Initiative Measure No. 1000 - The Washington Death with Dignity Act

Section Outline

Section 1. Definitions

Written Request for Medication to End Life in a Humane and Dignified Manner

Section 2. Who may initiate a written request for medication.
Section 3. Form of the written request

Safeguards

Section 4. Attending physician responsibilities
Section 5. Consulting physician confirmation
Section 6. Counseling referral
Section 7. Informed decision
Section 8. Family notification
Section 9. Written and oral requests
Section 10. Right to rescind request
Section 11. Waiting periods
Section 12. Medical record documentation requirements
Section 13. Residency requirement
Section 14. Disposal of unused medications
Section 15. Reporting requirements
Section 16. Effect on construction of wills, contracts, and statutes
Section 17. Insurance or annuity policies
Section 18. Construction of Act

Immunities and Liabilities

Section 19. Immunities--basis for prohibiting health care provider from participation--notification--permissible sanctions
Section 20. Liabilities
Section 21. Claims by governmental entity for costs incurred

Additional Provisions

Section 22. Form of the request
Section 23. Amendments
Section 24. Amendments
Section 25. Amendments
Section 26. Short title
Section 27. Severability
Section 28. Effective date
Section 29. New chapter in Title 70
Section 30. Captions, part headings, and subpart headings not law
Section 31. Expiration date

Initiative Measure No. 1000

1 AN ACT Relating to death with dignity; amending RCW 70.122.100;2 reenacting and amending RCW 42.56.360 and 42.56.360; adding a new3 chapter to Title 70 RCW; prescribing penalties; providing an effective4 date; and providing an expiration date.

5 BE IT ENACTED BY THE PEOPLE OF THE STATE OF WASHINGTON:

6 THE WASHINGTON DEATH WITH DIGNITY ACT

7 General Provisions

8 NEW SECTION. Sec. 1. DEFINITIONS The definitions in this

9 section apply throughout this chapter unless the context clearly

10 requires otherwise.

11 (1) "Adult" means an individual who is eighteen years of age or

12 older.

13 (2) "Attending physician" means the physician who has primary

14 responsibility for the care of the patient and treatment of the

15 patient's terminal disease.

16 (3) "Competent" means that, in the opinion of a court or in the

17 opinion of the patient's attending physician or consulting physician,

1 psychiatrist, or psychologist, a patient has the ability to make and

2 communicate an informed decision to health care providers, including

3 communication through persons familiar with the patient's manner of

4 communicating if those persons are available.

5 (4) "Consulting physician" means a physician who is qualified by

6 specialty or experience to make a professional diagnosis and prognosis

7 regarding the patient's disease.

8 (5) "Counseling" means one or more consultations as necessary

9 between a state licensed psychiatrist or psychologist and a patient for

10 the purpose of determining that the patient is competent and not

11 suffering from a psychiatric or psychological disorder or depression

12 causing impaired judgment.

13 (6) "Health care provider" means a person licensed, certified, or

14 otherwise authorized or permitted by law to administer health care or

15 dispense medication in the ordinary course of business or practice of

16 a profession, and includes a health care facility.

17 (7) "Informed decision" means a decision by a qualified patient, to

18 request and obtain a prescription for medication that the qualified

19 patient may self-administer to end his or her life in a humane and

20 dignified manner, that is based on an appreciation of the relevant

21 facts and after being fully informed by the attending physician of:

22 (a) His or her medical diagnosis;

23 (b) His or her prognosis;

24 (c) The potential risks associated with taking the medication to be

25 prescribed;

26 (d) The probable result of taking the medication to be prescribed;

27 and

28 (e) The feasible alternatives including, but not limited to,

29 comfort care, hospice care, and pain control.

30 (8) "Medically confirmed" means the medical opinion of the

31 attending physician has been confirmed by a consulting physician who

32 has examined the patient and the patient's relevant medical records.

33 (9) "Patient" means a person who is under the care of a physician.

34 (10) "Physician" means a doctor of medicine or osteopathy licensed

35 to practice medicine in the state of Washington.

