End-of-Life Choice, Palliative Care and Counseling

Posts Taggedpoll

Legal Interpretations Differ but Public Opinion United

Trust Doctors, not Government to Guide Aid in Dying

HONOLULU – Compassion & Choices Hawaii, the local affiliate of 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 today responded to an opinion on “assistance with dying” by Hawaii’s attorney general. The organization joined attorneys and physicians in expressing confidence that when the time comes, patients can request, and doctors will provide, aid in dying. Terminally ill, mentally competent Hawaii patients can request a prescription that gives them the peace of mind of knowing they could achieve a peaceful death in their homes, with their families and loved ones.

“Almost everyone in Hawaii agrees that terminally ill individuals, not government, should make end-of-life decisions and control end-of-life options,” said Robert “Nate” Nathanson, M.D., a founder of Hospice Hawaii. “The people of Hawaii overwhelmingly trust doctors to establish guidelines and respond appropriately to requests for medication to bring about a peaceful death if suffering becomes unbearable.” The results of a recent poll bear out Dr. Nathanson’s assertion. In the poll, 90% agreed the decision about aid in dying is a personal one between patient and doctor. Eighty-one percent (81%) said they trust their doctors to respond appropriately to a request for medication to bring about a peaceful death if suffering became unbearable. A complete summary of poll results can be found at CompassionAndChoicesHI.org.

The reasoning of the attorney general’s opinion is flawed. Focusing narrowly on a single 1909 statute, the opinion failed to appreciate how a constellation of Hawaii laws vests its citizens with broad autonomy over end-of-life decision-making. It does not mention findings in other states, including the persuasive authority of Baxter v. Montana or the recognition by Georgia’s attorney general that his state’s law against “assisting a suicide” does not cover aid in dying.

“The palliative benefits of aid in dying are very significant,”said Dr. Nathanson. “It offers relief for terminal pain and anxiety. And it lets some patients live longer and with peace of mind during their last days. This is comfort care at its best. When doctors cannot cure, at best they can provide relief.”

Chaired Professor at NYU Law School, frequent visiting Professor at Richardson and resident of Kailua Sylvia Law said, “Legal opinion differ and change over time. Hawaii has many laws which offer patients autonomy in end-of-life care and pain management. The state does not outlaw aid in dying with the sort of specificity required of a criminal prohibition. So it is reasonable to conclude Hawaii physicians can respond to these requests subject to best practices, without fear of prosecution.”

New Poll: Hawaii Voters Strongly Support Aid in Dying

77% of Voters Favor End-of-Life Choice for Terminally Ill,
Near the Highest Level of Support in Nation;
Near-Unanimous (90%) Support for Patient’s Right
s

HONOLULU – Compassion & Choices Hawaii, the local affiliate of the nation’s oldest and largest nonprofit organization working to improve care and expand choice at the end of life, today released a poll finding 77% of Hawaii voters support access to aid in dying. The survey showed overwhelming majorities believe self-determination at the end of life is their right, and trust individuals and doctors – not the government – to make decisions about this medical practice. Seventy-seven percent (77%) favor or strongly favor allowing mentally competent adults dying of a terminal disease to ask their doctors to prescribe medication that gives them the peace of mind they can achieve a peaceful death. This level of support is among the highest of any state in the nation.

Former State Representative Ernest “Juggie” Heen, who is suffering from incurable liver and pancreatic cancer, told the news conference, “I am part of the 77% who believe in choice, and hope for some measure of control at the end of life. I have sought treatment, but there is no cure for my cancer. Chemotherapy might offer a few weeks or months, but the cancer is incurable. I have lived a full life and want to achieve a peaceful death. When the time comes, a prescription for medication I could take myself to achieve a peaceful death would greatly ease my anxiety about pain and suffering.”

Hawaii pollster Barbara Ankersmit, president of QMark Research, conducted the poll and presented the findings at a Honolulu news conference. “More than three out of four favor allowing a mentally competent adult who is terminally ill the right to bring about their own peaceful death with the aid and consultation of their physician. Nearly all Hawaii voters believe that terminally ill individuals, not government, should make end-of-life decisions, control end-of-life options, and trust doctors to establish guidelines and respond appropriately.”

