Initiative 1000
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Initiative 1000 (I-1000) of 2008 established the
U.S. state In the United States, a state is a constituent political entity, of which there are 50. Bound together in a political union, each state holds governmental jurisdiction over a separate and defined geographic territory where it shares its so ...
of
Washington Washington most commonly refers to: * George Washington (1732–1799), the first president of the United States * Washington (state), a state in the Pacific Northwest of the United States * Washington, D.C., the capital of the United States ** A ...
's Death with Dignity Act ( RCW 70.245), which legalizes medical aid in dying with certain restrictions. Passage of this
initiative Popular initiative A popular initiative (also citizens' initiative) is a form of direct democracy by which a petition meeting certain hurdles can force a legal procedure on a proposition. In direct initiative, the proposition is put direct ...
made Washington the second U.S. state to permit some
terminally ill Terminal illness or end-stage disease is a disease that cannot be cured or adequately treated and is expected to result in the death of the patient. This term is more commonly used for progressive diseases such as cancer, rather than fatal injur ...
patients to determine the time of their own death. The effort was headed by former Governor
Booth Gardner William Booth Gardner (August 21, 1936 – March 15, 2013) was an American politician who served as the 19th governor of Washington from 1985 to 1993. He also served as the ambassador of the GATT. A member of the Democratic Party, Gardner previ ...
. The measure was approved in the November 4, 2008 general election. 1,715,219 votes (57.82%) were cast in favor, 1,251,255 votes (42.18%) against. There were 2,966,474 votes total. 30 of the state's 39 counties voted in favor of the initiative. In 1991, the similar
initiative Popular initiative A popular initiative (also citizens' initiative) is a form of direct democracy by which a petition meeting certain hurdles can force a legal procedure on a proposition. In direct initiative, the proposition is put direct ...
119 was rejected by Washington
voters Voting is the process of choosing officials or policies by casting a ballot, a document used by people to formally express their preferences. Republics and representative democracies are governments where the population chooses representatives ...
by a margin of 54 percent to 46 percent. I-119 would have allowed doctors to prescribe a
lethal Lethality (also called deadliness or perniciousness) is how capable something is of causing death. Most often it is used when referring to diseases, chemical weapons, biological weapons, or their toxic chemical components. The use of this term ...
dosage of medication, and also to administer it if the terminally ill patient could not self-administer. Unlike that initiative, I-1000 requires the patient to ingest the medication unassisted. The initiative is based on Oregon Measure 16, which
Oregon Oregon ( , ) is a U.S. state, state in the Pacific Northwest region of the United States. It is a part of the Western U.S., with the Columbia River delineating much of Oregon's northern boundary with Washington (state), Washington, while t ...
voters passed in 1994 but was not implemented until 1997. At that time, Oregon was the only other state to have enacted similar legislation. In 2013, Vermont became the third state to enact similar legislation. In 2016, California became the fourth state to enact similar legislation. All states on the West Coast now have similar legislation.


Specific provisions in the initiative

The official ballot summary for the measure, slightly amended following a February 2008 court challenge, is, "This measure would permit
terminally ill Terminal illness or end-stage disease is a disease that cannot be cured or adequately treated and is expected to result in the death of the patient. This term is more commonly used for progressive diseases such as cancer, rather than fatal injur ...
, competent, adult Washington residents medically predicted to die within six months to request and self-administer lethal medication prescribed by a physician. The measure requires two oral and one written request, two physicians to diagnose the patient and determine the patient is competent, a waiting period, and physician verification of an informed patient decision. Physicians, patients and others acting in good faith compliance would have criminal and civil immunity." Provisions in the law include: * The patient must be an adult (18 or over)
resident Resident may refer to: People and functions * Resident minister, a representative of a government in a foreign country * Resident (medicine), a stage of postgraduate medical training * Resident (pharmacy), a stage of postgraduate pharmaceut ...
of the state of Washington * The patient must be mentally competent, verified by two physicians (or referred to a mental health evaluation) * The patient must be terminally ill with less than 6 months to live, verified by two physicians. * The patient must make voluntary requests, without
coercion Coercion involves compelling a party to act in an involuntary manner through the use of threats, including threats to use force against that party. It involves a set of forceful actions which violate the free will of an individual in order to i ...
, verified by two physicians * The patient must be informed of all other options including
palliative Palliative care (from Latin root "to cloak") is an interdisciplinary medical care-giving approach aimed at optimizing quality of life and mitigating or reducing suffering among people with serious, complex, and often terminal illnesses. Man ...
and hospice care * There is a 15-day waiting period between the first oral request and a written request * There is a 48-hour waiting period between the written request and the writing of the prescription * The written request must be signed by two independent witnesses, at least one of whom is not related to the patient or employed by the health care facility * The patient is encouraged to discuss with family (not required because of confidentiality laws) * The patient may change their mind at any time and rescind the request * The attending physician may sign the patient's death certificate which must list the underlying terminal disease as the cause of death