36 (11) "Qualified patient" means a competent adult who is a resident

37 of Washington state and has satisfied the requirements of this chapter

1 in order to obtain a prescription for medication that the qualified

2 patient may self-administer to end his or her life in a humane and

3 dignified manner.

4 (12) "Self-administer" means a qualified patient's act of ingesting medication to end his or her life in a humane and dignified manner.

6 (13) "Terminal disease" means an incurable and irreversible disease

7 that has been medically confirmed and will, within reasonable medical

8 judgment, produce death within six months.

9 Written Request for Medication to End Life

10 in a Humane and Dignified Manner

11 NEW SECTION. Sec. 2. WHO MAY INITIATE A WRITTEN REQUEST FOR

12 MEDICATION. (1) An adult who is competent, is a resident of Washington

13 state, and has been determined by the attending physician and

14 consulting physician to be suffering from a terminal disease, and who

15 has voluntarily expressed his or her wish to die, may make a written

16 request for medication that the patient may self-administer to end his

17 or her life in a humane and dignified manner in accordance with this

18 chapter.

19 (2) A person does not qualify under this chapter solely because of

20 age or disability.

21 NEW SECTION. Sec. 3. FORM OF THE WRITTEN REQUEST. (1) A valid

22 request for medication under this chapter shall be in substantially the

23 form described in section 22 of this act, signed and dated by the

24 patient and witnessed by at least two individuals who, in the presence

25 of the patient, attest that to the best of their knowledge and belief

26 the patient is competent, acting voluntarily, and is not being coerced

27 to sign the request.

28 (2) One of the witnesses shall be a person who is not:

29 (a) A relative of the patient by blood, marriage, or adoption;

30 (b) A person who at the time the request is signed would be

31 entitled to any portion of the estate of the qualified patient upon

32 death under any will or by operation of law; or

33 (c) An owner, operator, or employee of a health care facility where

34 the qualified patient is receiving medical treatment or is a resident.

1 (3) The patient's attending physician at the time the request is

2 signed shall not be a witness.

3 (4) If the patient is a patient in a long-term care facility at the

4 time the written request is made, one of the witnesses shall be an

5 individual designated by the facility and having the qualifications

6 specified by the department of health by rule.

7 Safeguards

8 NEW SECTION. Sec. 4. ATTENDING PHYSICIAN RESPONSIBILITIES. (1)

9 The attending physician shall:

10 (a) Make the initial determination of whether a patient has a

11 terminal disease, is competent, and has made the request voluntarily;

12 (b) Request that the patient demonstrate Washington state residency

13 under section 13 of this act;

14 (c) To ensure that the patient is making an informed decision,

15 inform the patient of:

16 (i) His or her medical diagnosis;

17 (ii) His or her prognosis;

18 (iii) The potential risks associated with taking the medication to

19 be prescribed;

20 (iv) The probable result of taking the medication to be prescribed;

21 and

22 (v) The feasible alternatives including, but not limited to,

23 comfort care, hospice care, and pain control;

24 (d) Refer the patient to a consulting physician for medical

25 confirmation of the diagnosis, and for a determination that the patient

26 is competent and acting voluntarily;

27 (e) Refer the patient for counseling if appropriate under section

28 6 of this act;

29 (f) Recommend that the patient notify next of kin;

30 (g) Counsel the patient about the importance of having another

31 person present when the patient takes the medication prescribed under

32 this chapter and of not taking the medication in a public place;

33 (h) Inform the patient that he or she has an opportunity to rescind

34 the request at any time and in any manner, and offer the patient an

35 opportunity to rescind at the end of the fifteen-day waiting period

36 under section 9 of this act;

1 (i) Verify, immediately before writing the prescription for

2 medication under this chapter, that the patient is making an informed

3 decision;

4 (j) Fulfill the medical record documentation requirements of

5 section 12 of this act;

6 (k) Ensure that all appropriate steps are carried out in accordance

7 with this chapter before writing a prescription for medication to

8 enable a qualified patient to end his or her life in a humane and

9 dignified manner; and

10 (1)(i) Dispense medications directly, including ancillary

11 medications intended to facilitate the desired effect to minimize the

12 patient's discomfort, if the attending physician is authorized under

13 statute and rule to dispense and has a current drug enforcement

14 administration certificate; or

15 (ii) With the patient's written consent:

16 (A) Contact a pharmacist and inform the pharmacist of the

17 prescription; and

18 (B) Deliver the written prescription personally, by mail or

19 facsimile to the pharmacist, who will dispense the medications directly

20 to either the patient, the attending physician, or an expressly

21 identified agent of the patient. Medications dispensed pursuant to

22 this subsection shall not be dispensed by mail or other form of

23 courier.

