A year after assisted suicide was legalised in the District of Columbia, no one has taken advantage of it. Only two doctors in the US capital have indicated that they are willing to accept patients who want to receive lethal medications and only one hospital has allowed its doctors to participate.

“It’s been exceptionally, exceptionally slow,” Kat West, national director of policy and programs for Compassion and Choices, told the Washington Post. “Especially in the first year, there’s usually a lot of interest in learning a lot about these laws. That, we think, has been really dampened and discouraged in D.C. because of these administrative rules.”

Doctors are particularly reluctant to place their names on a government register, even if it is confidential. “They don’t want to be known as the doctor who gives out death prescriptions,” said Omega Silva, a retired doctor and a Compassion and Choices volunteer. According to the Post, no doctors testified in favour of the legislation when it was being debated, and several spoke against it. “Even those who say go ahead and pass the law — they don’t want to participate in it,” G. Kevin Donovan, the director of the Pellegrino Center for Clinical Bioethics at Georgetown University Medical Center, an opponent of the law, told the Post. “They want other people to do it for other patients. It’s very difficult for a physician to directly send their patients to death because everything in their training is to try and do what’s good for their patients.”   

Another significant obstacle is the attitude of Washington's large African-American community towards assisted suicide. Most of them are firmly opposed to its promise of greater autonomy over their lives. “Historically, African Americans have not had a lot of control over their bodies, and I don’t think offering them assisted suicide is going to make them feel more autonomous,” Georgetown University scholar Patricia King told the Washington Post. Some worry that ending their lives early will be their best option if they have poor treatment options.