End-of-Life Choice, Palliative Care and Counseling

Posts TaggedAPHA

Expert Panel Concurs: Hawaii Physicians Can Provide Aid in Dying

HONOLULU – Compassion & Choices, the nation’s oldest and largest nonprofit organization working to improve care and expand choice at the end of life, and the Hawai’i Death With Dignity Society (HDWDS), a local organization with similar goals, today announced the findings of a panel discussion on aid in dying. Experts on Hawaii law, medicine, elder care, legislative and end-of-life issues concluded Hawaii physicians may already provide aid in dying subject to professional best-practice standards.

“Hawaii law, through a number of statutory enactments, already empowers terminally ill patients with significant freedom to determine their course of medical care at the end of life and affords protection to physicians who provide care,” said panelist and Compassion & Choices Director of Legal Affairs Kathryn Tucker. “And a provision in a 1909 law unique to Hawaii gives terminally ill patients significant freedom of choice to determine their course of medical care at the end of life, and protection to physicians who provide care.”

“Most medical care is governed by professional standards of care.” said panelist Robert “Nate” Nathanson, MD, a founder of Hospice Hawaii. “These include many practices that may advance the time of death, such as withdrawal of life-sustaining treatment, voluntary stopping of eating and drinking (VSED), and palliative (terminal) sedation.”

“The Hawaii Public Health Association along with the American Public Health Association believes that people in Hawaii deserve a full range of options for palliative care and end-of-life.” Said panelist Deborah Zysman, MPH, President of the Hawaii Public Health Association. “This includes aid in dying. With proper safeguards in place, we believe that aid in dying poses no public health risk and that a mentally competent, terminally ill adult should be allowed to control the time, place, and manner of his or her impending death.”

Representative Blake Oshiro, Hawaii House Majority Leader, chaired the panel, which also included former State Representative Ernest “Juggie” Heen; Dante Carpenter, Chair, Democratic Party of Hawaii; former State Representative Eve Anderson; Mitch Burns, an attorney of elder law; Hawaii community volunteer Laura Thompson; Pam Lichty, MPH, member of the board of the ACLU of Hawaii; Scott Foster, co-founder of HDWDS; and Robert Orfali, author of Death with Dignity.

Orfali wrote his book to help give others the choice his wife, Jeri, wished she’d had. In her 50s, she faced ovarian cancer. “When she became terminally ill, Jeri wanted some form of insurance at the end,” Orfali said. “She did not want to die in pain. She believed in aid in dying and wanted to have medication just in case.”

“The people of Hawaii support the availability of aid in dying as an option for terminally ill, mentally competent adults,” said Representative Oshiro. “And it is good public policy. The experience in Oregon demonstrates that when aid in dying is available, hospice utilization increases dramatically, physicians seek more continuing medical education in treatment of pain and other distressing symptoms, and are more open to discussing end-of-life options with their patients.”

The lawyers and legislators on the panel concurred nothing in Hawaii law currently prohibits aid in dying. Patients and their doctors may make decisions governed by best medical practice, allowing them the opportunity to explore a wider variety of patient-directed end-of-life choices. Tucker, Compassion & Choices’ director of legal affairs, said, “We expect Hawaii residents will soon have the same broad range of end-of-life choices enjoyed by the people in Montana, Oregon and Washington.”