Sequim resident Linda Fleming, 66, became the first person to die under Washington’s "Death with Dignity" act.

Fleming took prescribed drugs to end her life Thursday night, May 21. She had Stage IV pancreatic cancer.

"The pain became unbearable and it was only going to get worse," Fleming wrote in a statement she prepared before her death.

Compassion & Choices of Washington, an advocacy group for people with terminal illnesses facing end-of-life choices, announced Fleming’s death Friday, May 22.

Died at home

Steve Hopcraft, Compassion & Choices media consultant, said Fleming died in her home with her Chihuahua, Seri, her physician and a support volunteer at her bedside.

One of Fleming’s two daughters spent about four hours with her earlier in the day. Fleming’s family supported her decision to use the Death With Dignity act, Compassion & Choices reported.

Fleming had lived in

Sequim for about eight years. She was divorced, but her ex-husband is making her funeral arrangements.

Hopcraft said Fleming "was stunned when she received her terminal diagnosis, as she had only recently begun feeling discomfort. Linda’s disease progressed rapidly and her pain worsened dramatically."

What she wrote

Fleming wrote:

"I had only recently learned how to live in the world as I had always wanted to, and now I will no longer be here. So my fatal disease arrived at a most inopportune time."

She developed abdominal pain in late March and received her cancer diagnosis April 24.

Fleming told her Compassion & Choices client support volunteer that she would be in a better place after she died.

"I am a very spiritual person, and it was very important to me to be conscious, clear-minded and alert at the time of my death," she wrote.

"The powerful pain medications were making it difficult to maintain the state of mind I wanted to have at my death. And I knew I would have to increase them.

"I am grateful that the Death with Dignity law provides me the choice of a death that fits my own personal beliefs."

Horsewoman, hiker

Fleming was an active woman who loved the outdoors and, at different points in her life, was an avid horsewoman, birdwatcher, camper, beachcomber, hiker, dog agility hobbyist and organic gardener, Hopcraft said.

She gathered signatures on petitions to put Initiative 1000, the Death with Dignity law, on the ballot. Voters approved the measure with 60 percent in favor – 61 percent in Clallam County.

Fleming also went back to school as an adult to become a social worker and worked with clients who experienced great suffering at the end of their lives.

"When she learned she had terminal pancreatic cancer, she was grateful and relieved that she would not have to suffer for a prolonged period of time, while cancer ravaged her body and drugs debilitated her mind," Hopcraft said.

"She worked diligently, with no second thoughts, to comply with the terms of the Death with Dignity Act, and was at peace with her death."

Provisions of act

The Washington Death with Dignity Act allows terminally ill adults seeking to end their lives to request lethal doses of medication from medical and osteopathic physicians.

These terminally ill patients must be Washington residents who have been diagnosed as having less than six months to live.

According to the Washington State Department of Health, five residents of the state have made written requests to end their lives since the act passed in November.

Fleming was the first known person to take the lethal medications – which cannot be administered by another party.

She took a fast-acting barbiturate that caused her to lose consciousness in seven minutes and to die after a few hours.

Compassion & Choices Executive Director Robb Miller said the method was similar to falling asleep.

"She experienced a peaceful death," Miller said.

"We’ve never heard of a patient reporting pain or discomfort."

Initiative 1000 was based on Oregon’s measure, which since its inception more than 10 years ago, has allowed at least 401 Oregonians to end their lives.

In both states, physicians and pharmacists are not required to write or fill lethal prescriptions if they are opposed to the law.

Some hospitals — including Olympic Medical Center (see related story on Page A-1) – have opted out of the law, which precludes their doctors from participating on hospital property.

Under the Washington law, any patient requesting lethal medication must be at least 18, declared competent and be a resident of the state.

Two doctors must certify that the patient’s diagnosis is a terminal condition with six months or less to live.

The patient must also must make two oral requests, 15 days apart, for the lethal prescription, plus a written request that is witnessed by two people.

Miller said Fleming and her family wanted her physician and her volunteer to remain anonymous because Fleming feared that opponents of Death with Dignity might harass or harm them.

Reach Matthew Nash at mnash@sequimgazette.com.