Death With Dignity Checklist for Patients
This checklist provides an overview of the steps involved in obtaining a prescription for life-ending medication under the Washington State Death with Dignity (DWD) law. It also outlines the law’s qualification criteria and lists current life-ending medication prescription options. An overview of End of Life Washington’s client support services is also provided.
Do You Qualify?
- Resident of Washington (contact us) for more information if you are out-of-state)
- 18 years of age or older
- Mentally competent to make an informed decision at the time of your request
- Terminal illness with life expectancy of 6 months or less
- Able to self-ingest the medications (contact us if you are unsure)
Requirements of the Law
- An Attending Physician (AP) who writes the prescriptions
- A Consulting Physician (CP) who verifies the diagnosis and prognosis
- Two oral requests for DWD with a minimum of 15 days between
- A written request for life-ending medications (Download Request for Medication form)
Step-by Step Instructions
- Make a clear request to use the WA Death with Dignity law to a Medical Doctor (MD) or Doctor of Osteopathy (DO), and be sure it is recorded in your medical chart.
- Identify and see an MD or DO who is willing to act as the Attending (Prescribing) Physician.
- Identify and see an MD or DO who is willing to act as the Consulting Physician.
- After seeing both AP and CP, complete the written request for medications and return it to the AP. Note: Be sure it is witnessed by two people at the time of signing.
- At least 15 days after the first oral request was recorded, make a second oral request for DWD to the Attending Physician.
No matter which you choose, your experience is peaceful.
Medications are mixed in 2-4 ounces of liquid, and ingested
- DDMAPh/DDMA – a compounded mixture of digoxin, diazepam, morphine, amitriptyline and phenobarbital (approximate cost $750)
- Medications are mixed in 2-4 ounces of liquid and ingested
End of Life Washington Services
- Our volunteers can help you find supporting physicians
- Our services are free
- Our volunteers can be there for you and your loved ones should you decide to take life-ending medications, so your final moments are burden-free for everyone present
- Submit an online support request or call us at 206.256.1636, option 1
Updated June 2022
The checklist is available in the following languages: Arabic, Chinese, Haitian-Creole, Korean, Russian, Spanish, and Tagalog.