Yes, assisted death is legal in Washington state. The Washington Death with Dignity Act has been in effect since 2009, after voters approved Initiative Measure No. 1000. The law allows terminally ill adults to request and self-administer life-ending medication under a set of strict eligibility requirements.
Who Qualifies Under the Law
To participate in Washington’s Death with Dignity program, you must meet all of the following criteria:
- Age: 18 years or older
- Residency: A current Washington state resident
- Terminal illness: Diagnosed with an incurable, irreversible disease expected to cause death within six months
- Decision-making capacity: Able to make and communicate an informed decision to healthcare providers
- Voluntariness: The request must come entirely from the patient, without coercion
Two independent physicians must confirm the terminal diagnosis and the six-month prognosis. If either physician is concerned that a mental health condition may be impairing the patient’s judgment, they can refer the patient to a licensed psychiatrist or psychologist for evaluation before the process moves forward.
How to Prove Washington Residency
You do not need to have lived in Washington for a specific length of time, but you do need to show that you are a current resident. The Washington Department of Health lists several acceptable documents: a driver’s license, voter registration, a mortgage or rental agreement, or a utility bill. This is not an exhaustive list, so other proof of residency may also be accepted.
The Request Process
The law requires multiple steps designed to confirm that the patient’s decision is informed and consistent over time. You must make two oral requests to your attending physician, separated by a waiting period. You also submit a written request, which must be signed in front of two witnesses.
Your attending physician is responsible for confirming your eligibility, explaining alternatives like hospice and palliative care, and ultimately writing the prescription if all criteria are met. A second, consulting physician independently reviews your medical records and confirms both the diagnosis and prognosis. These two physicians must be separate from each other.
Self-Administration Is Required
Washington’s law is specifically limited to what’s sometimes called “physician aid-in-dying,” not euthanasia. The patient must be physically capable of taking the medication themselves. A doctor cannot administer the lethal dose. This is a key legal distinction: the law authorizes a physician to prescribe the medication, but the final act belongs entirely to the patient. No one else can give it to them.
Providers Can Opt Out
No physician or healthcare facility is required to participate. Individual doctors can decline to write a prescription under the act, and healthcare systems (particularly those with religious affiliations) can adopt policies prohibiting participation at their facilities. If your doctor declines, they are generally expected to inform you so you can seek another provider, but the law does not compel anyone to be part of the process.
Cost of the Medication
The out-of-pocket cost varies widely depending on your insurance. A study published in JAMA Oncology found that among patients with private insurance that covered the medication, copayments ranged from $2 to over $1,200. However, a significant portion of patients in the study, about two-thirds, either paid cash or had federally funded insurance plans (like Medicare or Tri-Care) that did not cover any of the cost. Federal programs generally do not pay for aid-in-dying medication, which can leave some patients covering the full price themselves.
How Many People Use the Law
In 2023, 545 Washington residents participated in the Death with Dignity program, meaning they received a dispensed prescription under the law. Of those, 524 are known to have died. Not everyone who receives the medication ultimately takes it. Some patients find comfort simply in having the option available, even if they never use the prescription.
Usage has grown steadily since the law took effect. Washington was only the second state in the country to legalize this practice, following Oregon’s 1997 Death with Dignity Act. As of now, roughly a dozen U.S. states and Washington, D.C., have similar laws on the books, though the specific requirements vary by state.