by Lark Claassen, Volunteer Storyteller

On April 6th, Governor Inslee signed into law ESSB 5179 – Protecting Access to Medical Aid-In-Ding (MAID). ESSB 5179, which went into effect July 23, 2023, amends the original Death with Dignity Act, which was approved by Washington voters in 2008. The amended law addresses key barriers that have made it difficult for qualified patients to use it as intended.

The Death with Dignity Act gives terminally ill Washington adults access to prescription medications they can take to end their life peacefully: on their terms. Under the original act, two physicians (MD or DO) had to examine the patient and certify that they met all the criteria set by the law. A patient had to ask for the medications three times over the course of a 15-day waiting period: twice orally and once in writing. One of the two physicians would then send the prescription for a mixture of five different medications to the pharmacy to be filled. Because the prescription is for a mixture, only specialized compounding pharmacies have been able to fill the prescription.

Under the new law, the procedure of written and oral requests has been maintained, but the waiting period has been shortened from 15 days to seven days. The physicians can now send the prescription to the pharmacy by fax, and the pharmacies can fill the medications by mail. These changes improve access, especially for patients residing in one of the 27 counties in the state which do not have a compounding pharmacy. In the South Sound region, there is only one compounding pharmacy that will fill the prescription. Residents of the neighboring counties of Grays Harbor, Mason, and Lewis Counties do not have compounding pharmacies, so under the current law, the prescribing physician and patient must drive an hour or more to Olympia to hand-deliver the prescription and pick it up when it is ready.

Another key feature of the new law is changes in the licensure requirements for the healthcare providers who verify the patient’s qualifications and write the prescriptions. Under the new law Physician Assistants (PA) and Nurse Practitioners (ARNPs) can now serve as one of the two providers verifying and prescribing, and the licensure needed to certify a patient’s mental competence now includes social workers (LASW and LICSW), Licensed mental health counselors (LMHC) and psychiatric nurse practitioners (PMHNP). Although these improvements allow for greater access, the process of using the law will usually take 2-3 weeks.

For more information about the new law or to volunteer with End of Life Washington, please visit our website at


Lark Claassen is an Olympia resident, and a volunteer with End-of-Life Washington.