Deaths under Washington’s medical aid in dying program hit new high in 2022

The number of people who chose to take their own lives under the Washington Death with Dignity Act hit a new high in 2022.

Last year, 452 terminally ill adults legally obtained lethal doses of medication from a physician and 446 are known to have died, according to the state Department of Health’s annual report on the program. That’s 59 more deaths than recorded in 2021.

Officials say the increase may be a result of more people participating and state health department staff doing a better job collecting paperwork. Each person must fill out at least five separate forms that until changes made this year had to be signed and mailed to the department, which proved burdensome for medical providers.

“We have always reached out to providers when there are missing forms, but our staff has recently put a great deal more time and effort into contacting each provider and/or pharmacy to track down as much information as possible,” Department of Health spokesman John Doyle said in an email.

Cassandra Sutherland, client services manager for End of Life Washington, a nonprofit that provides counseling on end-of-life care, attributed some of the rise to greater awareness and understanding of the program. 

The organization has expanded its focus on advocacy and education in recent years with patients and health care and hospice providers.

“This law has existed for over a decade now. Everyone knows someone who knows about this law and brings it up for folks, increasing the number of people pursuing access when they are eligible,” she said.

Passage of a bill known as the Protecting Patient Care Act in 2020 is another reason numbers could be up as it will make it easier to obtain aid-in-dying services, she said.

Under the law, hospitals and operators of health care entities cannot prevent their providers from sharing information or referrals around resources for the Death with Dignity Act.

“This meant that all of the staff and providers in any restrictive health care system could talk about medical aid in dying without fear of being fired. The outcome of this has been more information to patients,” Sutherland said. “I do believe this has increased the number of eligible patients knowing this was a legal option.”

Death with Dignity allows residents at least 18 years old, with six months or less to live, to request lethal doses of medication from a physician. Voters approved it in 2008 and the program launched the following year. Today, medical aid in dying is legal in 10 states and Washington, D.C.

In Washington state, two doctors must confirm a patient’s medical condition and that the individual is acting voluntarily. A person must request medication three times, including once in writing.

Of the 446 who died last year, 363 did so after ingesting medication and 44 died without taking the prescribed dosage, based on registered death records and other documentation received by the Department of Health. It was not known if the others took the medication and two people died out of state, officials said.

Three out of four people who took a lethal dose died at home or in a private residence and 91% had some form of health insurance. 

Of the 444 people who died in the state, 234 were men and 210 were women and the overall average age was 74. Demographically, 93% were white and 4% Asian and nine out of 10 lived west of the Cascade mountains, according to the report.

Changes enacted this year are expected to result in greater participation in 2023. 

A new law adds advanced registered nurse practitioners and physician assistants to the list of qualified medical providers who can participate in the program. It also permits an attending medical provider to submit prescription orders to a pharmacist electronically and allows medications to be delivered by mail or courier, which had not been possible before.

Various required forms for the program can now be filed electronically which should streamline the data gathering process.

Editor’s note: The headline on this story was updated to replace the term “physician-assisted deaths” with “medical aid in dying.”