Supporters

The campaign was run by a coalition that includes former Washington governor,
Booth Gardner William Booth Gardner (August 21, 1936 – March 15, 2013) was an American politician who served as the 19th governor of Washington from 1985 to 1993. He also served as the ambassador of the GATT. A member of the Democratic Party, Gardner previ ...
. aid-in-dying advocates from Oregon, the
Death with Dignity National Center Death with Dignity National Center is a 501(c)(3) Nonpartisanism, nonpartisan nonprofit organization, headquartered in Portland, Oregon, that has led the legal defense of and education about Assisted suicide, Death with Dignity laws throughout t ...
,
Compassion & Choices Compassion & Choices is a nonprofit organization in the United States working to improve patient autonomy and individual choice at the end of life, including access to Palliative sedation, medical aid in dying. Its primary function is advocating f ...
, Compassion & Choices of Washington, Compassion & Choices of Oregon. The name of the official political advocacy group working on the campaign was changed from "It's My Decision" to "YES on 1000". State Senator
Darlene Fairley Darlene Cook Fairley (born 1943) was a member of the Washington State Senate The Washington State Senate is the upper house of the Washington State Legislature. The body consists of 49 members, each representing a district with a population o ...
, who chairs the Death with Dignity Disabilities Caucus, said that "as a matter of personal control and autonomy, it makes sense to let patients themselves decide what kind of medical care they want to receive and how long they want to suffer with a terminal illness." State Representative
Jamie Pedersen Jamie D. Pedersen (born September 9, 1968) is an American lawyer and politician serving as a member of the Washington State Senate, representing the 43rd district since 2013.American Medical Student Association The American Medical Student Association (AMSA), founded in 1950 and based in Washington, D.C., is an independent association of physicians-in-training in the United States. AMSA is a student-governed national organization. They have a membershi ...
, the American Medical Women's Association, the Lifelong AIDS Association, the
ACLU The American Civil Liberties Union (ACLU) is an American nonprofit civil rights organization founded in 1920. ACLU affiliates are active in all 50 states, Washington, D.C., and Puerto Rico. The budget of the ACLU in 2024 was $383 million. ...
, the National Women's Law Center, the Washington Chapter of the
National Association of Social Workers The National Association of Social Workers (NASW) is a professional organization of social workers in the United States. NASW has about 120,000 members. The NASW provides guidance, research, up to date information, advocacy, and other resources ...
, and the Washington State Public Health Association. The Washington State Psychology Association was
neutral Neutral or neutrality may refer to: Mathematics and natural science Biology * Neutral organisms, in ecology, those that obey the unified neutral theory of biodiversity Chemistry and physics * Neutralization (chemistry), a chemical reaction in ...
on I-1000, but found that "patients choose aid in dying because of a desire for
autonomy In developmental psychology and moral, political, and bioethical philosophy, autonomy is the capacity to make an informed, uncoerced decision. Autonomous organizations or institutions are independent or self-governing. Autonomy can also be ...
and the wish to avoid loss of
dignity Dignity is a human's contentment attained by satisfying physiological needs and a need in development. The content of contemporary dignity is derived in the new natural law theory as a distinct human good. As an extension of the Enlightenment- ...
and control, not because of a poor mental state, lack of resources or social support," and "the law has had a positive effect in terms of significant improvements in palliative care." The ''Newcastle News'' endorsed the measure in an October 7, 2008, editorial. "Some opponents of I-1000 will refer to the life-death option as assisted suicide, but this has no resemblance to suicide. It is a humane end to a life that is already ending," the editorial said.


