On Jan. 1, 2019, the Our Care, Our Choice Act became law in Hawaii, legalizing physician-assisted suicide. This new law allows adult Hawaii residents with a diagnosed terminal disease to request that their attending provider prescribe a lethal dose of medication for the purpose of ending their lives. It was announced in the media on May 26 that at least three people have now used the law to take their own lives.
Many organizations, including the American Medical Association, oppose physician-assisted suicide and have expressed concern that it has no place in an ethical practice of medicine.
“Physician-assisted suicide is fundamentally incompatible with the physician’s role as healer, would be difficult or impossible to control, and would pose serious societal risks” (AMA Principles of Medical Ethics I, IV).
In the face of grave illness, healthcare workers are called to provide compassionate care. Good hospice and palliative care are indispensable modalities when patients and their families are faced with serious disease to provide relief from pain and dignity to the patient.
The supposed “safeguards” in the Hawaii law are not enough to prevent serious abuse to elderly and vulnerable patients. For example, the required mental health evaluation is limited to a single counseling session for the purpose of determining if the patient is “capable” and not suffering from an undertreatment of depression; it may even be provided by a social worker via telehealth. The law further requires that the lethal prescription not be listed as the cause of death on the death certificate, which seems fraudulent.
Fortunately, you do have the right to OPT OUT of assisting patients in committing suicide. There is a conscience clause in the statute that states:
“No health care provider or health care facility shall be under any duty, whether by contract, statute, or any other legal requirement, to participate in the provision to a qualified patient of a prescription or of a medication to end the qualified patient’s life pursuant to this chapter.”
So we say all of the following to physicians, nurses, pharmacists, health care and social workers: If you refuse to participate in assisted suicide, no professional organization or association, health-care provider or facility, is allowed to penalize you.
There is also no requirement for you to find another provider for the patient if they are requesting assisted suicide. You only need to transfer any pertinent medical records to the new provider.
If a patient with a terminal disease asks about assisted suicide, this provides an opportunity for you to discuss other options in the hope of enriching their lives. Such discussions include treatments based on proportionate benefits as opposed to the burdens, which include discomfort, risk, and expense of the treatment in question.
It is important for you to discern the type of healthcare that you will provide to your fragile patients at their end of lives. Authentic care for human beings dictates that you opt out of assisted suicide and instead cherish life. Proponents will tell you that it is a matter of personal choice, but that “choice” can easily slip into a societal expectation; it can change our view of our kupuna from being honored elders and into one of seeing them merely as a burden to be eliminated.
Presumably you did not become a health-care provider to assist your patients in killing themselves.
Please let your patients know that you will not be providing lethal doses of drugs, but will treat them with respect and the good medical care and pain management that they deserve.
Pastor Klayton Ko is superintendent of the Hawaii Assemblies of God; Bill Stonebraker is senior pastor at Calvary Chapel of Honolulu; Larry Silva is bishop of the Diocese of Honolulu, Roman Catholic Church. They submitted this on behalf of at least 15 co-signatories (see names online at 808ne.ws/2wt3qSE Opens in a new tab).
