So what is happening in the U.S. concerning political movements and legislation?

Montana

On December 5, 2008, state District Court judge Dorothy McCarter ruled in favor of a terminally ill Billings resident who had filed a lawsuit with the assistance of Compassion & Choices, a patient rights group. The ruling states that competent, terminally ill patients have the right to self-administer lethal doses of medication as prescribed by a physician. Physicians who prescribe such medications will not face legal punishment. On September 2, 2009, the Montana Supreme Court heard arguments in Baxter v. Montana.

Oregon
Ballot Measure 16 in 1994 established the Oregon Death with Dignity Act , which legalizes physician-assisted dying with certain restrictions, making Oregon the first U.S. state and one of the first jurisdictions in the world to officially do so. The measure was approved in the 8 November 1994 general election in a tight race with the final tally showing 627,980 votes (51.3%) in favor, and 596,018 votes (48.7%) against. The law survived an attempted repeal in 1997, which was defeated at the ballot by a 60% vote. In 2005, after several attempts by lawmakers at both the state and federal level to overturn the Oregon law, the Supreme Court of the United States ruled 6-3 to uphold the law after hearing arguments in the case of Gonzales v. Oregon .

Texas
In 1999, the state of Texas passed the Texas Futile Care Law. Under the law, in some situations, Texas hospitals and physicians have the right to withdraw life support measures, such as mechanical respiration, from terminally ill patients when such treatment is considered to be both futile and inappropriate. In 2005, a six-month-old infant , Sun Hudson , with a uniformly fatal disease thanatophoric dysplasia , was the first patient in which “a United States court has allowed life-sustaining treatment to be withdrawn from a pediatric patient over the objections of the child’s parent.”

Washington
WASHINGTON DEATH WITH DIGNITY ACT
In 2008, assisted suicide in the state of Washington was made legal by Initiative 1000.
Initiative 1000 (I-1000) of 2008 established the U.S. state of Washington ‘s Death with Dignity Act 70.245, which legalizes physician-assisted dying with certain restrictions. Passage of this initiative made Washington the second U.S. state to permit some terminally ill patients to determine the time of their own death. The effort was headed by former Governor Booth Gardner.

The measure was approved in the November 4, 2008 general election. 1,715,219 votes (57.82%) were cast in favor, 1,251,255 votes (42.18%) against. There were 2,966,474 votes total. 30 of the state’s 39 counties voted in favor of the initiative.

In 1991, the similar initiative 119 was rejected by Washington voters by a margin of 54 percent to 46 percent. I-119 would have allowed doctors to prescribe a lethal dosage of medication, and also to administer it if the terminally ill patient could not self-administer. Unlike that initiative, I-1000 requires the patient to ingest the medication unassisted.

The initiative is based on Oregon Measure 16, which Oregon voters passed in 1994. Oregon is the only state to have enacted similar legislation, and overwhelmingly re-approve it after the Oregon State Legislature referred a repeal of it to voters in 1997.

Special provisions of Initiative 1000
The official ballot summary for the measure, slightly amended following a February 2008 court challenge, is, “This measure would permit terminally ill, adult Washington residents medically predicted to die within six months to request and self-administer lethal medication prescribed by a physician. The measure requires two oral and one written request, two physicians to diagnose the patient and determine the patient is competent, a waiting period, and physician verification of an informed patient decision. Physicians, patients and others acting in good faith compliance would have criminal and civil immunity.”

Provisions in the law include:

• The patient must be an adult (18 or over) resident of the state of Washington
• The patient must be mentally competent, verified by two physicians (or referred to a mental health evaluation)
• The patient must be terminally ill with less than 6 months to live, verified by two physicians.
• The patient must make voluntary requests, without coercion, verified by two physicians
• The patient must be informed of all other options including palliative and hospice care
• There is a 15 day waiting period between the first oral request and a written request
• There is a 48 hour waiting period between the written request and the writing of the prescription
• The written request must be signed by two independent witnesses, at least one of whom is not related to the patient or employed by the health care facility
• The patient is encouraged to discuss with family (not required because of confidentiality laws)
• The patient may change their mind at any time and rescind the request
  

Support of Initiative 1000
The campaign was run by a coalition that includes former Washington governor, Booth Gardner and aid-in-dying advocates from Oregon, the Death with Dignity National Center, Compassion & Choices (national) , Compassion & Choices of Washington, Compassion & Choices of Oregon. The name of the official political advocacy group working on the campaign was changed from “It’s My Decision” to “YES on 1000”.

State Senator Darlene Fairley, who chairs the Death with Dignity Disabilities Caucus, said that “as a matter of personal control and autonomy, it makes sense to let patients themselves decide what kind of medical care they want to receive and how long they want to suffer with a terminal illness.”

State Representative Jamie Pedersen, chair of LGBT for 1000, said, “people facing terminal illnesses gain peace of mind from knowing that their end-of-life choices will be respected. Everyone deserves that respect and can appreciate its importance.” Organizations that supported I-1000 include the American Medical Student Association, the American Medical Women’s Association, the Lifelong AIDS Association, the ACLU , the National Women’s Law Center, the Washington Chapter of the National Association of Social Workers, and the Washington State Public Health Association.

The Washington State Psychology Association was neutral on I-1000, but found that “patients choose aid in dying because of a desire for autonomy and the wish to avoid loss of dignity and control, not because of a poor mental state, lack of resources or social support,” and “the law has had a positive effect in terms of significant improvements in palliative care.”

The Newcastle News endorsed the measure in a Oct. 7, 2008, editorial. “Some opponents of I-1000 will refer to the life-death option as assisted suicide, but this has no resemblance to suicide. It is a humane end to a life that is already ending,” the editorial said.

Opposition of Initiative 1000
The Coalition Against Assisted Suicide opposed the measure. It included doctors and nurses, disability rights advocates and organizations, hospice workers, minorities, right-to-life organizations, Christian organizations, the Catholic Church, and politicians from both sides of the aisle. A more comprehensive look at the opposition to I-1000 can be found at the Coalition’s website.

The organization held that the danger of making doctors the agents of a patient’s death far outweighed any advantages to assisted suicide, or safeguards in the initiative’s text. They felt that legalization of assisted suicide would put pressure on minorities, the disabled, and the poor.

Actor Martin Sheen appeared in television ads opposing Initiative 1000. There has been some debate over one of Sheen’s statements: persons with depression can be given a lethal dose without prior professional assessment. According to the Washington Death with Dignity act, “Medication to end a patient’s life in a humane and dignified manner shall not be prescribed until the person performing the counseling determines that the patient is not suffering from a psychiatric or psychological disorder or depression causing impaired judgment.” This issue has been explored in the field of medical ethics.

Not Dead Yet, a disabilities advocacy group which joined with the Coalition Against Assisted Suicide, objected to the measure, arguing that it discriminates against and targets the disabled. They believe that disabled people who are worried they will become a burden to their families need help and pain relief for their conditions, not encouragement to die.

Unsuccessful Initiatives
Attempts to legalize euthanasia and assisted suicide resulted in ballot initiatives and legislation bills within the United States in the last 20 years. For example, Washington voters saw Ballot Initiative 119 in 1991, California placed Proposition 161 on the ballot in 1992, Oregon passed the Death with Dignity Act in 1994, and Michigan included Proposal B in their ballot in 1998. Despite the earlier failure, in November 2008 euthanasia was approved in Washington by Initiative 1000 .

The California Compassionate Choices Act was introduced in 2005, patterned after Oregon’s Death with Dignity Act. After being defeated in 2006, it was introduced as AB 374 in 2007.