INITIATIVE 1000

To the People

Chapter 1, Laws of 2009

DEATH WITH DIGNITY ACT

EFFECTIVE DATE: 03/05/09

Approved by the

People of the State of Washington

in the General Election on

November 4, 2008

ORIGINALLY FILED

January 24, 2008

Secretary of State

 1AN ACT Relating to death with dignity; amending RCW 70.122.100;

 2reenacting and amending RCW 42.56.360 and 42.56.360; adding a new

 3chapter to Title 70 RCW; prescribing penalties; providing an effective

 4date; and providing an expiration date.

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

 6THE WASHINGTON DEATH WITH DIGNITY ACT

 7General Provisions

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

 9section apply throughout this chapter unless the context clearly

10requires otherwise.

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

12older.

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

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

15patient's terminal disease.

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

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

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

 2communicate an informed decision to health care providers, including

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

 4communicating if those persons are available.

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

 6specialty or experience to make a professional diagnosis and prognosis

 7regarding the patient's disease.

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

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

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

11suffering from a psychiatric or psychological disorder or depression

12causing impaired judgment.

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

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

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

16a profession, and includes a health care facility.

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

18request and obtain a prescription for medication that the qualified

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

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

21facts 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

25prescribed;

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

27and

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

29comfort care, hospice care, and pain control.

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

31attending physician has been confirmed by a consulting physician who

32has 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

35to practice medicine in the state of Washington.

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

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

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

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

 3dignified manner.

 4(12) "Self-administer" means a qualified patient's act of ingesting

 5medication to end his or her life in a humane and dignified manner.

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

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

 8judgment, produce death within six months.

 9Written Request for Medication to End Life

10in a Humane and Dignified Manner

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

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

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

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

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

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

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

18chapter.

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

20age or disability.

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

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

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

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

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

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

27to 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

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

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

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

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

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

 2signed shall not be a witness.

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

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

 5individual designated by the facility and having the qualifications

 6specified by the department of health by rule.

 7Safeguards

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

 9The attending physician shall:

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

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

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

13under section 13 of this act;

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

15inform 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

19be prescribed;

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

21and

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

23comfort care, hospice care, and pain control;

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

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

26is competent and acting voluntarily;

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

286 of this act;

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

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

31person present when the patient takes the medication prescribed under

32this 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

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

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

36under section 9 of this act;

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

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

 3decision;

 4(j) Fulfill the medical record documentation requirements of

 5section 12 of this act;

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

 7with this chapter before writing a prescription for medication to

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

 9dignified manner; and

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

11medications intended to facilitate the desired effect to minimize the

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

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

14administration certificate; or

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

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

17prescription; and

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

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

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

21identified agent of the patient. Medications dispensed pursuant to

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

23courier.

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

25certificate which shall list the underlying terminal disease as the

26cause of death.

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

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

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

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

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

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

33decision.

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

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

36suffering from a psychiatric or psychological disorder or depression

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

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

 3dignified manner shall not be prescribed until the person performing

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

 5psychiatric or psychological disorder or depression causing impaired

 6judgment.

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

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

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

10decision. Immediately before writing a prescription for medication

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

12qualified patient is making an informed decision.

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

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

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

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

17request denied for that reason.

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

19prescription for medication that the qualified patient may self-

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

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

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

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

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

25the attending physician shall offer the qualified patient an

26opportunity to rescind the request.

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

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

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

30chapter may be written without the attending physician offering the

31qualified patient an opportunity to rescind the request.

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

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

 2of a prescription under this chapter.

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

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

 5under this chapter.

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

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

 8record:

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

10life in a humane and dignified manner;

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

12her life in a humane and dignified manner;

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

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

15has made an informed decision;

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

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

18has made an informed decision;

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

20counseling, if performed;

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

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

23section 9 of this act; and

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

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

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

27prescribed.

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

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

30Factors demonstrating Washington state residency include but are not

31limited 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

35state.

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

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

 3shall be disposed of by lawful means.

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

 5department of health shall annually review all records maintained under

 6this chapter.

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

 8upon writing a prescription or dispensing medication under this chapter

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

10required documentation with the department. All administratively

11required documentation shall be mailed or otherwise transmitted as

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

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

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

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

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

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

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

19health provides an inadequate or incomplete report, the department

20shall contact the person to request a complete report.

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

22collection of information regarding compliance with this chapter.

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

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

25public.

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

27the public an annual statistical report of information collected under

28subsection (2) of this section.

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

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

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

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

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

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

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

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

 2and dignified manner.

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

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

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

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

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

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

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

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

11health, or accident insurance or annuity policy.

