The District of Columbia's Death With Dignity Act

A new death with dignity law allows terminally ill patients to request aid in dying under certain conditions.

In late 2016, the Council of the District of Columbia approved a death with dignity bill, B21-0038, called the District of Columbia Death With Dignity Act. The bill passed with a veto-proof margin, and Mayor Muriel Bowser signed it on December 20, 2016. The law went into effect on February 18, 2017, after a mandatory 30-day Congressional review period expired.

On July 13, 2017, the Appropriations Committee of the U.S. House of Representatives voted to repeal D.C.’s Death With Dignity Act through an amendment to the proposed 2018 federal budget. And on September 14, 2017, the House passed the spending bill. However, the full Senate and President Trump must approve the measure before the District’s aid-in-dying law would be repealed.

On July 17, 2017, Mayor Bowser announced that all regulations required to fully implement the law are in place, allowing terminally ill patients in D.C. to request aid in dying in certain clearly defined situations.

This article first clarifies some confusing language related to death with dignity laws and then sets out the basics of the District of Columbia’s law.

Death With Dignity, Assisted Suicide, Right to Die: What’s the Difference?

“Death with dignity” is one of the most commonly accepted phrases describing the process by which a terminally ill person ingests prescribed medication to hasten death. Many people still think of this process as “assisted suicide” or “physician assisted suicide.” However, proponents of death with dignity argue that the term “suicide” doesn’t apply to terminally ill people who would prefer to live but, facing certain death within months, choose a more gentle way of dying. In fact, D.C.’s proposed law states that terminating one’s life under the law is not suicide. (See B21-0038, Section 16.)

Increasingly, health organizations are turning away from the term “suicide” to describe a terminally ill patient’s choice to reduce the suffering of an inevitable death. The phrase “aid in dying” is becoming a more accepted way to refer to this process.

You may also see the phrase “right to die” used in place of “death with dignity.” However, “right to die” is more accurately used in the context of directing one’s own medical care -- that is, refusing life-sustaining treatment such as a respirator or feeding tubes when permanently unconscious or close to death. You can provide your own health care directions by completing a District of Columbia living will and durable power of attorney for health care. (See the end of this article for more information.)

Death With Dignity Requirements in D.C.

To request a prescription for life-ending medication in D.C., a patient must be:

  • at least 18 years old
  • a District of Columbia resident
  • mentally capable of making and communicating health care decisions, and
  • diagnosed with a terminal disease that will result in death within six months.

A patient who meets the requirements above will be prescribed aid-in-dying medication only if:

  • The patient makes two verbal requests to their doctor, at least 15 days apart.
  • The patient gives a written request to the doctor, signed in front of two qualified, adult witnesses. (The law sets out the specific form that the patient must use.)
  • The prescribing doctor and one other doctor confirm the patient’s diagnosis and prognosis.
  • The prescribing doctor and one other doctor determine that the patient is capable of making medical decisions.
  • The patient has a psychological examination, if either doctor feels the patient’s judgment is impaired.
  • The prescribing doctor confirms that the patient is not being coerced or unduly influenced by others when making the request.
  • The prescribing doctor informs the patient of any feasible alternatives to the medication, including care to relieve pain and keep the patient comfortable.
  • The prescribing doctor asks the patient to notify their next of kin of the prescription request. (The doctor cannot require the patient to notify anyone, however.)
  • The prescribing doctor offers the patient the opportunity to withdraw the request for aid-in-dying medication before granting the prescription.

To use the medication, the patient must be able to ingest it on their own. A doctor or other person who administers the lethal medication may face criminal charges.

You can read the full text of the District of Columbia's Death With Dignity Act on the Council of the District of Columbia’s website.

Learn More

To find out more about the history and current status of death with dignity laws in the United States, visit the website of the Death With Dignity National Center.

For information about appointing a health care agent and making known your own wishes for medical care at the end of life, see the Living Wills & Medical Powers of Attorney section of Nolo.com.

Updated: 9/18/2017

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