Expanding Access to Death with Dignity

soft pastel photo of an older woman's hand and a younger person's hand

In February, the Seattle-King County Advisory Council on Aging & Disability Services voted unanimously to send a letter to Washington State Senate and Long-Term Care Committee members in support of legislation that would amend the Washington State Death with Dignity Act to expand access to its provisions (ESHB 1141).

Washingtonians voted for the passage of the Death with Dignity Act in 2008. It provides terminally ill and mentally capable individuals more healthcare options in their end-of-life care and access to medical aid in dying. The current law includes many regulatory roadblocks that restrict access to those experiencing the greatest need.

Unfortunately, ESHB 1141 is not going to advance during this year’s legislative session.

In a message in late February, End of Life WA executive director Judy Kinney wrote, “The legislative process has so many ups and downs, but the opportunity to work together was one of the highlights of this session. Hearing from you, having you connect with your legislators, and knowing that you were engaging your friends, loved ones and networks to advance ESHB 1141 inspired our advocacy team even on the challenging days.”

I want to share the components of ESHB 1141 anyway because I expect the Advisory Council will support new legislation in 2023. The legislation would have amended the law in three ways:

1. Modify definition of attending/consulting providers and mental health providers.The current law limits attending/consulting providers to medical doctors (MDs) and doctors of osteopathic medicine (DOs) who can prescribe life-ending medication. Finding two physicians to participate, especially in religiously affiliated hospitals, is a challenge. Similarly, inadequate access to mental healthcare services and treatment, especially in rural areas, compounds issues and leaves patients who need a mental health evaluation with few options.

ESHB 1141 would have allowed physician assistants and advanced registered nurse practitioners to fill in for attending/consulting providers and would extend the role of mental health providers to independent clinical social workers, advanced social workers, mental health counselors, and psychiatric advanced registered nurse practitioners. This amendment would put Washington in line with other states (New Mexico, Hawaii, Maine, New Jersey, and Vermont) that recognized the need to expand the network of authorized care providers who can support medical aid in dying.

2. Reduce the 15-day waiting period. Most individuals spend at least a month (in many cases, several months) wading through a cumbersome process to gain access to medical aid in dying. End of Life WA reports that more than one-third of its clients have difficulty finding physicians and more than one-fifth die within the mandatory 15-day waiting period.

ESHB 1141 would have changed the waiting period to 72 hours and waive that period if an eligible patient is unlikely to survive those 72 hours. This amendment would put Washington in line with other states (Oregon, New Mexico, and California) that recognize the need for shorter waiting periods to end unnecessary suffering.

3. Increase transparency in the practice.Many terminally ill individuals report incomplete or inaccurate information from healthcare providers, which results in them being unable to access the Death with Dignity law.

ESHB 1141 would have required hospitals to submit their policies on end-of-life care services and make this requirement permanent in statute.

According to End of Life WA representatives who gave an excellent presentation to our Advisory Council on February 11, currently 96 percent of those who request medical aid in dying are white. This statistic reflects the stark reality that many Black and brown residents of Washington state have difficulty accessing a full range of options to manage their healthcare. See also “Why ESHB 1141?” (End of Life WA, 1/3/2022).

People living with a terminal illness do not have the luxury of time; they need this option now. If the 2022 legislation had passed, basic eligibility requirements and core safeguards to protect vulnerable people would have been kept intact and unnecessary barriers that terminally ill Washingtonians must navigate to peacefully end their suffering would have been removed.

You can expect to hear more about this issue prior to the 2023 legislative session. In the meantime, I encourage you to read about end-of-life choices. If you have questions, I encourage you to contact End of Life WA.

Joe HaileyContributor Joe Hailey chairs the Seattle-King County Advisory Council on Aging & Disability Services. He welcomes input from readers via e-mail ( and encourages anyone interested in joining the ADS Advisory Council to consider applying when positions open. For more information, visit

This article originally appeared in the March 2022 issue of AgeWise King County.