Cambridge Quarterly of Healthcare Ethics

Special Section: Euthanasia and Physician-Assisted Suicide: Murder or Mercy?

Washington State Initiative 119: The First Public Vote on Legalizing Physician-Assisted Death

Peter M. McGougha1

a1 Professor in the Department of Family Medicine at the University of Washington School of Medicine in Seattle

In the fall of 1991, voters in Washington state were asked to consider a public initiative that sought to legalize physician-assisted death: Initiative 119. Drafted by Washington Citizens for Death with Dignity, the initiative was intended to amend the existing state natural death act in several ways:

1) expand the definition of “terminal condition” to include patients in irrevers ible coma or persistent vegetative state;

2) specifically name “artificial nutrition and hydration” as life-sustaining medical procedures that could be refused or withdrawn;

3) legally allow mentally competent patients with certifiably terminal conditions to request and receive “aid-in-dying” from their physician as a medical service.

The first two proposed amendments were widely acknowledged as timely and appropriate; a coalition of medical, religious, and community organizations had been actively working on such additions for several years. It was the proposal to legalize “aid-in-dying,” however, that represented a radical shift in the conduct of physicians towards their patients and a dramatic shift in social policy.

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