These are highlights of the poll:

•    77% favor allowing those who are dying of a terminal disease the choice to request and receive medication from their physician to bring about their peaceful death;
•    90% agree the decision about aid in dying is a personal one between patient and doctor;
•    87% believe people in the final stages of a terminal disease should have the right to bring about their peaceful death;
•    83% say the medical community rather than the government should establish proper guidelines and safeguards; and
•    81% trust their doctors to respond appropriately to a request for medication to bring about a peaceful death if suffering became unbearable.

A complete summary of poll results can be seen below. A PDF is available here.

Robert “Nate” Nathanson, M.D., a founder of Hospice Hawaii, believes that aid in dying is in line with current standards of medical care: “Most medical care is governed by practice standards. These include many practices that may advance the time of death,such as withdrawal of life-sustaining treatment and palliative sedation. Patients make these difficult decisions every day in consultation with their doctors, their loved ones and their own consciences. Aid in dying is no different.”

Experts on Hawaii law, medicine, elder care, legislative and end-of-life issues have concluded Hawaii physicians may already provide aid in dying subject to professional best-practice standards.

For more information visit CompassionAndChoicesHI.org.

New Poll: Oregon and Washington Residents Lead Nation on Informed Choice at the End of Life

National Journal-Regence Poll:
Over 70% OR and WA Voters Support Death With Dignity Acts

Compassion & Choices (C&C), the nation’s oldest and largest nonprofit advocating for
better end-of-life care and choices today responded to the recent poll “Living Well at
the End of Life,” conducted by The National Journal and Regence Foundation. The poll
reaffirms that Washingtonians and Oregonians prefer to enhance the quality of their life
when faced with a serious illness, rather than extending their lives with every possible
medical intervention. Public opinion research has consistently found that Americans
want terminally ill individuals to have the right to make their own informed choices at
the end of life.

“The vast majority of Americans want to know about their end-of-life choices, and it’s
no accident that Oregon and Washington are way ahead of the rest of the country,” said
Barbara Coombs Lee, president of Compassion & Choices. “The poll demonstrates that
Oregon and Washington, the two states with voter-enacted Death With Dignity laws,
lead the nation in communication and informed choice at the end of life. Aid in dying
has driven a conversation about end-of-life choices that has informed healthcare
recipients and improved outcomes for peaceful dying and uncomplicated grieving. .
Opponents claim aid in dying undermines other options, but the poll proves the
opposite. Informed patients, empowered with a range of end-of-life options, can
navigate the end of their lives according to their own values and beliefs.”

The poll compared responses from Oregon and Washington voters to national results.
On every question, Oregon and Washington voters far outpaced the nation in their
knowledge of end-of-life care and options. They also chose quality over quantity at the
end of life.

Below are some excerpts from the recent poll of 600 registered voters each in both
Oregon and Washington.

Now, thinking about these issues from a different perspective… I’m going to read you
the names of some different policies in (Oregon/Washington) and first please tell me if
you’ve heard of it, then please tell me if you have a favorable or unfavorable impression
of it.

33. The (next/first) one is the Death with Dignity Act…The Death with Dignity Act was
(approved by Oregon voters in 1994 and reaffirmed in 1997 / approved by Washington
voters in 2008). This act allows doctors to prescribe medicine for some of the most
seriously ill patients to take in order to voluntarily bring about their own death.
Now that you’ve heard some more information, do you generally have a favorable or
unfavorable opinion of this program? [IF FAVORABLE/UNFAVORABLE, ASKED:] Do you have a VERY (favorable/unfavorable) or a
SOMEWHAT(favorable/unfavorable) impression of The Death With Dignity Act?
OR WA
52% 44% Very Favorable
26% 25% Somewhat Favorable
7% 11% Somewhat Unfavorable
13% 16% Very Unfavorable
77% 70% TOTAL FAVORABLE

To view the poll’s topline results, click here: Living Well at the End of Life Poll-Topline Results.