The following editorial first appeared in The News Tribune of Tacoma.
Bill Newmann of Olympia has come full circle as a medical provider. He witnessed the first breath of life for many years as a family doctor. He’s present for the last breath in his current volunteer role helping families use Washington’s Death with Dignity Act.
“I used to deliver babies,” said Newmann, 75, in a recent interview with the TNT’s editorial page editor. “This is completely different, but just as awe-inspiring and wondrous and fulfilling in its own way.”
He and other advocates are pressing for legislation in Olympia that would expand access to aid-in-dying measures by changing the law for the first time since it was enacted 12 years ago.
The call to update the law is compelling. We respect medical and social work professionals who are dedicated to helping dying Washingtonians leave this world on their own terms — at home, peacefully, with a doctor’s prescription, free of needless pain, surrounded by loved ones.
The COVID-19 pandemic has highlighted the bitter tragedy of people dying in hospital rooms, alone.
Advocates are right to leave the bedrock safeguards of the law intact: A person using it must be mentally competent, not under duress and have a diagnosis of six months or less to live.
But legislators will skip a key step if they adopt House Bill 1141 as drafted. It could be that the proposed changes go too far, or not far enough.
What’s needed is a thorough study of the barriers that prevent Washington residents from accessing the Death with Dignity Act — a study that legislators authorized a year ago, but was vetoed by Gov. Jay Inslee as part of his early COVID-19 budget austerity measures.
A study conducted by the University of Washington, looking at everything from public awareness to geographic availability to the effectiveness of the 15-day waiting period, should be reauthorized with the governor’s blessing.
Washington voters made their wishes known by approving a ballot initiative in 2008; with a 58-percent yes vote, Washington became the second state, after Oregon, to adopt physician-assisted suicide laws. Today there are eight. The late Washington Gov. Booth Gardner of Tacoma, who suffered from Parkinson’s Disease, was a leader in the campaign to pass the initiative.
HB 1141 has passed the House and now sits in a Senate committee, where it could be amended. Some provisions seem sensible, such as expanding the range of health care providers who can carry out the duties of the act. The bill would allow advanced registered nurse practitioners, physician assistants and osteopathic physician assistants to participate, as long as a doctor remained involved as the consulting or prescribing physician.
But one proposed change has spawned the most division: reducing the waiting period between the first and second oral requests for a lethal prescription from 15 days to 72 hours.
At a public hearing last week, several doctors and family members cautioned against compressing the timeline; they told stories of patients who rebounded or had a good quality of life in the latter stages of a terminal diagnosis.
Others told stories of cancer patients suffering needless agony because they had to wait more than two weeks, in some cases enduring “a bad death” before their prescription could be filled.
Navigating these choppy ethical waters isn’t easy. But cutting the waiting period by 80% would be a major deviation from what voters approved and, in our view, needs careful examination.
There’s one area where improvements are clearly overdue — public awareness. According to state Department of Health data, of the 695 people who died using the law from 2016-18, 96 percent were white, 89 percent lived west of the Cascades and 71 percent were college educated.
The numbers point to a stark education and equity gap. Newmann, a volunteer consultant for End of Life Washington,says health care providers should routinely discuss aid-in-dying as an option, much like they now share information about living wills and advance directives.
Bottom line: “People in our culture just aren’t comfortable talking about death.”
Newmann has consulted on 40 to 50 deaths, he said, and started attending at bedsides a year or two ago. The law doesn’t require it, but he likes to be present in case there are side effects or complications with a patient self-administering their oral dosage — and also because of the “wonderful rapport” he builds with families.
After 12 years, there’s little question the original Death with Dignity Act is due for a refresh so more health care providers can assist more families.
A comprehensive study would help state leaders determine which parts.