For years since her diagnosis of terminal cancer, Tiger Mountain resident Kathy Sparks has been fighting an uncertain and losing battle to stay alive. But she’s grateful a new law – The Death With Dignity Act – will at least allow her to control when and how she dies.

Speaking publicly at a March 4 press conference at the Seattle Public Library almost a year after the law took effect, Sparks, 56, told the audience that once all other options were exhausted, the ability to control her end-of-life care gave her the ”peace of mind” she desired.

Passed by voters as Initiative 1000 in 2008, the law allows terminally ill adults to obtain lethal doses of medication when diagnosed with six months or less to live.

A former hospice nurse, Sparks said that experience made her aware of planning for the worst to avoid unnecessary pain and suffering.

“I know the dying process all too well,” she said. “I needed to prepare for that.”

The former hospice nurse appeared alongside representatives speaking on behalf of Compassion & Choices of Washington (CCW), a non-profit advocacy group supporting the Death With Dignity law.

Growing up in sunny Florida, the fair-skinned Sparks said she wasn’t entirely surprised to find a small mole that appeared on her left forearm was diagnosed as Stage-2 Melanoma. But the condition changed her life, forcing her to quit her job as a nursing instructor at Renton Technical College as she underwent a variety of treatments to stop the cancer. Despite having what she called excellent health insurance and medical attention, the cancer eventually spread to her breasts and lymph nodes, resulting in more surgeries. A terminal diagnosis last December forced her to consider how and when she wanted to die and start the legal process of receiving a lethal dose of drugs to end her life.

“I don’t want to die,” she said. “I’m trying very hard to live … (but) I’m glad I live in a compassionate state that gives me these choices.”

The press conference was called to highlight a new report from the state Department of Health (DOH) reviewing the effects of the law in 2009.

CCW Medical Director Dr. Tom Preston, a retired Seattle cardiologist, said giving life-ending prescriptions to patients is a safe, rare and legal practice that should be made available to all who seek it.

The DOH reported 63 residents were prescribed lethal doses and 36 died after taking it. Of those who died, two awoke briefly after taking the prescription, while one other regurgitated, and nearly all died in a domestic setting with other family members nearby. Based on the total number of reported deaths in the state in 2008, those who died under the Death With Dignity law amounted to less than a tenth of one percent.

Preston also conceded, however, a large number of patients weren’t able to use the Death With Dignity law because doctors, hospices and hospitals refused to provide the service. The law allows doctors and hospitals to opt out of providing such prescriptions.

In Issaquah, Overlake will not allow providers to participate in the law. Nor will providers at the Catholic Church-associated Providence Marianwood nursing home. Virginia Mason and Swedish allow providers to make referrals, but only off-premises.

Providence Marianwood Foundation Director Steve Gallion, who raises money to support the 24-hour nursing home, said she disagreed with his employer’s decision to ban providers at Marianwood from giving their patients the option under the Death With Dignity law.

“I’m not even allowed to all it by that name,” he said. “I have to call it physician-assisted suicide.”

The procedure to acquire the life-ending drugs are somewhat complicated and time consuming, requiring two doctors and paperwork and at best could take up to 6 weeks. CCW spokesperson Steve Hopcraft urged the public to speak with their health care provider about end-of-life care before a serious illness or accident to determine exactly what sorts of treatments they can provide.

“It should be Kathy’s decision, not the Pope’s, not the hospital, not the doctor,” said Hopcraft. “We encourage patients to talk to their doctor. You can’t expect them to do this at the last minute.”

Reflecting on her end-of-life care preparations, Sparks said she and her husband have been busy putting her affairs in order. She’s been reviewing a “bucket list” of things that are important to her and deciding on how best to spend her time. A trip to the Great Barrier Reef in Australia is on the list, as well as a slightly-less ambitious weekly breakfast date with friends at the Issaquah Cafe for some pancakes. After living in Issaquah for 17 years, Sparks said she’s just enjoying her life one day at a time.

“I go with my German shepherd out on the mountain and hike with him every day,” she said. “I love Tiger Mountain. I’ll probably have my ashes scattered here. It’s home to me.”