Hawaii

Dec 20, 2012Aid in Dying Is Not Suicide

By Dr. Charles F. Miller
Honolulu Civil Beat
12/20/12

I was interested to read Christopher Flanders’ letter on behalf of the Hawaii Medical Association in response to Civil Beat’s Oct. 5, 2012, article, “New Aid-in-Dying Service Gets Inquiries.” Flanders was responding to the piece’s closing question, “Is the aid-in-dying movement a humane approach to a difficult subject, or is it a violation of ethical standards?” I appreciate this opportunity to keep the issue of end-of-life choice in the forefront for healthy discussion.

I believe Flanders is correct when he states that, “The physician’s primary obligation is to advocate for the individual patient.” That is why I, and the majority of Hawaii physicians as well as state residents, feel that physicians should help their terminally ill patients achieve a peaceful death when patients request it and when options for recovery are nil.

Nov 13, 2012Aid-in-Dying Supporters Vow to Help Hawaii’s Terminally Ill

by Lara Yamada
KITV News
November 12, 2012

“In the end of February, it was discovered I had kidney cancer,” said hospice care worker Dorothy Haden, who has stage four cancer.

“I tried to live my life with dignity, and I do want to end my life with dignity,” said former lawmaker Earnest Juggie Heen, who has liver and pancreatic cancer.

Both said they want to choose how and when they end their lives.

“It’s our position that aid in dying is legal and it can be incorporated into medical practice legitimately here in Hawaii,” said Barbara Coombs Lee, who is the president of Compassion & Choices, a national nonprofit organization that supports aid in dying. She returned to Hawaii in early November, one year after a small group of Hawaii doctors first prescribed life-ending medication to a terminally ill patient.

“Hawaii has a constellation of laws that have never really criminalized aid in dying,” she said.

She said in the past year, 31 people have inquired about aid in dying, seven qualified to receive medication, and four were actually prescribed it, but she said all four died of natural causes before taking that prescription.

“People just want the comfort. They just want peace of mind,” she told KITV4 reporter Lara Yamada. More

Oct 5, 2012New Aid-in-Dying Service Getting Inquiries

by Chad Blair
Honolulu Civil Beat
October 5, 2012

Compassion & Choices Hawaii, a nonprofit organization working to improve care and expand choice at the end of life, received 31 local inquiries in its first year of service.

The figure comes from an annual report released by the Physician Advisory Council for Aid in Dying, or PACAID, a group of local doctors that collaborates with Compassion & Choices Hawaii and can prescribe life-ending medication if necessary.

PACAID has a rigorous eligibility process that applicants must go through, and of those 31 inquiries only seven qualified to consult with a PACAID doctor.

Of the seven, four received a prescription for medication “which they could ingest to end their life and suffering in peace and dignity, at the time of their choosing,” according to a Compassion & Choices press release.

As of Thursday, two of the four patients died from natural causes and none had taken the medication.

“Terminally ill people get peace of mind from knowing they can request medication that will allow them to achieve a peaceful death,” Mary Steiner, campaign manager for Compassion & Choices Hawaii, said in a statement. “Some people get a prescription and don’t take the medication for weeks or months. They go on living their life.”

Steiner dismissed arguments from opponents of aid in dying that patients would use the medication prematurely.

“The report shows just the opposite, as we have seen in other states where the option is available,” she said. “Patients frequently say that the peace of mind and control they gain makes it easier to live out their remaining days.” More

Sep 21, 2012A Graceful Exit: Taking Charge at the End of Life

by Claudia Rowe
YES! Magazine

September 19, 2012

I was standing in my cubicle, a 24-year-old fact-checker envisioning a publishing career of glamor and greatness, suddenly shaking as I read the document my mother had mailed. It detailed her wish that I promise never to keep her or my father alive with artificial respirators, IV-drip nourishment, or anything else she deemed “extreme.”

I was horrified, and slightly angry. My mom was a 54-year-old literature professor who’d spent the 1970s eating whole grains and downing vitamins. She was healthier than anyone I knew. Why get so dramatic now? It seemed ghoulish, not to mention premature. But I scrawled my signature at the bottom of the page and shoved it into an envelope, my mother’s voice in my head, prodding me along.

As with the whole wheat and vitamins, my mother—back in 1990—was onto something long before it became conventional wisdom. But these days, Americans’ approach to aging and death is rapidly evolving, pushed both by the numbers and the grim reality behind them: In 40 years, there will be 19 million Americans over 85, all at high risk of losing the ability to care for themselves or dwindling away due to organ failure, dementia, or chronic illness. (The days of a sudden fatal heart attack are fading; by 2008, the death rate from coronary heart disease was down 72 percent from what it was in 1950.)

So while many seniors now live vigorous lives well into their 80s, no one gets a free pass. Eating right and exercising may merely forestall an inevitable and ruinously expensive decline. By 2050, the cost of dementia care alone is projected to total more than $1 trillion.

My mom’s decision to face her end came not from any of these facts, but from the nightmare of watching her own mother’s angry decline in a New York nursing home. “You’re all a bunch of rotten apples,” Grandma growled at visitors, the words erupting from her otherwise mute lips. And there she sat for three years, waiting to die. “Why can’t you just get me some pills so I can go?” she would sometimes wail.

The slide toward death was only slightly less awful for my father’s mother. Grandma Ada would greet me with a dazed smile—though it was impossible to know if she recognized the person standing in front of her wheelchair—before thrashing with involuntary spasms. An aide would come to restrain her, and then my dad and I would leave.

This cannot be right. This cannot be what we want for our parents—or ourselves. More

Sep 14, 2012Isle drama renews interest in ‘death with dignity’ idea

The worrisome account of 95-year-old Karen Okada adds new emphasis to Hawaii’s long debated, but never acted on, issue of death with dignity.

Okada in 1998 had prepared directions that her life not be artificially prolonged and now is living a semi-comatose state at Queen’s Medical Center with a feeding tube.

Star-Advertiser reporter Dan Nakaso wrote that the Queen’s Ethics Committee found that “continuing to provide antibiotic treatment and nutritional supplementation is in violation of Ms. Okada’s instructions … and such treatment should be discontinued.”

Family members disagreed, the entire matter is in court, and the worry and fear continue.

There is a certain democracy in knowing that death comes to all and makes everyone equal, although those living with those at the end of life know that no matter how dedicated the care, there is always the feeling that something more should be done. If the loved one is not going to get better, then what to do? More

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