A survey in the latest issue of the Hastings Center Report found that most hospices in Oregon, the first state to legalize physician-assistance in dying, either do not participate in or have limited participation in requests for such assistance. Both legal and moral reasons are identified.
This finding is significant because hospices are considered important for assuring that physician-assisted death is carried out responsibly, write the authors, Courtney S. Campbell, the Hundere Professor of Religion and Culture at Oregon State University, and Jessica C. Cox, the Hundere Program Assistant and a second year graduate student at Oregon State. Most patients in Oregon who choose physician-assisted death are enrolled in hospice care. Hospices' role is largely confined to providing information about the law in a neutral manner, the study found. Patients must then work on their own to find physicians who are willing to help them die.
The survey report was based on responses from 55 hospice programs in Oregon, or 86 percent of the total. It compared their policy statements, program guidelines, and staff education materials to address patient inquiries about the Death with Dignity Act. The act, passed in 1995, permits physicians to prescribe a fatal dose of medication to a terminally ill patient who requests it, as long as several criteria are met. Twenty-five percent of the hospices surveyed did not participate in the law at all and 27 percent had limited participation, meaning that when patients asked about physician-assisted death a staff member merely referred them to the attending physician without any conversation.
All of the hospices prohibited staff from helping patients obtain and take medications to end their lives. Few of the programs had a policy allowing staff to be with patients when they took life-ending medication.