Thursday, August 4, 2011

Assisted Suicide Report Lacks Information about Consent

(published in the King County Bar Association, Bar Bulletin, July 2011; for a print version, click here).
By Margaret Dore

On March 10, the Washington State Department of Health issued a formal report about our physician-assisted suicide act.1 However, the report does not address whether the people who died under the act did so on a voluntary basis.

Washington's Act

Washington's assisted-suicide act was enacted via a ballot initiative in 2008 and went into effect in 2009.2 During the election, proponents claimed that the act's passage would assure individuals control over their deaths.
The act, however, does not assure such control. 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.3 There are also no witnesses required at the death.4 Without disinterested witnesses, the opportunity is created for someone else to administer the lethal dose to the person without his consent.

The Assisted-Suicide Report

Statistical Information

The Department of Health report focuses on statistical information. This information states that lethal doses were dispensed to 87 people during 2010. Of these 87 people, 51 are reported to have died after ingesting a lethal dose.5

Physician Reports

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.6

According to the report, the data for these statistics were obtained from an "After Death Reporting Form" completed by the prescribing physician after each death.7 According to the report, however, the prescribing physician is rarely present at the death.8 If that is the case, he or she is necessarily relying on other persons for the data reported.

Patient "Concerns"

The report seeks to document the "concerns" of the people who died, which led to their requesting the lethal dose.9 The data for these concerns come from the "After Death Reporting Form," which lists seven questions to be checked off by the prescribing doctor.10 These choices do not include the possibility of abuse by an heir.11

The report also provides no information as to whether the people who died consented when the lethal dose was administered. In other words, there is no information regarding whether the deaths were truly voluntary.12

Margaret K. Dore is an elder law/appellate attorney in Washington. She is a former law clerk to the Washington Supreme Court and 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

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1 Washington State Department of Health 2010 Death with Dignity Act Report ("Report"), issued March 10, 2011, available at
2 Washington's assisted-suicide law was passed as Initiative 1000 on November 4, 2008, and went into effect on March 5, 2009. See RCW 70.245.903.
3 RCW 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.
4 See Washington's act in its entirety at RCW 70.245.010 et. seq.
5 Report, Executive Summary, at 1.
6 Report at 9, Table 5 ("Circumstances and complications relating to ingestion of medication prescribed under the Death with Dignity Act of the participants who have died").
7 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).
8 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 at 9, Table 5.
9 Report at 7, Table 3.
10 See After Death Reporting Form, supra note 7, Question 7.
11 Id.
12 The 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