24 (2) The attending physician may sign the patient's death

25 certificate which shall list the underlying terminal disease as the

26 cause of death.

27 NEW SECTION. Sec. 5. CONSULTING PHYSICIAN CONFIRMATION. - Before

28 a patient is qualified under this chapter, a consulting physician shall

29 examine the patient and his or her relevant medical records and

30 confirm, in writing, the attending physician's diagnosis that the

31 patient is suffering from a terminal disease, and verify that the

32 patient is competent, is acting voluntarily, and has made an informed

33 decision.

34 NEW SECTION. Sec. 6. COUNSELING REFERRAL. If, in the opinion of

35 the attending physician or the consulting physician, a patient may be

36 suffering from a psychiatric or psychological disorder or depression

1 causing impaired judgment, either physician shall refer the patient for

2 counseling. Medication to end a patient's life in a humane and

3 dignified manner shall not be prescribed until the person performing

4 the counseling determines that the patient is not suffering from a

5 psychiatric or psychological disorder or depression causing impaired

6 judgment.

7 NEW SECTION. Sec. 7. INFORMED DECISION. A person shall not

8 receive a prescription for medication to end his or her life in a

9 humane and dignified manner unless he or she has made an informed

10 decision. Immediately before writing a prescription for medication

11 under this chapter, the attending physician shall verify- that the

12 qualified patient is making an informed decision.

13 NEW SECTION. Sec. 8. FAMILY NOTIFICATION. The attending

14 physician shall recommend that the patient notify the next of kin of

15 his or her request for medication under this chapter. A patient who

16 declines or is unable to notify next of kin shall not have his or her

17 request denied for that reason.

18 NEW SECTION. Sec. 9. WRITTEN AND ORAL REQUESTS. To receive a

19 prescription for medication that the qualified patient may self-

20 administer to end his or her life in a humane and dignified manner, a

21 qualified patient shall have made an oral request and a written

22 request, and reiterate the oral request to his or her attending

23 physician at least fifteen days after making the initial oral request.

24 At the time the qualified patient makes his or her second oral request,

25 the attending physician shall offer the qualified patient an

26 opportunity to rescind the request.

27 NEW SECTION. Sec. 10. RIGHT TO RESCIND REQUEST. A patient may

28 rescind his or her request at any time and in any manner without regard

29 to his or her mental state. No prescription for medication under this

30 chapter may be written without the attending physician offering the

31 qualified patient an opportunity to rescind the request.

32 NEW SECTION. Sec. 11. WAITING PERIODS. (1) At least fifteen days

1 shall elapse between the patient's initial oral request and the writing

2 of a prescription under this chapter.

3 (2) At least forty-eight hours shall elapse between the date the

4 patient signs the written request and the writing of a prescription

5 under this chapter.

6 NEW SECTION. Sec. 12. MEDICAL RECORD DOCUMENTATION REQUIREMENTS.

7 The following shall be documented or filed in the patient's medical

8 record:

9 (1) All oral requests by a patient for medication to end his or her

10 life in a humane and dignified manner;

11 (2) All written requests by a patient for medication to end his or

12 her life in a humane and dignified manner;

13 (3) The attending physician's diagnosis and prognosis, and

14 determination that the patient is competent, is acting voluntarily, and

15 has made an informed decision;

16 (4) The consulting physician's diagnosis and prognosis, and

17 verification that the patient is competent, is acting voluntarily, and

18 has made an informed decision;

19 (5) A report of the outcome and determinations made during

20 counseling, if performed;

21 (6) The attending physician's offer to the patient to rescind his

22 or her request at the time of the patient's second oral request under

23 section 9 of this act; and

24 (7) A note by the attending physician indicating that all

25 requirements under this chapter have been met and indicating the steps

26 taken to carry out the request, including a notation of the medication

27 prescribed.

