The recent success of the medical aid-in-dying bill in the Hawai Legislature is heartening. This is a very compassionate and wise piece of legislation. It is still making its way through the Legislature where it will continue to meet some opposition.
Medical aid-in-dying brings a sense of control and peace of mind to patients and their families. With access to life-ending medications prescribed by a physician, they don’t have to fear relentless suffering and pain as they travel the road to their death. I will address two sources of opposition.
First, there are people of deep religious and spiritual faith who believe that medical aid-in-dying violates their God’s law. It is their constitutionally protected right to express their beliefs. Particular religious tenets, however, should never become the basis for law or public policy.
Second, there is opposition from some in the medical community. They have concerns about a “slippery slope,” where medical aid-in-dying will become a form of forced euthanasia and will abuse the most vulnerable members of our community. Those who are mentally and physically disabled and those who might be coerced into hastening their death, must be protected at all costs. Even a hint of such abuses needs to be carefully investigated.
These abuses, however, are not seen in 20 years of meticulously kept data by the Oregon Health Authority on the Death with Dignity law, which Hawaii’s bill is based on.
It is useful to look at a report from the Palliative Care in Oncology Symposium, held in San Francisco in September 2016. Dr. Charles Blanke, a respected oncologist and researcher at Oregon Health Sciences University, along with other researchers, reported that there was no abuse of those who chose to use Death with Dignity.
They carefully examined the Oregon data, from both the state and community. Using statistical analysis, they found no slippery slope, no abuse of vulnerable people, indicating that the safeguards and restrictions in the Oregon law have been effective. These reports are evidence-based. The law works as intended. The Hawaii bill has even more safeguards than the Oregon law.
Blanke reported that, “In Oregon, multiple rules have to be followed, and no evidence has emerged that the strict criteria are not being adhered to” (see www.medscape.com/viewarticle/869023).
Nurses, social workers, doctors and caregivers have their ethics and commitments to their practice, which should not be doubted. They are personal in nature, and as such, they should also not become the basis for law or public policy.
It’s worth noting that the American Academy of Hospice and Palliative Medicine has changed its official position from opposition to neutrality, and that the American Public Health Association supports access to medical aid-in-dying.
Malachy Grang, R.N., is a former hospice nurse in Oregon and current hospice volunteer in Hawaii.
