Questions to ask your doctor:
Where did you go to medical school?
How much time do you spend with your patients?
Do you believe it’s a sin to plan your own death?
When Washington state’s Death with Dignity law is enacted this week, experts say people who think they may want to take advantage of it should decide now who their health care provider will be.
“You need to find out now if your doctor shares your values, because when you are terminally ill, when you’re close to your death, that’s not the time to find out,” said Barbara Coombs Lee, president of Compassion &Choices, a Denver-based organization that advocates physician-assisted death.
Voters in November approved the law, which allows terminally ill patients who have been given less than six months to live to ask for a fatal dose of drugs.
Doctors and other health care providers can refuse to write those prescriptions.
Washington is the second state in the country to approve such a law. Oregon’s Death with Dignity Act has been in place for about a decade. Montana does not have a similar law, but health care workers there are protected from prosecution if they give a terminally ill person life-ending drugs.
Doing so is a crime elsewhere in the country. Four people were arrested last week in Georgia and Maryland after they helped a cancer-stricken person commit suicide. They’re facing up to five years in prison on charges of assisting suicide.
The new law is so controversial in Washington that many hospitals won’t allow the practice to occur within their walls. Hospitals, doctors and other health care providers have the right to opt out. Even at hospitals and hospice organizations that plan to help people end their lives, doctors, nurses and others are protected under federal law if they choose not to participate.
Just one of Snohomish County’s four hospitals, Cascade Valley Hospital in Arlington, plans to allow its doctors and other health care providers to give life-ending drugs to patients who meet the legal requirements.
“We leave the choice up to the individual physician,” assistant hospital administrator Heather Logan said. “I don’t know if any of our physicians will choose to do so, but it leaves the option with the provider.”
The county’s three other hospitals, Providence Regional Medical Center in Everett, Stevens Hospital in Edmonds and Valley General Hospital in Monroe, will not allow the practice to occur within hospital walls.
Before making a decision, board members at Valley General Hospital tried to get information on how people in that community voted on the issue, but were unsuccessful, hospital spokeswoman Monica Sylte said.
The board last week issued a 30-day, temporary policy against participating in Death with Dignity, and that policy will likely be made permanent unless the board receives new information, she said.
Stevens Hospital is publicly funded, but there’s no requirement in the law that health care agencies supported by tax dollars provide life-ending medicine, Vice President of Planning Jack Kirkman said.
Providence Regional Medical Center, a nonprofit Roman Catholic hospital, will not allow doctors to prescribe life-ending medication while they’re being paid by the hospital, said Karina Jennings, vice president of marketing for Providence Health &Services for Washington and Montana. The religion considers suicide a sin.
Still, the hospital’s policy doesn’t bar doctors who work there from prescribing the medicine while they’re not on the hospital clock, Jennings said.
“What they do in their own time is their business,” she said.
Hospital policies against life-ending medication are empty gestures, said Lee, of Compassion &Choices.
In most cases, terminally ill people die in hospice care, often at home, she said. In Oregon, more than 300 people have taken life-ending drugs since 1998. Nearly all of those people died at home, Lee said.
The laws in Oregon and Washington specifically allow doctors to enter into private agreements with patients that aren’t subject to hospital policies, Lee said.
The Washington State Hospice and Palliative Care Organization has hosted several educational meetings and conference calls to help health care providers prepare for the law’s enactment, executive director Anne Koepsell said.
“For decades it has been an ethically appropriate decision for someone in hospice care to say, ‘I’m not going to eat anymore,’” Koepsell said. “What’s different about physician-assisted suicide is that the doctor is writing that prescription.”
Koepsell said her organization is training health care providers on how to talk about newly legalized options for end-of-life care with patients and families.
Lee hopes the new law will encourage people to stop referring to the practice as “suicide.”
“That’s like calling people who jumped from the World Trade Center, with flames at their back, suicidal,” Lee said. “They’re not suicidal, they don’t want to die, but they are dying. They are hoping to choose the least-worst way.”
Krista J. Kapralos: 425-339-3422 or kkapralos@heraldnet.com.
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