28 NEW SECTION. Sec. 13. RESIDENCY REQUIREMENT. Only requests made

29 by Washington state residents under this chapter may be granted.

30 Factors demonstrating Washington state residency include but are not

31 limited to:

32 (1) Possession of a Washington state driver's license;

33 (2) Registration to vote in Washington state; or

34 (3) Evidence that the person owns or leases property in Washington

35 state.

1 NEW SECTION. Sec. 14. DISPOSAL OF UNUSED MEDICATIONS. Any

2 medication dispensed under this chapter that was not self-administered

3 shall be disposed of by lawful means.

4 NEW SECTION. Sec. 15. REPORTING REQUIREMENTS. (1) (a) The

5 department of health shall annually review all records maintained under

6 this chapter.

7 (b) The department of health shall require any health care provider

8 upon writing a prescription or dispensing medication under this chapter

9 to file a copy of the dispensing record and such other administratively

10 required documentation with the department. All administratively

11 required documentation shall be mailed or otherwise transmitted as

12 allowed by department of health rule to the department no later than

13 thirty calendar days after the writing of a prescription and dispensing

14 of medication under this chapter, except that all documents required to

15 be filed with the department by the prescribing physician after the

16 death of the patient shall be mailed no later than thirty calendar days

17 after the date of death of the patient. In the event that anyone

18 required under this chapter to report information to the department of

19 health provides an inadequate or incomplete report, the department

20 shall contact the person to request a complete. report.

21 (2) The department of health shall adopt rules to facilitate the

22 collection of information regarding compliance with this chapter.

23 Except as otherwise required by law, the information collected is not

24 a public record and may not be made available for inspection by the

25 public.

26 (3) The department of health shall generate and make available to

27 the public an annual statistical report of information collected under

28 subsection (2) of this section.

29 NEW SECTION. Sec. 16. EFFECT ON CONSTRUCTION OF WILLS, CONTRACTS,

30 AND STATUTES. (1) Any provision in a contract, will, or other

31 agreement, whether written or oral, to the extent the provision would

32 affect whether a person may make or rescind a request for medication to

33 end his or her life in a humane and dignified manner, is not valid.

34 (2) Any obligation owing under any currently existing contract

35 shall not be conditioned or affected by the making or rescinding of a

1 request, by a person, for medication to end his or her life in a humane

2 and dignified manner.

3 NEW SECTION. Sec. 17. INSURANCE OR ANNUITY POLICIES. The sale,

4 procurement, or issuance of any life, health, or accident insurance or

5 annuity policy or the rate charged for any policy shall not be

6 conditioned upon or affected by the making or rescinding of a request,

7 by a person, for medication that the patient may self-administer to end

8 his or her life in a humane and dignified manner. A qualified

9 patient's act of ingesting medication to end his or her life in a

10 humane and dignified manner shall not have an effect upon a life,

11 health, or accident insurance or annuity policy.

12 NEW SECTION. Sec. 18. CONSTRUCTION OF ACT. (1) Nothing in this

13 chapter authorizes a physician or any other person to end a patient's

14 life by lethal injection, mercy killing, or active euthanasia. Actions

15 taken in accordance with this chapter do not, for any purpose,

16 constitute suicide, assisted suicide, mercy killing, or homicide, under

17 the law. State reports shall not refer to practice under this chapter

18 as "suicide" or "assisted suicide." Consistent with sections 1 (7),

19 (11), and (12), 2 (1) , 4(1) (k), 6, 7, 9, 12 (1) and (2), 16 (1) and (2),

20 17, 19(1) (a) and (d), and 20(2) of this act, state reports shall refer

21 to practice under this chapter as obtaining and self-administering

22 life-ending medication.

