There have been many important developments in the right-to-die movement in the past couple of years. But for dramatic impact few of them can compare to Initiative 119, a question facing voters in Washington state when they go to the polls Nov. 5.
After a decade of failed efforts to persuade the state legislature to close loopholes in the state's Natural Death Act, 223,000 citizens -- 73,000 more than the state required -- signed petitions to put a "death with dignity" initiative on the November ballot.
Two provisions of the initiative would clarify points in the state's Natural Death Act, which the state legislature approved in 1979. Those provisions have caused little controversy.
But a third provision takes Washington state into new legal territory by legalizing a physician's efforts to provide aid in dying under controlled circumstances to adult, terminally ill patients who are judged to be mentally competent.
Even in the Netherlands, where the legal and medical systems have worked out a compromise that allows doctors to administer lethal injections without incurring criminal penalties, active euthanasia is tolerated, but not legal. There's a chance the Dutch Parliament may vote this fall on legalization of active euthanasia. Otherwise, Washington state stands alone in its attempt to step over a legal boundary that most governments refuse to cross.
Not surprisingly, the battle lines in the state have been drawn rather fiercely. Opponents of the measure are presenting it as an effort to turn doctors into killers. Supporters see it as a way of allowing patients to face death with dignity and to retain control over decisions about the medical treatment they will receive or refuse at the end of life.
As the election approaches, sophisticated media campaigns are bombarding voters with these conflicting messages.
Human Life of Washington, a major opponent of the initiative, says it has requested $1.5 million from the National Right to Life organization for its campaign. Other donations and campaign efforts are expected from groups such as the Washington State Medical Association. Although the medical association has long supported efforts to amend the state's Natural Death Act, it adamantly opposes any measure that would legalize a physician's participation in deliberately hastening death.
Meanwhile, in a gray office building in Seattle, scores of volunteers are working the phones and stuffing envelopes to mobilize the thousands of voters who tell pollsters they support the concept of aid in dying. Despite the state medical association's stand, the long list of organizations supporting the initiative includes groups of doctors and nurses organized specifically to work for passage of the measure.
Diane McDade, spokeswoman for Washington Citizens for Death with Dignity, says that by the end of September her organization had collected $1 million, and expects the total to reach $1.3 million -- 80 percent of it from small gifts of $30 or less.
All of this means that Washington state is shaping up as an important battleground, where voters can express their own opinions about a subject their legislators have shied away from.
For those who consider aid-in-dying a step too far, it's worth noting that Initiative 119 came about only after a decade in which reasonable efforts to clarify and refine the state's Natural Death Act were stopped year after year by a vocal minority. There's a lesson here: Many Americans feel they have lost control over decisions about death and dying -- and now they seemed determined to take back that control.