With the B.C. Court of Appeals set to weigh in on physician-assisted suicide in Canada, CTV News headed south of the border to explore how the practice has been implemented in Washington State.

The Death with Dignity Act has permitted assisted suicides in Washington since 2009, but only for terminally ill patients who have less than six months to live – people like Meg Holmes.

In the prime of her life, Holmes loved playing orchestra clarinet, the great outdoors and her job at a Seattle cancer research centre.

But three years ago, she began feeling ill. Her husband Andrew Taylor said Holmes started coming home from her job early, and sometimes stayed home altogether.

Soon enough, they received her devastating diagnosis.

“With difficulty, I got Meg dressed, took her to the emergency room and within half an hour they diagnosed her with a brain tumour,” Taylor said.

Meg underwent surgery, and recovered. Life went back to normal.

“Went back to playing with the orchestra, we got to go hiking, bicycling and we got to go on two backpacking trips together,” Taylor said. “So we had 15 months of very good life together.”

But in March 2011, Holmes' tumour returned and paralyzed her left side. Another surgery and treatment could not slow its growth.

She began talking to her husband about the Death with Dignity Act.

Physician-assisted death is only available in Washington under strict conditions. Patients requesting a lethal dose of medication must get approvals from two separate doctors, an attending physician and a consulting physician, and can be referred for a psychological examination.

They are required to make one written request and two spoken requests, spaced at least 15 days apart.

“The idea is to ensure that it’s a well-considered, rational choice on behalf of the patient,” said Robb Miller, executive director of the advocacy group Compassion and Choices.

Patients must also be able to take the lethal dose themselves.

“It isn’t euthanasia where, you know, someone can be put to death,” Miller said. “The patient has to be able to swallow the medication or push it into a stomach tube using a syringe. So it takes an action by the patient.”

Last year, 103 people were granted prescriptions. Of those, 70 died after ingesting the medication and 19 died without it.

Miller said his organization doesn’t care whether patients take the dose. He argues that some simply benefit from the peace of mind of knowing they have a choice.

Among those who chose to end their lives was Meg Holmes.

In October, Holmes' family gathered at her bedside. She took a cup of colourless liquid and drank it as they watched.

Her husband said she was asleep by the time she finished the cup.

“She got to die peacefully and quietly in the presence of her family, and that, I think, is all I think anybody can ask in life," Taylor said.

With a report from CTV British Columbia’s Maria Weisgarber