23 (2) Nothing contained in this chapter shall be interpreted to lower

24 the applicable standard of care for the attending physician, consulting

25 physician, psychiatrist or psychologist, or other health care provider

26 participating under this chapter.

27 Immunities and Liabilities

28 NEW SECTION. Sec. 19. IMMUNITIES--BASIS FOR PROHIBITING HEALTH

29 CARE PROVIDER FROM PARTICIPATION--NOTIFICATION--PERMISSIBLE SANCTIONS.

30 (1) Except as provided in section 20 of this act and subsection (2) of

31 this section:

32 (a) A person shall not be subject to civil or criminal liability or

33 professional disciplinary action for participating in good faith

1 compliance with this chapter. This includes being present when a

2 qualified patient takes the prescribed medication to end his or her

3 life in a humane and dignified manner;

4 (b) A professional organization or association, or health care

5 provider, may not subject a person to censure, discipline, suspension,

6 loss of license, loss of privileges, loss of membership, or other

7 penalty for participating or refusing to participate in good faith

8 compliance with this chapter;

9 (c) A patient's request for or provision by an attending physician

10 of medication in good faith compliance with this chapter does not

11 constitute neglect for any purpose of law or provide the sole basis for

12 the appointment of a guardian or conservator; and

13 (d) Only willing health care providers shall participate in the

14 provision to a qualified patient of medication to end his or her life

15 in a humane and dignified manner. If a health care provider is unable

16 or unwilling to carry out a patient's request under this chapter, and

17 the patient transfers his or her care to a new health care provider,

18 the prior health care provider shall transfer, upon request, a copy of

19 the patient's relevant medical records to the new health care provider.

20 (2) (a) A health care provider may prohibit another health care

21 provider from participating under this act on the premises of the

22 prohibiting provider if the prohibiting provider has given notice to

23 all health care providers with privileges to practice on the premises

24 and to the general public of the prohibiting provider's policy

25 regarding participating under this act. This subsection does not

26 prevent a health care provider from providing health care services to

27 a patient that do not constitute participation under this act.

28 (b) A health care provider may subject another health care provider

29 to the sanctions stated in this subsection if the sanctioning health

30 care provider has notified the sanctioned provider before participation

31 in this act that it prohibits participation in this act:

32 (i) Loss of privileges, loss of membership, or other sanctions

33 provided under the medical staff bylaws, policies, and procedures of

34 the sanctioning health care provider if the sanctioned provider is a

35 member of the sanctioning provider's medical staff and participates in

36 this act while on the health care facility premises of the sanctioning

37 health care provider, but not including the private medical office of

38 a physician or other provider;

1 (ii) Termination of a lease or other property contract or other

2 nonmonetary remedies provided by a lease contract, not including loss

3 or restriction of medical staff privileges or exclusion from a provider

4 panel, if the sanctioned provider participates in this act while on the

5 premises of the sanctioning health care provider or on property that is

6 owned by or under the direct control of the sanctioning health care

7 provider; or

8 (iii) Termination of a contract or other nonmonetary remedies

9 provided by contract if the sanctioned provider participates in this

10 act while acting in the course and scope of the sanctioned provider's

11 capacity as an employee or independent contractor of the sanctioning

12 health care provider. Nothing in this subsection (2) (b) (iii)-prevents:

13 (A) A health care provider from participating in this act while

14 acting outside the course and scope of the provider's capacity as an

15 employee or independent contractor; or

16 (B) A patient from contracting with his or her attending physician

17 and consulting physician to act outside the course and scope of the

18 provider's capacity as an employee or independent contractor of the

19 sanctioning health care provider.

20 (c) A health care provider that imposes sanctions under (b) of this

21 subsection shall follow all due process and other procedures the

22 sanctioning health care provider may have that are related to the

23 imposition of sanctions on another health care provider.

24 (d) For the purposes of this subsection:

25 (i) "Notify" means a separate statement in writing to the health

26 care provider specifically informing the health care provider before

27 the provider's participation in this act of the sanctioning health care

28 provider's policy about participation in activities covered by this

29 chapter.

