Doctors without Borders


By a vote of 59 percent to 41 percent on November 4, 2008, Washington State voters endorsed a ballot initiative to legalize physician-assisted suicide (PAS). If the final outcome was never much in doubt, the margin of victory was surprising. In 1991, an initiative in favor of euthanasia had been defeated in Washington. But this time Washington’s proponents shifted to PAS. The assumption, a shrewd one, was that the public would be more willing to accept a patient’s self-administered death than one directly carried out by a doctor.

What, if anything, are the national implications of the Washington vote? The answer to that question is unclear. When Oregon’s PAS law, passed as a ballot initiative in 1994, went into effect in 1997, there was a widespread expectation that other states would soon follow. With the exception of Washington, that has not happened. There seem to be no states anywhere now near a change in their laws, either through legislative or ballot initiatives. A number of such efforts in a variety of states failed in the 1990s, and recent years have not seen similar bursts of activity. The Washington vote might reignite such efforts, but that is by no means certain.

The history of the Oregon initiative and law offers some hints about what may happen in Washington. In Oregon, the most unexpected outcome has been the small number of people who have taken advantage of the law, only...

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About the Author

Daniel Callahan, a former Commonweal editor, is president emeritus of the Hastings Center and the author of What Price Better Health: Hazards of the Research Imperative.