Providence Health Care System, the largest medical provider in the Northwest, says none of its facilities may be used in assisting suicide.

Roman Catholic nuns founded the group, which includes care facilities in Olympia, Seattle, Issaquah, Everett, Centralia and three others in the state. The system is a Catholic ministry, and the church views assisted suicide as immoral.

“We truly don’t think that a physician should be put in the position of aiding a patient in taking his or her own life,” said spokeswoman Karina Jennings.

The state’s largest provider of hospice care is also a Catholic organization: Franciscan Health System, which operates facilities in Tacoma, Lakewood and Federal Way.

“We are studying the details of the new law, and we will, as an organization, be discussing our options,” said Franciscan spokesman Gale Robinette.

MultiCare Health System, a four-hospital group based in Tacoma, is still developing its policy, spokesman Todd Kelley said Friday. MultiCare is not a faith-based organization.

Opponents of the initiative have said they’ll consider a lawsuit to stop the law before it goes into effect March 4.

Legislators, meanwhile, are sitting on the sidelines.

“I haven’t heard anyone coming forward with efforts to tweak this or that. As far as I can tell, we’re going to be watching it going into effect and see how people deal with it,” said Sen. Karen Fraser, D-Olympia, chairwoman of the state Senate Health Care Committee.

“Given the voters’ margin on that measure, I just don’t foresee the political will to do anything with that measure,” she added.

One decision lawmakers could face is whether state-paid health insurance will cover the lethal doses of medicine.

Oregon’s public health program does cover the drugs. But it would take direct action by the Washington Legislature to pay for them here because no federal money may be used, according to the state Department of Social and Health Services.

What if an individual medical provider is morally conflicted?

“Our law is an ‘opt-in’ law for both the pharmacist and the physician,” said Rob Miller, executive director of Compassion & Choices of Washington, which supported I-1000. “No pharmacist or physician is required to participate.”

In Washington, Gov. Chris Gregoire has pushed for rules that require pharmacists to fill any legal prescription. She was reacting to cases in which some pharmacists refused to fill prescriptions for emergency contraceptives.

But the assisted-suicide initiative likely trumps those rules, said Tim Church, spokesman for the Department of Health.

The agency is establishing a program to track who uses the Death with Dignity Act and why. It estimates the program will cost $79,000 to start and run in its first two years.

That process will include writing rules about how use of the measure will be tracked. The public will be able to comment on those proposed rules.

Miller predicts that questions and interest will fade as the Death with Dignity Act becomes routine.

“In Oregon, people had the same fears and concerns about how the law will work. But what they have found is that it has worked well year after year after year,” he said. “It’s new in Washington and it’s getting a lot of attention … but it’s really not rocket science.”

INITIATIVE 1000 BASICS

The Death with Dignity Act allows terminally ill patients to receive lethal medications. The person must make two oral requests, and one in writing that is witnessed by two people.

Two doctors must diagnose a patient as having six months or less to live, and declare the patient competent to make the decision to end his or her life. To be eligible, the patient must be 18 or older and be a Washington state resident.