30 (ii) "Participate in this act" means to perform the duties of an

31 attending physician under section 4 of this act, the consulting

32 physician function under section 5 of this act, or the counseling

33 function under section 6 of this act. "Participate in this act" does

34 not include:

35 (A) Making an initial determination that a patient has a terminal

36 disease and informing the patient of the medical prognosis;

37 (B) Providing information about the Washington death with dignity

38 act to a patient upon the request of the patient;

1 (C) Providing a patient, upon the request of the patient, with a

2 referral to another physician; or

3 (D) A patient contracting with his or her attending physician and

4 consulting physician to act outside of the course and scope of the

5 provider's capacity as an employee or independent contractor of the

6 sanctioning health care provider.

7 (3) Suspension or termination of staff membership or privileges

8 under subsection (2) of this section is not reportable under RCW

9 18.130.070. Action taken under section 3, 4, 5, or 6 of this act may

10 not be the sole basis for a report of unprofessional conduct under RCW

11 18.130.180.

12 (4) References to "good faith" in subsection (1) (a) , (b)-, and (c)

13 of this section do not allow a lower standard of care for health care

14 providers in the state of Washington.

15 NEW SECTION. Sec. 20. LIABILITIES. (1) A person who without

16 authorization of the patient willfully alters or forges a request for

17 medication or conceals or destroys a rescission of that request with

18 the intent or effect of causing the patient's death is guilty of a

19 class A felony.

20 (2) A person who coerces or exerts undue influence on a patient to

21 request medication to end the patient's life, or to destroy a

22 rescission of a request, is guilty of a class A felony.

23 (3) This chapter does not limit further liability for civil damages

24 resulting from other negligent conduct or intentional misconduct by any

25 person.

26 (4) The penalties in this chapter do not preclude criminal

27 penalties applicable under other law for conduct that is inconsistent

28 with this chapter.

29 NEW SECTION. Sec. 21. CLAIMS BY GOVERNMENTAL ENTITY FOR COSTS

30 INCURRED. Any governmental entity that incurs costs resulting from a

31 person terminating his or her life under this chapter in a public place

32 has a claim against the estate of the person to recover such costs and

33 reasonable attorneys' fees related to enforcing the claim.

34 Additional Provisions

1 NEW SECTION. Sec. 22. FORM OF THE REQUEST. A request for a

2 medication as authorized by this chapter shall be in substantially the

3 following form:

4 REQUEST FOR MEDICATION. TO END MY LIFE IN A HUMAN AND DIGNIFIED MANNER

5 I, . . . . . . . . . . . . . . . . . . . . . . . . . . , am an adult of sound mind.

6 I am suffering from ., . . . . . . . . . . . . . . . . . . . . . . . . . . , which my

7 attending physician has determined is a terminal disease and which has

8 been medically confirmed by a consulting physician.

9 I have been fully informed of my diagnosis, prognosis, the nature

10 of medication to be prescribed and potential associated risks, the

11 expected result, and the feasible alternatives, including comfort care,

12 hospice care, and pain control.

13 I request that my attending physician prescribe medication that I

14 may self-administer to end my life in a humane and dignified manner and

15 to contact any pharmacist to fill the prescription.

16 INITIAL ONE:

17 . . . . . . I have informed my family of my decision and taken their

18 opinions into consideration.

19 . . . . . . I have decided not to inform my family of my decision.

20 . . . . . . I have no family to inform of my decision.

21 I understand that I have the right to rescind this request at any

22 time.

23 I understand the full import of this request and I expect to die

24 when I take the medication to be prescribed. I further understand that

25 although most deaths occur within three hours, my death may take longer

26 and my physician has counseled me about this possibility.

27 I make this request voluntarily and without reservation, and I

28 accept full moral responsibility for my actions.

29 Signed: . . . . . . . . . .

30 Dated : . . . . . . . . . .

31 DECLARATION OF WITNESSES

32 By initialing and signing below on or after the date the person

33 named above signs, we declare that the person making and signing the

34 above request:

1 Witness 1 Witness 2

2 Initials Initials

3 . . . . . . . . . . . 1. Is personally known to us or has provided proof of identity;

4 . . . . . . . . . . . 2. Signed this request in our presence on the date of the person's signature;

5 . . . . . . . . . . . 3. Appears to be of sound mind and not under duress, fraud, or undue influence;

6 . . . . . . . . . . . 4. Is not a patient for whom either of us is the attending physician.

