Three decades of experience has taught Compassion & Choices that in order for dying people to have real access to hard-won medical aid-in-dying laws, robust public campaigns are essential to educate and empower the public, health professionals and healthcare systems. It is equally necessary to provide grassroots organizing support to communities who want access to their law and feel abandoned by local healthcare systems that try to prohibit their doctors from practicing medical aid in dying.
Compassion & Choices’ “access campaigns” integrate medical aid in dying into standard healthcare practice in states with laws. These campaigns enable people to access all their legal options through their own doctors and in their preferred medical setting. And it means that now and decades from now, medical aid in dying will be a secure feature of the healthcare landscape, able to withstand the legal and legislative attacks that happen routinely in authorized states.
Compassion & Choices also provides inservice education and instructional videos to doctors and other medical professionals, and model policies to hospitals and hospices. We deliver confidential one-on-one consultations through our Doc2Doc and Pharmacist2Pharmacist programs, enabling practitioners in authorized states who are unfamiliar with medical aid in dying to talk to a colleague with years of experience in this medical practice via a toll-free number.
Just last year in California, our access campaigns compelled nearly 500 healthcare facilities and more than 100 hospices to adopt policies supportive of medical aid in dying, saving patients from having to re-establish relationships with a new healthcare system at a most difficult time.
Accomplishments: Implementing the Laws
Passing medical aid-in-dying laws is just the beginning. Compassion & Choices remains in authorized states to ensure that patients have ready access to their options under the laws, and that the laws are successfully implemented and integrated into standard medical practice.
Just a few days before the California End of Life Option Act took effect in June 2016, the Los Angeles Times reported that Pasadena-based Huntington Hospital decided to forbid its 800 affiliated physicians from participating in the law. Such a high-profile rebuke would have been a blow to the law’s early implementation and acted as a contagion for other healthcare systems, so our local volunteers and staff organized community residents who were outraged by the decision to speak out. The result: Huntington reversed its position and announced it in a full-page open letter advertisement in the LA Times, telling community residents they got the message that this option was important to them.
A year into our California Access Campaign, nearly 500 healthcare facilities (including Kaiser Permanente, UCSF, Stanford, Tenet, Sutter and UCLA) and more than 100 hospice locations (including Vitas, Seasons and Gentiva) have adopted policies supportive of patient choice, and they fully back the doctors and medical professionals who choose to participate. Another milestone for the movement is that 80 percent of private insurance companies have elected to cover the cost of aid-in-dying medication, including Blue Cross, Blue Shield, Kaiser Permanente, Sutter, many local health plans and all Medi-Cal plans.
The Colorado Access Campaign provided education and model policies to all the healthcare systems and hospices in the state, including participating in several high profile medical association webinar and conference events. And in just the first six months of the law, all of the large secular healthcare systems and two of the largest hospice systems in the state adopted policies supportive of patient end-of-life choice.
After less than two years, the Compassion & Choices Access Campaign in Oregon secured a 70 percent increase in physicians participating in medical aid in dying and prescribing medication. In one case, outreach from a patient and Compassion & Choices’ staff led the Portland Clinic, a large specialty facility, to drop its 18-year prohibition against medical aid in dying and allow its patients to access this important end-of-life care option.
After advocates from across Vermont met with stakeholders to encourage the large Dartmouth-Hitchcock health system’s participation, it instituted a policy to support the eligible Vermonters it serves in accessing medical aid in dying. In its first year, our Access Campaign helped catalyze a 400 percent increase in medical aid-in-dying prescriptions — a pivotal sign of public faith in the law — and an important step toward securing its long-term success.