Assisted suicide in Washington state is legal under the Death with Dignity Act, codified at RCW 70.245, which lets a terminally ill adult resident obtain a prescription they can take themselves to end their life. The law requires two qualified medical providers to confirm the diagnosis and the patient’s mental competence, sets a multi-step request process with built-in waiting periods, and treats coercion or forgery as a serious felony. A 2023 amendment widened the pool of providers who can participate, but the core patient eligibility rules and safeguards have not changed.
Who Qualifies
Every one of these has to be true:
- You are at least 18 years old.
- You are a current resident of Washington.
- You have been diagnosed with an incurable, irreversible disease expected to cause death within six months.
- You are able to make and communicate an informed healthcare decision.
An attending provider and a consulting provider must each independently confirm the terminal diagnosis and your competence.1Washington State Department of Health. Death with Dignity Act If either has any concern about your ability to make an informed decision, the law requires a referral for a psychological or psychiatric evaluation before any prescription can be written.
Before 2023, only licensed physicians could serve as the attending or consulting provider. The definition of “qualified medical provider” now also includes physician assistants and advanced registered nurse practitioners.2Washington State Legislature. Washington Code RCW 70.245.010 – Definitions At least one of the two providers, though, must be a physician or osteopathic physician. Both roles cannot be filled by non-physician providers.
The statute does not define residency with specificity. The Department of Health lists several documents that commonly serve as proof: a Washington driver’s license, voter registration, a mortgage or rental agreement, or a utility bill.3Washington State Department of Health. Frequently Asked Questions About Death with Dignity No single one is mandatory, and the list is not exhaustive. If you recently relocated or lack conventional proof, raise it with your attending provider early.
The Request Process, Step by Step
The process is designed so that it cannot be rushed. From the first request to a prescription in hand takes at least about two and a half weeks.
Two Oral Requests, 15 Days Apart
You must make two separate oral requests to your attending provider, and the two requests must be at least 15 days apart. Each is documented, and the provider confirms it was made voluntarily.1Washington State Department of Health. Death with Dignity Act
A Written Request With Two Witnesses
You also submit a written request on a form that substantially follows the template in the statute. You sign and date it in the presence of two witnesses, who attest that you appear competent, are acting voluntarily, and are not being coerced.4Washington State Legislature. Washington Code RCW 70.245.030 – Form of the Written Request
Witness rules trip people up. Your attending provider cannot serve as a witness at all. At least one witness must be someone who is not a relative by blood or marriage, not entitled to any part of your estate, and not an owner, operator, or employee of the healthcare facility where you are being treated.4Washington State Legislature. Washington Code RCW 70.245.030 – Form of the Written Request The second witness carries no such restriction. A family member can fill that role, contrary to the common assumption that no relatives can witness.
A 48-Hour Waiting Period, Then the Prescription
After the written request is submitted, at least 48 hours must pass before the provider can write the prescription. You can rescind your request at any point, and the attending provider is required to tell you so.
Once the prescription is issued, you must take the medication yourself. No provider, family member, or other person is allowed to administer it. Self-administration is one of the law’s core safeguards.
What It Costs and Whether Insurance Pays
Federal law prohibits using congressional appropriations to provide, pay for, or cover any health service furnished for the purpose of causing death, and that prohibition covers both Medicare and Medicaid.5Office of the Law Revision Counsel. 42 US Code 14402 – Restriction on Use of Federal Funds Under Health Care Programs The medication is an out-of-pocket cost. Prices vary with the drug compounded, but expect at least several hundred dollars.
Private insurance is not a given either. Some plans exclude coverage, and you should check your specific policy rather than assume.
The federal restriction also reaches the Department of Veterans Affairs. VA physicians cannot prescribe or participate, even in a state where the practice is legal. A veteran who wants to use Washington’s law has to see a non-VA provider and pay for the medication privately.
How the Death Is Recorded
A death under the Death with Dignity Act is not classified as suicide. The attending provider may sign the death certificate and must list the underlying terminal disease as the cause of death.1Washington State Department of Health. Death with Dignity Act That matters for survivors. Life insurance policies with a suicide exclusion clause cannot use the death as grounds to deny benefits, and the death does not carry the stigma or estate complications a suicide classification would produce.
Providers Choose Whether to Participate
No healthcare provider is required to take part. The statute states that only willing providers participate in prescribing or dispensing.6Washington State Legislature. Washington Code RCW 70.245.190 – Immunities, Basis for Prohibiting Health Care Provider from Participation A provider who declines cannot be penalized, fired, or stripped of privileges, and a provider who chooses to participate is equally protected.
Healthcare facilities, including religiously affiliated hospitals, can prohibit the process on their premises so long as they give public notice of the policy and inform providers with privileges there. A facility cannot, however, stop a provider from participating at a different location on that provider’s own time. If your current provider will not participate and you want to transfer care, that provider must hand over your relevant medical records on request.6Washington State Legislature. Washington Code RCW 70.245.190 – Immunities, Basis for Prohibiting Health Care Provider from Participation
Providers who follow the law in good faith are shielded from civil liability, criminal charges, and professional discipline. Those who cut corners, such as issuing a prescription without a consulting provider’s confirmation, skipping the waiting periods, or failing to file required documentation, fall outside that protection and can face discipline up to license suspension or revocation.
Penalties for Coercion or Forgery
The law reserves its harshest penalties for people who try to manipulate the process. Two acts are Class A felonies:
- Altering or forging a patient’s request without authorization, or concealing or destroying a rescission, with the intent or effect of causing the patient’s death.
- Exerting undue influence on a patient to request the medication, or to destroy a rescission.
A Class A felony in Washington carries up to life in prison and a fine of up to $50,000.7Washington State Legislature. Washington Code RCW 70.245.200 – Willful Alteration/Forgery, Coercion or Undue Influence, Penalties8Washington State Legislature. Washington Code RCW 9A.20.021 – Maximum Sentences for Crimes Civil liability is preserved as well, so families can sue for damages caused by misconduct, and nothing in the statute shields anyone from other Washington criminal laws that may apply.