WA Case Medical Homicide

 State probe finds hospital 'sloppy' in man's death

http://www.tri-cityherald.com/news/local/article31786419.html
August 20, 2010

By Sheila Hagar, Walla Walla Union-Bulletin

WALLA WALLA -- A Washington state Department of Health investigation found procedural problems at Providence St. Mary Medical Center in a death that Walla Walla County Coroner Frank Brown has listed as a medical homicide.

The department launched its investigation when a caller to the state's complaint hotline alleged that a 60-year-old patient at the hospital died March 1 of accidental acute morphine overdose. The caller, who is not named in the report, pointed to a forensic pathologist's autopsy, health officials said.

Brown labeled the death "medical homicide," a decision agreed with by Dr. Carl Wigren, the forensic pathologist who performed the autopsy. Wigren is paid by the county for his services.

Washington's Act Allows Euthanasia

By Margaret Dore, Esq., MBA

Washington's Death with Dignity Act, Chapter 70.245, RCW, allows a patient to "self-administer" a lethal dose to end his or her life. See e.g., RCW 70.245.010(11). On close examination, this term allows euthanasia.

Per the act, self-administer is defined as the “act of ingesting.” RCW 70.245.010(12) states:

“Self-administer” means a qualified patient’s act of ingesting medication to end his or her life . . .   (Emphasis added)

The act does not define “ingest.”  Dictionary definitions include:

[T]o take (food, drugs, etc.) into the body, as by swallowing, inhaling, or absorbing.” (Emphasis added). 

With these definitions, someone else putting the lethal dose in the patient’s mouth qualifies as proper administration because the patient will be “swallowing” the lethal dose, i.e., “ingesting” it. Someone else placing a medication patch on the patient’s arm will qualify because the patient will be “absorbing” the lethal dose, i.e., “ingesting” it. Gas administration, similarly, will qualify because the patient will be “inhaling” the lethal dose, i.e., “ingesting” it. With self-administer defined as mere ingesting, someone else is allowed to administer the lethal dose to the patient. 

Allowing someone else to administer the lethal dose to the patient is "euthanasia" under generally accepted medical terminology. The American Medical Association's Ethics Opinion 2.21 states: 

"Euthanasia is the administration of a lethal agent by another person to a patient . . . " (Emphasis added).

Washington's act allows euthanasia.