End-of-Life Choice, Death with Dignity, Palliative Care and Counseling

Oregon News

Oregon AG Urged Not to Waive Merger Review for Catholic Hospitals in 6 States

Groups Note Catholic Ethical & Religious Directives Restrict Reproductive, End-logoof-Life Care

(Portland, OR – Jan. 14, 2016) Thirteen public interest organizations have written Oregon Attorney General Ellen Rosenblum urging her to reject a request for a waiver from the standard process for reviewing merger transactions by the nation’s 6th largest nonprofit hospital system, Providence Health & Services, and St. Joseph Health.

“This proposed transaction involves eight hospitals across Oregon, and a total of almost 50 hospitals across six states [Alaska, California, Montana, Oregon, Texas, Washington],” the groups said in the letter sent to AG’s office on Jan. 8. “Even absent the transfer of assets, significant changes in health care delivery are likely to occur…it behooves the Attorney General to undertake the full review process to ensure that this transaction preserves existing health care services and benefits the public interest.”

St. Joseph and Providence are both Catholic health systems. Catholic hospitals must typically follow the Ethical and Religious Directives (ERDs) promulgated by the United States Conference of Catholic Bishops. The ERDs many forbid reproductive health services, including all birth control methods, sterilization, miscarriage management, abortion, the least invasive treatments for ectopic pregnancies, and some infertility treatments. The ERDs provide no exceptions for risks to a patient’s health or even life.

In addition, the ERDs limit medical end-of-life decision making of patients by restricting options for advanced directives, surrogate decision-making, and withdrawal of life-sustaining procedures in Catholic healthcare settings. Providence and St. Joseph operate hospitals in four states – California, Montana, Oregon, and Washington – that authorize medical aid in dying as an end-of-life care option for terminally ill adults.

“Every patient who enters a hospital, clinic, doctor’s office, or any other medical setting expects that she or he will receive treatment information and services that meet the standard of care,” the letter notes. “Yet, the restrictions the ERDs place on Catholic hospitals are severe limitations that violate basic evidence-based standards of care – accepted medical practice and as adopted by the major professional medical associations.”

When Harrison Medical Center in Bremerton, WA affiliated in 2013 with the Franciscan [Catholic] Health System, doctors at Harrison were forbidden from performing “elective” abortions or writing prescriptions for aid-in-dying medication to terminally ill adults who request it.

Or. Rev. Stat. 65.807(1) requires that the Attorney General conduct a public hearing on the proposed transaction,” the letter concludes. “The purpose of the public meeting is to receive input and comments from the immediate community to be directly affected. This critical step in the review process should not be waived.”

The California Attorney General’s office has rejected a similar waiver request.

The following groups signed the letter:

National Health Law Program

ACLU of Oregon

Asian Pacific American Network of Oregon

Catholics for Choice

Compassion & Choices

Lambda Legal Defense and Education Fund

Legal Voice


NARAL Pro Choice Oregon

Northwest Health Law Advocates

Physicians for Reproductive Health

Pride Foundation

Western States Center

You can read the full letter by clicking here.

Groups Concerned Walgreens’ Collaboration with Catholic Health Provider Will Limit Consumer Access to Important Medical Services

logo(Portland, OR – Dec. 14, 2015) Nineteen public interest organizations that advocate for patients’ rights and comprehensive health care access are concerned about the impact on health care consumers of a collaboration between the nation’s largest drug store chain, Walgreens, and a Catholic health care provider to open up to 25 in-store health clinics in Oregon and Washington.

In a letter emailed to Walgreens today, the 19 organizations sought to learn whether religious doctrine will limit access to important medical services, information, and referrals at the clinics operated by the Catholic health care provider, Providence Health & Services, and its affiliate, Swedish Health Services, and will limit Walgreens’s pharmacies’ ability to fill prescriptions. Providence Health & Services will own and operate the proposed clinics and employees of Providence Health & Services and Swedish Health Services with staff them.

