Washington’s Death With Dignity Act – Part 2
Several weeks ago, I published an article (which may be found here) to introduce Washington’s Death with Dignity Act (RCW 70.245, or the “Act”) and to outline the qualifications necessary to receive physician-assisted death. In addition to these qualifications, the Act imposes extensive duties on physicians to ensure the wishes of the patient are completely and legally fulfilled.
Physicians hold extensive statutory duties when executing the process of administering medical aid-in-dying. The Act requires the affirmative consent of two physicians; one attending physician’s consent and one consulting physician’s consent. Pursuant to RCW 70.245.040, the attending physician—the physician primarily responsible for the care of the patient—must fulfill a number of duties such as:
1) making an initial determination of a patient’s terminal disease, competence, and the validity of the voluntary nature of their request;
2) request that the patient demonstrate Washington residency;
3) ensure that the patient is making an informed decision;
4) refer the patient to a consulting physician for medical confirmation of the determinations made in item (1);
5) refer the patient for counseling, if appropriate;
6) recommend that the patient notify next of kin;
7) counsel the patient about the importance of having another person present when the patient takes the medication prescribed under this chapter;
8) inform the patient of the importance of not taking the medication in a public place;
9) inform the patient that he or she has an opportunity to rescind the request at any time and in any manner, and offer the patient an opportunity to rescind at the end of the fifteen-day waiting period;
10) verify, immediately before writing the prescription for medication, that the patient is making an informed decision;
11) fulfill the medical record documentation requirements of RCW 70.245.120;
12) ensure that all appropriate steps are carried out before writing a prescription for medication to enable a qualified patient to end his or her life in a humane and dignified manner; and
13) dispense medications directly and in a manner that most effectively minimizes the patient’s pain and discomfort.
Washington’s Department of Health also requires physicians to complete several layers of reporting regarding their interactions with and recommendations for the patient. WAC 246-978-020.
Physicians must comply with these various statutes and regulations. Doing so ensures the process of administering lethal medication is properly carried out and that patients can fully understand the weight and consequences of their decisions.