According to Public Disclosure Commission filings through Oct. 10, 2008, the Yes on I-1000 committee raised $3,222,145.89 in 2008. The largest single contribution came from Compassion & Choices Washington Initiative PAC ($626,500). Top contributors included Compassion & Choices organizations (a total of $945,700 for 2008), former Washington governor Booth Gardner ($420,000), the Oregon Death with Dignity PAC ($356,142.30), and the American Civil Liberties Union of Washington ($61,562.50).
By mid-April 2008, initiative supporters said they had raised nearly $900,000 and had spent two-thirds of those funds through March on their petition drive to get the measure on the ballot and on fund raising efforts to fund the election battle if they succeeded.
"It isn't cheap," Blair Butterworth, one of the group's consultants, said. "We are also spending money at the beginning to build a sustainable list of donors who will be with us the duration of the campaign," he said.
The Coalition Against Assisted Suicide was the organization officially opposing 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.
Their primary objections to I-1000 were that the dangers of making doctors bring death to patients far outweighs any advantages to assisted suicide and safeguards in the initiative text. They felt that the legalization of assisted suicide would put lethal pressure on minorities, the disabled, and the poor.
They cited several problematic aspects of the initiative text, noting that I-1000:
- Endangers those struggling with the high cost of health care. Under I-1000 an ill and vulnerable person could be pressured to “choose” a fatal drug overdose rather than be given the health care and support they need. No one wants to be a financial burden; mixing I-1000 with our current unequal and expensive healthcare system would be deadly. In Oregon Medicaid pays for assisted suicide for poor residents under the category of “comfort care”. The drug costs less than $100 – far less than medications and treatments to make patients comfortable. Already some Oregon patients seeking chemotherapy drugs for cancer have been denied treatment but sent a letter suggesting they consider assisted suicide (“A Gift of Treatment,” The Register-Guard, Eugene, Oregon June 3, 2008)
- Allows doctors to give lethal drugs to mentally ill or depressed patients. Many people feel sad, lonely, or afraid when they are seriously ill. Under I-1000 any such “cry for help” by a fearful or depressed person could easily be mistaken for a request for assisted suicide. Depressed or mentally ill persons can be given lethal doses with no psychological evaluation required (“A psychological disorder…does not necessarily disqualify a person.” [Oregonian, 10/17/99]). In Oregon in 2007, no one was referred for psychological evaluation.
- Does not require that spouses and family be told before a doctor gives a loved one a lethal overdose. Under I-1000, a spouse or family member need not be consulted before the patient is given lethal drugs (I-1000, [Sec. 8]). Afterward, the family might never be told the truth of how their loved one died. Finding out after the fact that a loved one intentionally died from a drug overdose would be devastating for grief-stricken family members.
- Has no safeguards for the patient after the prescription is written. No one needs to witness the death, only the initial request. There are no provisions to ensure that the patient is competent when the overdose is taken, that the patient is not pressured into taking the drugs, or that the fatal dose was not given to the patient against his or her will.
- Allows other people to give the patient the lethal overdose. Initiative 1000 states that the patient “may” self-administer the lethal overdose, but does not make the requirement mandatory.
- Allows beneficiaries to witness death requests. Estate law wisely frowns on heirs witnessing wills, but I-1000 allows beneficiaries to sign as a witness to the request for lethal drugs. I-1000 is dangerous because the death does not need to be witnessed, and there is the real possibility that people will be coerced or forced into ending their lives. Common sense tells us that no one who benefits from a death should be involved in giving lethal drugs to the patient; I-1000 does not include this common-sense safeguard.
- Requires a doctor to falsify death certificates. I-1000 requires doctors to lie on the death certificate, so the fatal overdose is not listed. Instead, doctors are directed to fill out the death certificate as if the patient died of natural causes. Relatives would never know the real cause of death, and vital statistics could not be used to track assisted suicide. [I-1000, Section 4, (1)(ii)(B)(2)]
- Has secretive and inadequate reporting so any abuses will never be known. The assisted suicide initiative requires that information on assisted suicide be collected [I-1000, Sec. 15]. However, there are no penalties for incomplete or inaccurate reports. And there are no penalties for failing to report. The original reports are kept secret and sealed from any possible independent study. The Oregonian, the state’s major newspaper, complained in 2005 that the law’s reporting system “seems rigged to avoid finding” the answers. [Living with the Dying ‘Experiment,’ Oregonian, 3/8/05]
- Protects even bad or incompetent doctors from lawsuits. The doctors who prescribe drug overdoses would be given protection from lawsuits or disciplinary action by medical authorities. Most doctors are capable and honest, but I-1000 would make it impossible to stop assisted suicide malpractice. If doctors make a “good faith” effort to obey the law, they cannot be sued.
Not Dead Yet, a disabilities advocacy group which has joined with the Coalition Against Assisted Suicide, objects to the measure because they said:
- It discriminates against and targets the disabled.