As a Catholic health care system, Providence Health & Services is required to follow the Ethical and Religious Directives (ERDs) promulgated by the United States Conference of Catholic Bishops. These directives forbid or severely restrict critical reproductive and end-of-life health care services at Catholic health facilities, including contraception, abortions, fertility treatments, vasectomies, tubal ligations, aid in dying, and advance directives that are contrary to Catholic teachings.

“In our states we have consistently seen that when secular entities join with religious health systems, the services, information or referrals provided at the secular entity become limited by religious doctrine,” wrote the groups, which include Compassion & Choices, the nation’s leading advocacy organization for expanding choice in end-of-life care. “Customers and patients have the right to information regarding all of their options in order to make educated health care decisions. How does Walgreens plan to protect its customers’ rights to receive information about all available reproductive and end-of-life health information?”

When Harrison Medical Center in Bremerton, Washington affiliated with a religious health system in 2013, doctors at Harrison were no longer able to prescribe medications to assist with aid in dying, as allowed by Washington’s Death with Dignity law. When Swedish Health Services affiliated with Providence Health & Services in 2012, it stopped providing what it terms “elective” abortions at Swedish facilities.

Some religious health systems even restrict the information and referrals that their health providers are allowed to give to patients. Further, adherence to the ERDs increases the likelihood that LGBTQ individuals and their families will face discrimination in seeking to access health care services consistent with their medical needs.

“We appreciate Walgreens’s objective to provide customers with convenient access to basic health services. However, as Providence Health & Services is a religious health system, we are very concerned that these clinics will limit patients’ access to important health services,” wrote the groups, including Compassion & Choices, the nation’s leading end-of-life choice advocacy organization. “Customers or patients who request services at these clinics or at Walgreens’s pharmacies are entitled to assurances that the services, information, and referrals they receive will not be restricted by religious doctrine.”

The following groups signed the letter:

American Civil Liberties Union of Oregon
American Civil Liberties Union of Washington
Asian Pacific American Network of Oregon (APANO)
Basic Rights Oregon
Compassion & Choices
Gender Justice League
Lambda Legal Defense and Education Fund, Inc.
Legal Voice
NARAL Pro-Choice Oregon
NARAL Pro-Choice Washington
National Health Law Program
Northwest Health Law Advocates
Oregon Foundation for Reproductive Health
Pierce County AIDS Foundation
Planned Parenthood Advocates of Oregon
Planned Parenthood Votes Northwest & Hawaii
Pride Foundation
Western States Center

Post-Brittany Maynard Poll: Most U.S. Doctors Now Support Aid in Dying

By Sean Crowley

For the first time, most American physicians believe by a 23 percent margin (54% vs. 31%) that patients with an “incurable and terminal” disease should have the option to choose death with dignity, also known as the medical practice of aid in dying.

That is the conclusion of an online survey conducted by Medscape of 17,000 U.S. doctors representing 28 medical specialties.

The previous Medscape survey on this issue in 2010 showed physicians support medical aid in dying by a five percent margin (46% vs. 41%).

“It represents a remarkable shift,” said Arthur Caplan, founding head of the division of bioethics at NYU Langone Medical Center, in an interview with NBC News. “If physician opposition continues to weaken, it is likely that despite fierce resistance from some religious groups and some in the disability community, more states will follow Oregon, Washington and Vermont, and legalize.”

The exact question wording in both the 2014 and 2010 surveys asking physicians if they support or oppose aid in dying, respectively, are below:

“I believe terminal illnesses such as metastatic cancers or degenerative neurological diseases rob a human of his/her dignity. Provided there is no shred of doubt that the disease is incurable and terminal, I would support a patient’s decision to end their life, and I would also wish the same option was available in my case should the need arise.”

“Physicians are healers. We are not instruments of death. This is wrong.”

Medscape conducted the 2014 poll between Sept. 18 and Nov. 12, so it received a significant part of the responses after the Oct. 6 launch of Brittany Maynard’s joint campaign with Compassion & Choices to authorize aid in dying in states nationwide.

In addition to death-with-dignity laws enacted in Oregon, Washington, and Vermont, courts in Montana and New Mexico have authorized aid in dying.

Brittany Maynard’s Story Inspires 20 Newspapers Across Nation to Endorse Death With Dignity

By Patti Brooks

Brittany Maynard’s historic joint partnership with Compassion & Choices to expand access to death with dignity nationwide has sparked a national conversation about end-of-life choice.