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

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

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

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

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

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

18as "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),

2017, 19(1) (a) and (d), and 20(2) of this act, state reports shall refer

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

22life-ending medication.

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

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

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

26participating under this chapter.

27Immunities and Liabilities

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

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

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

31this section:

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

33professional disciplinary action for participating in good faith

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

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

 3life in a humane and dignified manner;

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

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

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

 7penalty for participating or refusing to participate in good faith

 8compliance with this chapter;

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

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

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

12the appointment of a guardian or conservator; and

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

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

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

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

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

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

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

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

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

22prohibiting provider if the prohibiting provider has given notice to

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

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

25regarding participating under this act. This subsection does not

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

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

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

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

30care provider has notified the sanctioned provider before participation

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

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

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

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

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

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

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

38a physician or other provider;

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

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

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

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

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

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

 7provider; or

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

 9provided by contract if the sanctioned provider participates in this

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

11capacity as an employee or independent contractor of the sanctioning

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

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

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

15employee or independent contractor; or

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

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

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

19sanctioning health care provider.

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

21subsection shall follow all due process and other procedures the

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

23imposition 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

26care provider specifically informing the health care provider before

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

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

29chapter.

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

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

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

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

34not include:

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

36disease and informing the patient of the medical prognosis;

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

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

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

 2referral to another physician; or

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

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

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

 6sanctioning health care provider.

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

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

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

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

1118.130.180.

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

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

14providers in the state of Washington.

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

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

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

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

19class A felony.

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

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

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

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

24resulting from other negligent conduct or intentional misconduct by any

25person.

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

27penalties applicable under other law for conduct that is inconsistent

28with this chapter.

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

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

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

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

33reasonable attorneys' fees related to enforcing the claim.

34Additional Provisions

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

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

 3following form:

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

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

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

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

 8been medically confirmed by a consulting physician.

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

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

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

12hospice care, and pain control.

13I request that my attending physician prescribe medication that I

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

15to contact any pharmacist to fill the prescription.

16INITIAL ONE:

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

18opinions into consideration.

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

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

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

22time.

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

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

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

26and my physician has counseled me about this possibility.

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

28accept full moral responsibility for my actions.

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

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

31DECLARATION OF WITNESSES

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

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

34above request:

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

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

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

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

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

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

17facility.

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

19each reenacted and amended to read as follows:

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

21under this chapter:

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

23RCW 69.45.090;

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

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

2669.41.280, and 18.64.420;

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

28collected and maintained by a quality improvement committee under RCW

2943.70.510 or 70.41.200, or by a peer review committee under RCW

304.24.250, or by a quality assurance committee pursuant to RCW 74.42.640

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

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

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

 270.56.020 or 70.56.040, regardless of which agency is in possession of

 3the information and documents;

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

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

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

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

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

 9sought by the submitting entity under RCW 43.72.310;

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

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

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

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

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

15of health shall continue to treat information designated under this

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

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

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

19demonstrate the continuing need for confidentiality;

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

21through 18.71.340;

22(f) Except for published statistical compilations and reports

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

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

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

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

27of health under RCW 70.05.170;

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

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

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

3170.225 RCW; and

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

3370.-- RCW (sections 1 through 22, 26 through 28, and 30 of this act)

34except as provided in section 15 of this act.

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

36health care information of patients.

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

 22007 c 259 s 49 are each reenacted and amended to read as follows:

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

 4under this chapter:

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

 6RCW 69.45.090;

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

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

 969.41.280, and 18.64.420;

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

11collected and maintained by a quality improvement committee under RCW

1243.70.510, 70.230.080, or 70.41.200, or by a peer review committee

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

1474.42.640 or 18.20.390, or by a hospital, as defined in RCW 43.70.056,

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

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

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

18of the information and documents;

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

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

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

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

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

24sought by the submitting entity under RCW 43.72.310;

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

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

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

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

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

30of health shall continue to treat information designated under this

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

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

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

34demonstrate the continuing need for confidentiality;

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

36through 18.71.340;

37(f) Except for published statistical compilations and reports

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

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

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

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

 4of health under RCW 70.05.170;

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

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

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

 870.225 RCW; and

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

1070.-- RCW (sections 1 through 22, 26 through 28, and 30 of this act)

11except as provided in section 15 of this act.

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

13health care information of patients.

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

15read as follows:

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

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

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

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

20euthanasia.

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

22cited as the Washington death with dignity act.

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

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

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

26persons or circumstances is not affected.

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

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

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

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

3130 of this act constitute a new chapter in Title 70 RCW.

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

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

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

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

 52009.Originally filed in Office of Secretary of State January 24, 2008.

Approved by the People of the State of Washington in the General Election on November 4, 2008.