The program's policy - written by the Seattle Cancer Care Alliance's medical director and approved by a majority of the medical executive committee members, as with any clinical policy - requires that patients request information about medically assisted suicide from their physicians, or that these clinicians raise the topic, to be considered for referral. Participation is entirely voluntary for medical staff and faculty members.
Every patient who is a potential participant is first assigned an advocate, a licensed social worker employed by the Alliance, who assists patients, family members, pharmacists, and physicians throughout a multistep process of participating. This advocate also tracks compliance with required documentation for the state Department of Health.
The advocate, as well as the attending physician, ensures that all potential participants are aware of alternatives to medically assisted suicide, such as palliative care and hospice care. The patient's terminal status is verified, and if the attending physician doesn't wish to participate, a prescribing physician and a consulting physician are chosen from a group of willing providers.
The traditional Western ethic has always placed great emphasis on the intrinsic worth and equal value of every human life regardless of its stage or condition . â€¦ This traditional ethic is . . . being eroded at its core and may eventually be abandoned . . . Hard choices will have to be made . . . that will of necessity violate and ultimately destroy the traditional Western ethic with all that portends. It will become necessary and acceptable to place relative rather than absolute values on such things as human lives. . . . One may anticipate . . . death selection and death control whether by the individual or by society.*