The Washington State Death with Dignity (DWD) Act passed into law in November 2008 and allows terminally ill adults with a life expectancy of fewer than 6 months to request lethal doses of barbiturate medications to end their lives. Participants have cited concerns about loss of autonomy, dignity, and ability to engage in activities that make life enjoyable as reasons for participating in the program.1,2 Since 2009, the number of DWD prescriptions dispensed in Washington State has steadily increased, and the majority of patients (approximately 75% with cancer diagnoses) to whom the medications are dispensed will ingest them.1 The DWD program has generally been considered successful and patients have reported feeling grateful to have an option for physician-assisted death.2 Today, however, patients and their families are raising new concerns about the high cost of DWD medication and the unaffordability of ending their lives in this way.