More terminally ill requesting lethal drugs under new law

Since Jan. 1, when medically assisted death became legal in Hawaii, at least 17 patients have requested lethal drugs to end their lives and at least three of them went on to use the medication to “have a peaceful death.”

That’s according to Compassion &Choices Hawaii, part of a national nonprofit organization that advocates for laws that allow those nearing the end of life to choose how and when they die.

Hawaii residents with a prognosis of no more than six months may request lethal prescriptions under the medical- aid-in-dying law, also known as physician-assisted suicide, which is currently authorized in eight states and Washington, D.C.

The wife of a Kona man suffering from prostate cancer who died May 5 described her husband’s final moments in a note provided to the Honolulu Star-Advertiser via Compassion &Choices. The woman, who did not want to be identified, said he “showered, shaved, put on his dress shorts and nicest aloha shirt for the last dance. We were on the deck and it was a beautiful clear day with birds singing, light breeze. (He) was joking and talking story until he drank the medication,” she wrote.

“He laid down just like he does for a nap. In a minute or so he went into a deep sleep. All total maybe 30 minutes. This was the lasting memory he wanted to leave with me. He died in absolute peace and control of his own destiny on Cinco de Mayo.”

Dr. Charles Miller, a physician at Kaiser Permanente who oversees medical-aid-in-­dying requests, said the health care organization has received 17 referrals and written six lethal prescriptions since the start of the year.

“Four of the patients died without ever having the chance of getting prescriptions, others are still in the process,” he said.

Including Miller, there are at least half a dozen Kaiser doctors willing to write the prescriptions, he said. At least three pharmacies are filling the prescriptions, which can be mailed between islands. The medication costs around $400.

Federally funded programs including Medicare, the health insurance program for seniors, and the veterans program, do not cover the cost of the medication, though the state Medicaid program for low-income residents will cover it, along with most commercial health plans.

Patients deemed mentally capable and able to take the medication on their own will be able to request a prescription after two doctors confirm the patient has a terminal illness and a six-month prognosis. Patients must make two separate appeals for medication, with a 20-day waiting period between the first and second requests. Also required is a written request overseen by two witnesses, one of whom is prohibited from being a beneficiary of the patient’s estate.

It is a criminal offense to tamper with a patient’s request or to coerce someone into medically assisted death.

Compassion &Choices has run a series of public service announcements, including one with actor Richard Chamberlain and longtime Honolulu lobbyist John Radcliffe, to educate Hawaii residents on the new law. It is also sponsoring community presentations statewide and offering one-on-one assistance to patients having difficulty accessing the law.

The process has gotten easier and quicker for dying patients, with one recently completing it within 22 days, said Samantha Trad, Hawaii state director at Compassion &Choices. Typically around a third of patients who go through the process never actually use the medication but “have it on hand to give them peace of mind.”

Radcliffe, 77, was the first person to request medical aid in dying on Jan. 2, the day after the law went into effect. He was diagnosed with terminal cancer in multiple organs in 2014 and was given six to 24 months to live. He filled the prescription two months later on March 2.

“Here I am going on several years now,” he said in an interview last week. “It was great to be that guinea pig. One of the main things about terminal illness is the stress that’s involved in it. There’s a lot of stress and you have to figure out how to deal with that. I don’t feel any better or worse medically because of it. I feel better psychologically because I have (the lethal prescription) there.”

The state Department of Health projects as many as 40 to 70 patients will seek medical aid in dying this year. There are about 10,500 deaths annually in the islands. The Health Department will begin reporting the number of prescriptions written and number of patients who actually used the medication beginning July 1.