7 Printed Name of Witness 1: : . . . . . . . . . . : . . . . . . . . . .

8 Signature of Witness 1/Date: : . . . . . . . . . . : . . . . . . . . . .

9 Printed Name of Witness 2 : . . . . . . . . . . : . . . . . . . . . .

10 Signature of Witness 2/Date: : . . . . . . . . . . : . . . . . . . . . .

11 NOTE: One witness shall not be a relative by blood, marriage, or

12 adoption of the person signing this request, shall not be entitled to

13 any portion of the person's estate upon death, and shall not own,

14 operate, or be employed at a health care facility where the person is

15 a patient or resident. If the patient is an inpatient at a health care

16 facility, one of the witnesses shall be an individual designated by the

17 facility.

18 Sec. 23. RCW 42.56.360 and 2007 c 261 s 4 and 2007 c 259 s 49 are

19 each reenacted and amended to read as follows:

20 (1) The following health care information is exempt from disclosure

21 under this chapter:

22 (a) Information obtained by the board of pharmacy as provided in

23 RCW 69.45.090;

24 (b) Information obtained by the board of pharmacy or the department

25 of health and its representatives as provided in RCW 69.41.044,

26 69.41.280, and 18.64.420;

27 (c) Information and documents created specifically for, and

28 collected and maintained by a quality improvement committee under RCW

29 43.70.510 or 70.41.200, or by a peer review committee under RCW

30 4.24.250, or by a quality assurance committee pursuant to RCW 74.42.640

31 or 18.20.390, or by a hospital, as defined in RCW 43.70.056, for

32 reporting of health care-associated infections under RCW 43.70.056, and

1 notifications or reports of adverse events or incidents made under RCW

2 70.56.020 or 70.56.040, regardless of which agency is in possession of

3 the information and documents;

4 (d) (i) Proprietary financial and commercial information that the

5 submitting entity, with review by the department of health,

6 specifically identifies at the time it is submitted and that is

7 provided to or obtained by the department of health in connection with

8 an application for, or the supervision of, an antitrust exemption

9 sought by the submitting entity under RCW 43.72.310;

10 (ii) If a request for such information is received, the submitting

11 entity must be notified of the request. Within ten business days of -

12 receipt of the notice, the submitting entity shall provide a written

13 statement of the continuing need for confidentiality, which shall be

14 provided to the requester. Upon receipt of such notice, the department

15 of health shall continue to treat information designated under this

16 subsection (1)(d) as exempt from disclosure;

17 (iii) If the requester initiates an action to compel disclosure

18 under this chapter, the submitting entity must be joined as a party to

19 demonstrate the continuing need for confidentiality;

20 (e) Records of the entity obtained in an action under RCW 18.71.300

21 through 18.71.340;

22 (f) Except for published statistical compilations and reports

23 relating to the infant mortality review studies that do not identify

24 individual cases and sources of information, any records or documents

25 obtained, prepared, or maintained by the local health department for

26 the purposes of an infant mortality review conducted by the department

27 of health under RCW 70.05.170;

28 (g) Complaints filed under chapter 18.130 RCW after July 27, 1997,

29 to the extent provided in RCW 18.130.095(1); ((and))

30 (h) Information obtained by the department of health under chapter

31 70.225 RCW; and

32 (i) Information collected by the department of health under chapter

33 70.-- RCW (sections 1 through 22, 26 through 28, and 30 of this act)

34 except as provided in section 15 of this act.

35 (2) Chapter 70.02 RCW applies to public inspection and copying of

36 health care information of patients.