In fact, since our campaign launch on Oct. 6, Brittany has inspired at least 20 newspapers in 11 states to editorialize in support of the medical practice of aid in dying for terminally ill, mentally competent adults.

Below are excerpts of the 20 editorials in alphabetical order of the 11 states.


Brittany Maynard Releases New Video in Campaign to Authorize Death With Dignity in California, Nationwide

She Discusses Her Declining Health But Reserves Right Not to Take Life-Ending Medication

(Portland, OR – Oct. 30, 2014) Terminally ill 29-year-old Brittany Maynard has released a new video as part of her joint campaign with Compassion & Choices to expand access to death with dignity in California and other states nationwide. The video is available at http://www.thebrittanyfund.org/.

Brittany has an aggressive, fatal form of brain cancer, diagnosed on New Year’s Day. She and her family took on the incredibly difficult task of moving from the San Francisco Bay Area to Portland, Oregon, to access Oregon’s death-with-dignity law authorizing the medical practice of aid in dying. This medical practice offers terminally ill, mentally competent adults the option to request a prescription for medication they can take to end their dying process if it becomes unbearable.

Nearly nine million have watched her first video since it was posted on YouTube Oct. 6. And 3.5 million people have visited the campaign website to help expand access to death with dignity in Brittany’s name at www.thebrittanyfund.org.

“Brittany is a teacher by training, and now she is teaching the world that everyone deserves the opportunity to die with dignity. She is changing hearts and minds on an unprecedented scale on this basic human-rights issue,” said Compassion & Choices President Barbara Coombs Lee, who recently met with Brittany and her family. An attorney, who was an ER and ICU nurse and physician assistant for 25 years, Coombs Lee coauthored the law Brittany is accessing.

On New Year’s Day, after months of suffering through severe headaches, Brittany learned she had brain cancer. Three months later, after undergoing surgery, she found her brain tumor had grown massively. That is when physicians told her she would likely die within months. Brittany has had her life-ending medication since shortly after that. She tentatively planned to take the medication in early November, but she has made it clear that timing depends entirely on how rapidly her cancer progresses and the severity of her symptoms.

“If November 2 comes along and I’ve passed, I hope my family is still proud of me and the choices I made,” says Brittany in the new video at www.thebrittanyfund.org. “And if November 2 comes along and I’m still alive, I know that we’ll just still be moving forward as a family out of love for each other and that that decision will come later.

“It sounds so cliché: “We take things one day at a time,” but it’s like, that’s the only way to get through this,” says Brittany’s husband, Dan Diaz, in the video. “You take away all of the material stuff, all the nonsense that we all seem to latch onto as a society, and you realize that those moments are really what matter.”

“The worst thing that could happen to me is that I wait too long … My most terrifying set of seizures was about a week or so ago,” Brittany says in the video, which was recorded Oct. 13-14. “I remember looking at my husband’s face at one point and thinking, ‘I know this is my husband, but I can’t say his name,’ and ended up going to the hospital.”

“It’s not my job to tell her how to live, and it’s not my job to tell her how to die,” says Brittany’s mom, Debbie Ziegler, in the video. “It’s my job to love her through it.”

“Well if all my dreams came true I would somehow survive this, but I mostly likely won’t,” Brittany says in the video. “So beyond that, having been an only child for my mother, I want her to recover from this and not break down, you know, not suffer from any kind of depression. My husband is such a lovely man, I want him to – you know I understand everyone needs to grieve ­– but I want him to be happy, so I want him to have a family.”

“My goal of course is to influence this policy for positive change, and I would like to see all Americans have access to the same healthcare rights,” Brittany concludes in the video. “But beyond that public policy goal, my goals really are quite simple, and they mostly do boil down to my family and friends, and making sure they all know how important they are to me and how much I love them.”

In addition to Oregon, aid in dying is authorized in Washington, Montana, Vermont and New Mexico. Compassion & Choices has campaigns to authorize this medical practice in California, Colorado, Connecticut, Massachusetts and New Jersey.