Robb Miller has been the Executive Director of Compassion & Choices of Washington—an affiliate of Compassion & Choices—since 2000. He was also one of the leaders of the coalition that passed Initiative 1000, the Washington Death with Dignity Act, with nearly 60% of the vote in 2008.

When the Washington Department of Health issued its third annual report on the Washington State Death with Dignity Act in early May, there was little interest from the media and no good news for opponents of patient autonomy at the end-of-life.

The lack of interest from the media tells us there was nothing sensational and no controversies to report. On the other hand, less media coverage means less awareness about the law.

Only 16 more people received prescriptions for life-ending medication as compared to 2010, and only 10 more died after receiving prescriptions. Of the 94 individuals who died, 70 self-administered medication, and 19 didn't—32% of patients who acquired prescriptions in 2011 elected not to take the medication. This is bad news for opponents who claimed that people who use the law would be anxious to die and would take the medication prematurely. The report indicates just the opposite.

"Oregon and Washington are currently the only two states with Death with Dignity Acts."

Today, I was looking at a copy of the Washington Death with Dignity Act to check out a specific piece of information, and I realized the law is 20 pages long. Because I work with it everyday, I'm familiar with the law's intricacies, but seeing it laid out page after page, I realized many individuals who are looking at it for the first time may be overwhelmed. I thought I'd provide a bit of a recap for our followers.

Oregon and Washington are currently the only two states with Death with Dignity Acts. The laws are similar in both states, allowing terminally ill adult residents who are mentally competent to request a prescription from a physician for a medication to hasten death. These patients must also be able to self-administer the medication. The process is voluntary for everyone involved — patient, physician, pharmacist, health care facility.

Who's eligible to use the Oregon or Washington laws?

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.

Voters of Washington stood up for the rights of terminally ill individuals and passed the Washington Death with Dignity Act - 58.68% (yes) to 41.32% (no).

15 years ago, Oregon voters changed the entire debate about end-of-life care. After surviving repeal efforts, legal challenges that went all the way to the Supreme Court and efforts by the Bush Administration to shut down the law, we have shown that our law in Oregon works, just as it will work in Washington. We have shown that people can have control over the end of their lives in a dignified, safe way that has improved end-of-life care from pain control to hospice.

Now, the real winners are people who will face a terminal illness knowing that they have control, knowing that they can decide when it is the right time for them to end their suffering. And tonight, we honor those brave people who fought so long for this right, but died before seeing their efforts come to fruition.

The Washington Death with Dignity initiative has received an unprecedented number of newspaper endorsements - 21 in all! Below are links to many of them.