1 Sec. 24. RCW 42.56.360 and 2007 c 273 s 25, 2007 c 261 s 4, and

2 2007 c 259 s 49 are each reenacted and amended to read as follows:

3 (1) The following health care information is exempt from disclosure

4 under this chapter:

5 (a) Information obtained by the board of pharmacy as provided in

6 RCW 69.45.090;

7 (b) Information obtained by the board of pharmacy or the department

8 of health and its representatives as provided in RCW 69.41.044,

9 69.41.280, and 18.64.420;

10 (c) Information and documents created specifically for, and

11 collected and maintained by a quality improvement committee under RCW

12 43.70.510, 70.230.080, or 70.41.200, or by a peer review-?committee

13 under RCW 4.24.250, or by a quality assurance committee pursuant to RCW

14 74.42.640 or 18.20.390, or by a hospital, as defined in RCW 43.70.056,

15 for reporting of health care-associated infections under RCW 43.70.056,

16 and notifications or reports of adverse events or incidents made under

17 RCW 70.56.020 or 70.56.040, regardless of which agency is in possession

18 of the information and documents;

19 (d) (i) Proprietary financial and commercial information that the

20 submitting entity, with review by the department of health,

21 specifically identifies at the time it is submitted and that is

22 provided to or obtained by the department of health in connection with

23 an application for, or the supervision of, an antitrust exemption

24 sought by the submitting entity under RCW 43.72.310;

25 (ii) If a request for such information is received, the submitting

26 entity must be notified of the request. Within ten business days of

27 receipt of the notice, the submitting entity shall provide a written

28 statement of the continuing need for confidentiality, which shall be

29 provided to the requester. Upon receipt of such notice, the-department

30 of health shall continue to treat information designated under this

31 subsection (1)(d) as exempt from disclosure;

32 (iii) If the requester initiates an action to compel disclosure

33 under this chapter, the submitting entity must be joined as a party to

34 demonstrate the continuing need for confidentiality;

35 (e) Records of the entity obtained in an action under RCW 18.71.300

36 through 18.71.340;

37 (f) Except for published statistical compilations and reports

38 relating to the infant mortality review studies that do not identify

1 individual cases and sources of information, any records or documents

2 obtained, prepared, or maintained by the local health department for

3 the purposes of an infant mortality review conducted by the department

4 of health under RCW 70.05.170;

5 (g) Complaints filed under chapter 18.130 RCW after July 27, 1997,

6 to the extent provided in RCW 18.130.095(1); ((and))

7 (h) Information obtained by the department of health under chapter

8 70.225 ROW; and

9 (i) Information collected by the department of health under chapter

10 70.-- RCW (sections 1 through 22, 26 through 28, and 30 of this act)

11 except as provided in section 15 of this act.

12 (2) Chapter 70.02 RCW applies to public inspection and copying of

13 health care information of patients.

14 Sec. 25. RCW 70.122.100 and 1992 c 98 s 10 are each amended to

15 read as follows:

16 Nothing in this chapter shall be construed to condone, authorize,

17 or approve mercy killing ((or physician assisted suicide, or to permit

18 any affirmative or deliberate act or omission to end life other than to

19 permit the natural process of dying)), lethal injection, or active

20 euthanasia.

21 NEW SECTION. Sec. 26. SHORT TITLE. This act may be known and

22 cited as the Washington death with dignity act.

23 NEW SECTION. Sec. 27. SEVERABILITY. If any provision of this act

24 or its application to any person or circumstance is held invalid, the

25 remainder of the act or the application of the provision to other

26 persons or circumstances is not affected.

27 NEW SECTION. Sec. 28. EFFECTIVE DATE. This act takes effect one

28 hundred twenty days after the election at which it is approved, except

29 for section 24 of this act which takes effect July 1, 2009.

30 NEW SECTION. Sec. 29. Sections 1 through 22, 26 through 28, and

31 30 of this act constitute a new chapter in Title 70 RCW.

1 NEW SECTION. Sec. 30. CAPTIONS, PART HEADINGS, AND SUBPART

2 HEADINGS NOT LAW. Captions, part headings, and subpart headings used

3 in this act are not any part of the law.

4 NEW SECTION. Sec. 31. Section 23 of this act expires July 1,

5 2009.

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Code Rev/KK:cro 18 I-2139.1/08