End-of-Life Choice, Palliative Care and Counseling

Compassion Drives ‘Aid in Dying’ Movementby Chris


By Mary Steiner

Jun 02, 2013

Vermont recently approved historic legislation allowing aid in dying, sometimes referred to as “death with dignity.”

Its The Patient Choice at End of Life Act represents a tremendous advance for citizens of that state and the entire movement to expand end-of-life choice. Although widely covered in media on the East Coast, this important development received little attention in Hawaii.

Aid in dying allows terminally ill, mentally competent adult patients to request, and physicians to prescribe, life-ending medication when they their suffering unbearable to bring about a peaceful death.

Vermont is the first state to enact such a law legislatively. Oregon and Washington passed death-with-dig- nity acts by referendum, while the Montana Supreme Court ruled in 2009 that physicians there may provide aid in dying.

The new Vermont law, which the governor signed on May 20, contains provisions similar to Oregon’s Death with Dignity Act and policies in Hawaii. It follows Oregon’s model, but after three years, those requirements expire, at which time professional practice standards will prevail, as they do in Hawaii.

Hawaii is in the enviable position of having aid in dying as a standard medical practice. Two years ago, Compassion & Choices, the largest and most comprehensive choice-in-dying organization in the U.S., analyzed our state’s statutes and determined that a constellation of Hawaii laws gives our citizens broad autonomy over end-of-life decisions, including aid in dying.

Hawaii does not need legislation to permit this practice. It already trusts doctors to set best practices for aid in dying and other end-of-life procedures. Terminally ill individuals are able to make these very personal decisions in consultation with family, doctors and their own personal and spiritual beliefs. Patients should not have to suffer intolerably at the end of their lives, and Hawaii doctors can help.

In 1994, Oregon enacted its Death with Dignity Act. A requirement of the act is for the state to collect information on compliance and to issue annual reports. Recently, the state released its 2012 report that included 15 years’ worth of data. The data proves the law works as intended, and without the abuses some originally predicted. Statistics show the practice of aid in dying is rarely used, but having it provides comfort to terminally ill individuals.

For example, in 2012, 115 Oregonians had prescriptions written, and 77 hastened their deaths. This was less than 0.2 percent of all deaths in that state.

Compassion & Choices Hawaii maintains strictly confidential records on all its clients. Once someone contacts our toll-free number, a counselor returns the call and performs an assessment. We recommend that terminally ill patients be admitted to hospice, and if the patient requests aid in dying, the counselor will make the referral to a doctor who, after reviewing all of the medical records and scans, may be willing to write a prescription for life-ending medication.

Doctors in Hawaii practice aid in dying now, utilizing best medical practices. Prescriptions are being written and, consistent with the Oregon statistics, rarely ingested — though the peace of mind and comfort that prescriptions can provide is invaluable.

Compassion & Choices Hawaii helps people plan for and achieve a good death. We work to change attitudes, practices and policies so that every person can access the information and options they need to have more control and comfort at the end of life.