- They belief 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.
"This capitalizes on those fears people have about a disability, about people losing bodily control and function, that people would be better off dead than having to face that," Not Dead Yet spokesman Duane French said.
Gov. Christine Gregoire and Republican challenger Dino Rossi both opposed I-1000.
Previously, Gov. Gregoire was taking no position on the measure. According to her spokesman at that time, "Gov. Gregoire believes this is a deeply personal issue, and she is not going to tell people how to believe. Voters in Washington will have to make up their own minds."
The Washington Medical Association has opposed assisted suicide since 1991, when the broader Washington Initiative 119 went to voters.
"We believe physician-assisted suicide is fundamentally incompatible with the role of physicians as healers," said Dr. Brian Wicks, the association's president. "Patients put their trust in physicians, and that bond of trust would be irrevocably harmed by the provisions of this dangerous initiative."
Two Spokane attorneys formed "Democrats Against Assisted Suicide" to educate people that the issue crosses party lines, income levels, and education levels.
Greg Magnoni, a spokesman for the Archdiocese of Seattle, said that Archbishop Alex Brunett and two other bishops authorized 290 Catholic parishes in Washington to take up a collection for the Coalition Against Assisted Suicide. 
TV and radio ads
The Coalition Against Assisted Suicide launched its first set of radio ads. The spots featured actor Martin Sheen, a pro-life Democrat known for his role as the president in the popular television drama West Wing.
Sheen called the measue "a dangerous idea that could hurt low-income people who need medical care. It's a step backwards and I urge you to vote no."
He added that "Initiative 1000 would open up a loophole that health care insurers could exploit to cut payments for the disabled and the working poor—encouraging them to use assisted suicide. This is exactly the wrong direction for real health care in America."
"It's opposed by nurses, disability groups and the 9,000 doctors in the Washington state medical association," Sheen concluded. "People who are ill need real medical care and compassion and not lethal drugs."
Video of the ad: "No on Inititative 1000"
According to Public Disclosure Commission filings through Oct. 10, 2008, the Coalition Against Assisted Suicide raised $1,371,385.09 in 2008. Of that, 784,559.74 (57%) was from a number of Catholic organizations and churches. The largest contribution ($200,000) came from the Knights of Columbus in New Haven, Connecticut.
By mid-August, Catholic groups had contributed more than $130,000 to the opposition campaign, with the largest single check ($50,000) coming from the Seattle Archdiocese.
Campaign finance records from other states show that the Catholic Church and affiliated groups contributed nearly two-thirds of the funding in opposition to death with dignity in every state in which it has been on the ballot. The Catholic Church hierarchy spent $746,000 in 1991 in Washington, $2.2 million in 1992 in California, nearly $1 million in Oregon in 1994, $1.7 million in Oregon in 1997, $2.2 million in Michigan in 1998, and $1.3 million in Maine in 2000.
Overall, opponents to death with dignity spent more than $5 million to defeat it in Michigan in 1998. Opponents have outspent supporters by a ratio of 6 to 1 in the last two elections in which death wth dignity was on the ballot.
Barbara Coombs Lee, president of the Compassion and Choices national network, said they expect the biggest money in opposition to the measure is yet to come. "The money will come late, it will come in very large contributions and it will come from the political arms of the Catholic Church," she said. "It will go to buy lots and lots of media time to try and scare people."
Alex Schadenberg executive director of Canada's Euthanasia Prevention Coalition, has asked supporters to donate to the Washington Coalition Against Assisted Suicide to help counter the pro-euthanasia advertising campaign.
"We cannot allow the euthanasia lobby to brainwash the public by running television commercials without a counter-point-of-view," he said in an email. Anti-euthanasia campaigners fear that should the Washington state initiative pass, there will be a "wild-fire response" of other state initiatives to legalize assisted suicide "everywhere."
In February 2008, the Coalition Against Assisted Suicide filed a complaint in Thurston County Superior Court challenging the initiative's proposed ballot title, arguing that the ballot title doesn't let voters know the "specific impact" of the initiative on existing laws. They say that the measure, were it to pass, would create "an entire protocol for facilitating suicide."
But on Feb. 29, 2008, Thurston County Superior Court Judge Chris Wickham refused to add the words "physician-assisted suicide" to the ballot or official voters pamphlet description for the measure. "It is a somewhat loaded term," Judge Wickham said.
Instead of "suicide," voters will read that Initiative 1000 would allow some terminally ill patients "to request and self-administer lethal medication" prescribed by a doctor. The court declined to add specific language requested by opponents of the measure and largely upheld the description as written by the state attorney general's office.
Human Life of Washington, a pro-life group, opposes the measure. The group has been running a radio ad campaign against the initiative, but because the ads do not mention the initiative, the group argues that they are issue advocacy and not election ads and thus do not require them to disclose their donors.