Opposition

The Coalition Against Assisted Suicide opposed the measure. It included doctors and nurses, disability rights advocates and organizations,
hospice Hospice care is a type of health care that focuses on the palliation of a terminally ill patient's pain and symptoms and attending to their emotional and spiritual needs at the end of life. Hospice care prioritizes comfort and quality of life b ...
workers,
minorities The term "minority group" has different meanings, depending on the context. According to common usage, it can be defined simply as a group in society with the least number of individuals, or less than half of a population. Usually a minority g ...
, right-to-life organizations, the
Catholic Church The Catholic Church (), also known as the Roman Catholic Church, is the List of Christian denominations by number of members, largest Christian church, with 1.27 to 1.41 billion baptized Catholics Catholic Church by country, worldwid ...
and other
Christian A Christian () is a person who follows or adheres to Christianity, a Monotheism, monotheistic Abrahamic religion based on the life and teachings of Jesus in Christianity, Jesus Christ. Christians form the largest religious community in the wo ...
organizations, and politicians. The organization held that the danger of making doctors the agents of a patient's death far outweighed any advantages to assisted suicide, or safeguards in the initiative's text. They felt that legalization of assisted suicide would put pressure on minorities, the disabled, and the poor. Actor
Martin Sheen Ramón Gerard Antonio Estévez (born August 3, 1940), known professionally as Martin Sheen, is an American actor. His work spans over six decades of television and film, and his accolades include three Emmy Awards, a Golden Globe Award, and ...
appeared in television ads opposing Initiative 1000. There has been some debate over one of Sheen's statements: persons with depression can be given a lethal dose without prior professional assessment. According to the Washington Death with Dignity act, "Medication to end a patient's life in a humane and dignified manner shall not be prescribed until the person performing the counseling determines that the patient is not suffering from a psychiatric or psychological disorder or depression causing impaired judgment." This issue has been explored in the field of medical ethics.


Results


See also

* Act 39 in
Vermont Vermont () is a U.S. state, state in the New England region of the Northeastern United States. It borders Massachusetts to the south, New Hampshire to the east, New York (state), New York to the west, and the Provinces and territories of Ca ...
, the first state to pass a death with dignity law by legislative action * California End of Life Option Act *
Oregon Death with Dignity Act Measure 16 of 1994 established the U.S. state of Oregon's Death with Dignity Act ( ORS 127.800–995), which legalizes medical aid in dying (commonly referred to as physician-assisted suicide) with certain restrictions. Passage of this initiati ...
, a ballot initiative passed in 1994 in the neighboring state of
Oregon Oregon ( , ) is a U.S. state, state in the Pacific Northwest region of the United States. It is a part of the Western U.S., with the Columbia River delineating much of Oregon's northern boundary with Washington (state), Washington, while t ...
* '' Baxter v. Montana'', a court decision legalizing aid in dying in Montana. * ''
Washington v. Glucksberg ''Washington v. Glucksberg'', 521 U.S. 702 (1997), was a List of landmark court decisions in the United States, landmark decision of the U.S. Supreme Court, which unanimously held that a right to assisted suicide in the United States was not prote ...
'', a 1997 Supreme Court decision upholding the State of Washington's Natural Death Act of 1979, a ban on assisted dying that the Death with Dignity Act repealed. *
Assisted suicide in the United States In the United States, the term "assisted suicide" is typically used to describe what proponents refer to as "medical aid in dying" (MAID), in which a terminally ill adult is prescribed, and self-administers, barbiturates if they feel that they ...
* Compassion and Choices * Voluntary Assisted Dying Act 2017 (Victoria)


References


External links


Official Washington State Department of Health page on the DWDA
with Annual Reports
Ballotpedia entry on Washington Initiative 1000


In support

*{{usurped,
Yes! on I-1000 Committee
}
Death With Dignity National Center


In opposition


Coalition Against Assisted Suicide


Further reading


''Wall Street Journal'': "Social Issues Dominate 2008 Ballot Initiatives," Aug. 7, 2008


* ttp://blogs.thenewstribune.com/oped/2007/12/05/death_with_dignity_initiative_set_for_2008 ''The News Tribune'': "Death with Dignity initiative set for 2008," Dec. 5, 2007
''Associated Press:'' "Washington state mulls assisted suicide measure," June 16, 2008


* ttp://www.newsroomamerica.com/usa/story.php?id=421573 ''NewsroomAmerica.com:'' "Wash. Considers Assisted Suicide Measure," June 16, 2008
''Seattle Post-Intelligencer'': "Playing God or dignified death? Faith-based groups taking crucial role in initiative battle" October 13, 2008
Death in Washington (state) 2008 Washington (state) ballot measures Initiatives in the United States Assisted suicide in the United States Euthanasia legislation