Three initiatives will appear on the general election ballot in Washington state. Following are Spokesman-Review endorsements on those measures.

Initiative 1000: Initiative 1000 would allow terminally ill people to end their lives by ingesting physician-prescribed drugs. We oppose Initiative 1000 for these reasons:

 It places doctors – and the state – in the position of hastening death.

The Hippocratic Oath requires physicians to heal, rather than harm. “It has been a long-standing tradition in medicine to not give medication that you know the patient will take to die,” said Dr. Jeff O’Connor, president of the Spokane County Medical Society. The county’s medical society and the Washington State Medical Association are opposed to the initiative.

 No urgent need exists for state intervention.

The so-called “Death with Dignity” movement gained momentum in the early 1990s before the expansion of hospice programs and advances in end-of-life care.

In 2005, 1.2 million people nationally received hospice care; this number increased 10 percent by 2006, and the trend continues upward as our population ages.

Oregon has not been inundated with demand to use the law; only 341 patients have died under its terms in the past decade. Also, as cold as this sounds, men and women possess the option now to kill themselves, without the involvement of the state.

 The elderly and sick could feel pressure to end their lives to save medical expenses.

Patients must fill out a form requesting the life-ending medication. Two witnesses must sign the request. One witness can be someone who will inherit money from the patient. How much finance-based coercion has gone on in Oregon? It’s impossible to know. Oregon’s Department of Human Services compiles a statistical report on the law each year, but the information is mostly provided by the few doctors who prescribe the life-ending medicines.

The Oregonian’s editorial board recently came out against Washington’s initiative, which is nearly identical to Oregon’s law. The main concern? The law’s lack of transparency. The board wrote: “Essentially, a coterie of insiders run the program, with a handful of doctors deciding what the public may know.”

We acknowledge that the dying process sometimes involves profound indignities, but it can also bring forth profound emotional healing for patients and their families. In our illness- and death-averse culture, we can’t legislate away all suffering. Vote no on Initiative 1000.

Initiative 985: Initiative 985 would tap the sales tax from cars to create a state fund designed to alleviate traffic in the most congested areas. Currently that money goes into the general fund, where it can be spent on any service, such as education or health care. The initiative also snatches locally generated money from red-light runners and any state funds earmarked for public art that is transportation-related.

With Initiative 776, Tim Eyman enlisted all of the state’s voters to try to defeat an effort in four counties in Western Washington to raise motor vehicle licensing fees to finance mass transit. With I-985, voters statewide will determine whether transportation dollars should be largely diverted to two congested counties on the West Side.

Eyman doesn’t tell this West Side story, of course. He doesn’t mention that 37 counties will be losing more transportation dollars than they gain, according to an analysis by the Sightline Institute. But you only have to look at the state’s congestion relief map to figure out that most of the money will go to King and Snohomish counties.

More flexibility with High Occupancy Vehicle lanes? We don’t have those. Traffic jams that back cars up for hours at a time? That’s rare around here. That’s not to say there aren’t traffic problems on the east side of the Cascades; it’s just that I-985 doesn’t address them. With the sole focus on congestion, more lightly populated counties with safety issues are ignored. Even other counties with traffic delays are ignored because the delays are not as lengthy as those in greater Seattle.

Communities like Spokane wouldn’t be able to use the revenue raised from red-light runners to engineer safer intersections. That’s like emptying the parking meters and sending the cash to Seattle.

Congestion in the Interstate 5 corridor is a problem, but Eyman’s solution would not address the aches, pains and runny noses elsewhere in the state. In fact, it takes money from those areas and pretends it is cost-free.

The truth is that there are no auto-centric solutions to traffic jams in big cities. No metropolitan area has ever paved its way out of the problem. None has solved it with better schemes to clear accidents or more flexible car-pool lanes or the other efficiencies that Eyman touts.

The solution must be comprehensive. Eyman likes to invoke a state audit on transportation, but not the part that recommends “increasing efforts to have people use carpools, transit and telecommuting.”

The genius of Eyman’s cynical pitch is that it is focused on the frustrated motorist who is inching along a Seattle freeway and looking for quick escape. Even if I-985 passes, that motorist will remain annoyed.

The state needs solutions that look past the hood of that single-occupant vehicle. I-985 isn’t it.

Initiative 1029: As voters examine Initiative 1029 on Washington’s Nov. 4 general election ballot, certain statistics deserve their attention.

Long-term care providers hire about 20,000 people a year to deliver services.

The percentage of Washingtonians who are over 65 will nearly double by 2025, from 11 percent to 20 percent.

The Legislature will convene in three months facing a revenue shortfall of more than $3 billion.

All those numbers bear on I-1029, which would require more training and federal background checks for most long-term care providers. The state Office of Financial Management estimates the measure would cost the state almost $30 million for the first full biennium.

How much it would cost as the population ages over the next couple of decades is harder to predict. But it’s imperative that state lawmakers concentrate their attention in 2009 on dealing with plunging revenue estimates compounded by the nation’s economic difficulties.

So, is this measure really necessary?

The implied concern behind I-1029 is unchallenged. Citizens who require long-term care because of age or impairment should be able to expect competence, professionalism and ethics. So should their families. This justifies government oversight.

At present, long-term care providers must undergo training and state criminal background checks. If those requirements fail to serve the public interest, advocates have offered only anecdotal evidence of it.

But the OFM fiscal impact report makes it clear that the state would incur millions in costs just to implement the measure. And the expense will only go up as the client population grows.

Beyond that, the added body of rules and regulations will have to be administered, at a cost. And more stringently trained workers will command higher pay, adding to the relentlessly upward pressure on the cost of health care. Will those higher wages attract more workers into the field to keep up with demographic trends? Or will the added hassle of training requirements drive many away? Maybe, and maybe.

If convincing evidence can be shown that the public is endangered by the current regulatory climate, a measure like I-1029 might be in order. Right now, the case hasn’t been made, and Washington’s economic condition won’t tolerate millions in added costs on the strength of anecdotes and speculation.