In May 2008, Human Life, a pro-life group opposing the measure, filed a federal lawsuit against Washington's requirement that it disclose its contributors. Human Life's attorney argues that disclosure could expose donors to harassment and intimidation. The court held that Human Life was conducting a political campaign, and that the public has an interest in disclosure of those campaign donations.
The state Attorney General argued that voters have a right to know who is funding the commercials, leading Human Life to file a suit challenging the law. But U.S. District Court Judge John Coughenour ruled July 11, 2008, that Human Life must obey state election laws while its legal challenge is pending.  In July, the federal judge denied Human Life's request for a preliminary injunction and ruled that Human Life was engaging in a political campaign and must follow state campaign finance laws and disclose their donors. 
- See also Polls, 2008 ballot measures.
A poll conducted Aug. 11 and 12, 2008, showed 51% of respondents were leaning toward supporting Initiative 1000, while 26% indicated they were leaning against it. Undecided voters made up 23%. The poll was sponsored by KING 5 and conducted by Survey USA. It included 1,000 adults and 718 likely voters.
A statewide Elway Poll from early August indicated a higher level of undecided voters, with 39% of those polled saying they favor the measure and 26% opposing it.
A poll released the last week of October showed strong support for I-1000, with 56 percent in favor, 38 percent opposed and 6 percent undecided.
Path to the ballot
The measure was certified for the November 2008 ballot on Aug. 13, 2008. Supporters of the initiative filed approximately 320,000 valid signatures on July 2, 2008. Approximately 170,000 of the necessary signatures were gathered by volunteers, the rest by a paid petition drive management company from California, Progressive Campaigns, Inc..
Supporters turned in their first batch of signatures for the measure on June 26, 2008.
- Wall Street Journal: "Social Issues Dominate 2008 Ballot Initiatives," Aug. 7, 2008
- LA Times: "Washington's right to die battle is personal," June 22, 2008
- The News Tribune: "Death with Dignity initiative set for 2008," Dec. 5, 2007
- Associated Press: "Washington state mulls assisted suicide measure," June 16, 2008
- Seattle Times: "Identifying donors becomes issue in right-to-die campaign," June 16, 2008
- NewsroomAmerica.com: "Wash. Considers Assisted Suicide Measure," June 16, 2008
- Official election results
- Washington Secretary of State, 2008 Election Results
- State of Oregon web site: Death with Dignity Act
- Seattle Times: "My life does not belong to the state or the church," Jan. 17, 2008
- The Daily News: "Gardner revives discussion about assisted suicide," Jan. 22, 2008
- Newcastle News: Editorial: "Death with Dignity initiative promotes a humane choice," Oct. 7, 2008
- LifeSiteNews.com: "Oregon Euthanasia Activists Empty Coffers to Pass Washington State Assisted Suicide Bill," Sept. 24, 2008
- Public Disclosure Commission database of contributions
- Contribution detail
- Life News, Oregon Assisted Suicide Advocates Donate $200,000 for Washington Campaign, March 5, 2008
- Daily Herald: "Right-to-die backers ahead," April 15, 3008
- LifeNews.com: "Spokesman's Son, Disability Groups Oppose Washington Assisted Suicide Prop," June 16, 2008
- KNDO-TV News: "Gregoire opposes Eyman initiative, Rossi for," Oct. 9, 2008
- Los Angeles Times: "Washington's right to die battle is personal," June 22, 2008
- Wenatchee World: "Right-to-die initiative making its way to state ballot," July 14, 2008
- Seattle Post-Intelligencer: "Catholics fighting Wash. suicide initiative," Sept. 3, 2008
- News Tribune: "Catholic parishes raising money to fight assisted suicide initiative," Sept. 4, 2008
- LifeNews.com: "Washington Group Airs First Ads Against Assisted Suicide, Feature Martin Sheen," Sept. 30, 2008
- Oregon Public Broadcasting News: "Assisted Suicide Issue Heats Up In Washington," Aug. 14, 2008
- Citizen Link
- Spokesman Review: "Suicide not in initiative summary," March 1, 2008
- News Tribune: "Human Life’s donors should be disclosed," May 21, 2008
- Post Chronicle: "Judge: Group Must Disclose Donors," July 11, 2008
- Seattle Times: "Assisted-suicide foes want donor privacy," May 20, 2008
- Seattle Times: "Death with Dignity foes lose effort to protect donors," July 9, 2008
- LifeNews.com: "Washington Poll Finds Strong Support for Assisted Suicide Ballot Proposal," Aug. 15, 2008
- The Oregonian: "Washington voters consider measure for terminally ill", October 30, 2008
- All Headline News: "Washington's Doctor-Assisted Suicide Initiative Gathers Public Support," July 4, 2008
- Expenditure detail
- Seattle Times: "Supporters of Initiative 1000 turn in signatures," June 26, 2008