The straight talk on implementation of the Death with Dignity Act

There have been news stories circulated that suggest implementation is going badly in Washington with few physicians willing to prescribe. One particularly disturbing story focused on the plight of a terminally ill man in eastern Washington who could not find a physician to prescribe under the auspices of the law. This was a tragic story; but, unfortunately, it was to be expected.

Death with Dignity offers patients one more option at the end of life — an option that, prior to the law being enacted, would have risked criminal prosecution for their loved ones and their physicians. It is, therefore not surprising that physicians were unwilling to change their practices the day after the law went into effect. In our culture, changes take time and the existence of a law does not mean that actions change overnight. The plight of a man dying without the relief of Death with Dignity was not a symptom of implementation failure, it was a symptom of years of cultural failure to address the problems of protracted dying brought about by advances in medical technology.

So, implementation will build slowly in Washington. We know this because we were here in Oregon for the first years of implementation. It will take time for physicians and pharmacists to become familiar and comfortable with the process, and it will not happen overnight. We still deal with similar issues in Oregon. Implementation in Washington is unfolding along the same trajectory that it did in Oregon. We should take comfort in this fact, and support physicians and pharmacists who are changing the ways they practice medicine.

As of this posting, four people have used the Washington law, the first in May, 2009. Monitor the implementation statistics on Washington.