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Prepare to implement Our Care, Our Choice Act on Jan. 1

Originally published in the Honolulu Star-Advertiser on August 28. Reposted with permission.

After a 20-year fight, the “Our Care, Our Choice Act” goes into effect on Jan. 1, authorizing medical aid in dying in the state of Hawaii.

This compassionate medical practice gives terminally ill, mentally capable adult residents with six months or less to live the option to request and receive a prescription from their doctor that they may choose to take to minimize suffering and achieve a peaceful death.

Medical aid in dying is strongly supported by more than 80 percent of Hawaii voters, and the peoples’ victory this year demon- strated that a sustained grassroots effort, representing the will of the people and supported by a courageous Legislature, can bring about truly meaningful, positive change.

But while we now have a law on the books, our work is far from done. The Our Care, Our Choice Act takes effect just four months from now. It is vital that our islands’ health professionals, educators and health care institutions prepare now for the addition of this end-of-life option for our terminally ill kamaaina.

The Hawaii Society of Clinical Oncology (HSCO), a professional organization representing over 90 percent of the state’s cancer doctors, has posted educational tools on its website to assist health care providers, pharmacists, patients and their families in understanding the new law. Policy templates for health care organizations are also available. Additionally, HSCO will host two educational programs for our members to aid in understanding and implementation of the law.

I urge health care, hospice and palliative care organizations to prepare now. We know, from experience in other states which have authorized the practice, that when this law goes into effect Jan. 1, there will be dying patients making requests of their doctors for this compassionate end-of-life care option.

The new law is complex and requires many steps by both patients and providers to successfully comply with all regulations. Because this is a major expansion of end-of-life options available to the people of Hawaii, it is vital that all health care providers involved in the care of terminally ill patients become familiar with these new requirements. If we truly aim to serve our patients, it is incumbent on us, Hawaii’s medical providers, to be ready. Preparing now will avoid administrative and patient-care problems — unnecessary suffering and delays when every minute counts.

Health care consumers play a huge role, too. Whether or not you have a terminal illness, begin talking with your health care providers now. Make your wishes known, and ask them if they will support you should you ever decide to pursue the option. Talk to your loved ones as well.

Compassion & Choices has launched the Hawaii Access Campaign, a volunteer-led effort to educate the community, health-care professionals and systems to ensure terminally ill adults here have meaningful access to the new law. Excellent resources, including informational videos, a request form for educational presentations, a research tool to help patients locate providers who will honor their choices, a Doc2Doc consultation line, and much more can be found at www.compassionandchoices.org/hawaii. The site soon will be updated to include information in Tagalog, Ilocano, Japanese, Chinese, Korean and Hawaiian languages.

Those interested in supporting the statewide education campaign are invited to attend a volunteer training in Honolulu this Thursday; see www.facebook.com/CompassionandChoicesHawaii.

Just knowing they have the option of medical aid in dying can bring a tremendous sense of relief and peace of mind to dying patients, enabling them to fully enjoy their precious time remaining. Together, we must ensure that our law is successfully implemented, so that Hawaii’s terminally ill adults who don’t want to suffer needlessly have meaningful access to this end-of-life option if they choose it.


Chuck Miller, M.D., F.A.C.P., served for 30 years in the U.S. Army Medical Department and was chief of hematology at Kaiser Medical Center in Honolulu. He is a director and past president of the Hawaii Society of Clinical Oncology.