Honolulu police searched the home of a 73-year-old psychiatrist Friday for evidence he may have illegally assisted in the death of an 88-year-old woman in October at her home in the Punahou area.

The woman was a patient under the Our Care, Our Choice Act, the state law that allows for the prescription of a life-ending medication under certain requirements, including being able to self-administer the lethal dose.

Police Saturday reported opening a second-degree murder investigation of the woman’s death, saying it is the first such case it has investigated involving a patient under Hawaii’s aid-in- dying statute.

A Honolulu Police Department bulletin said the woman, whose name was not released, died at home at 5:34 p.m. but contains a discrepancy on the date in question, reporting it alternately as Oct. 8 and Oct. 9. The Honolulu Star- Advertiser was unable to get a clarification from police officials Saturday.

HPD’s homicide detail received a report Oct. 15 alleging that prior to her death, the doctor “assisted in administering the lethal prescription, which caused the female to choke. At one point, she motioned for the doctor to stop, but he continued to administer the prescription.”

The bulletin does not say who made the allegation but does name the doctor. The Star-Advertiser was unable to reach the physician Saturday and generally does not identify suspects until they are charged with a crime.

In this case, the doctor has neither been arrested nor charged with a crime.

After performing an autopsy on the 88-year-old woman, the Honolulu Medical Examiner’s Office ruled her death a homicide, police said. When contacted Saturday, the Medical Examiner’s Office deferred until Monday identifying the woman or providing any information on the case.

The Our Care, Our Choice Act, formally Hawaii Revised Statutes Chapter 327L, went into effect in 2019, establishing eligibility requirements and safeguards for terminally ill patients wishing to end their lives. Patients must be a Hawaii resident at least 18 years of age or older, able to take the prescribed medication themselves and mentally capable of making an informed decision.

Once deemed eligible by three health care providers, the patient may submit a written request for the life- ending medication.

Hawaii remains the only state requiring three providers to conduct a mental capacity evaluation.

Amendments to the law that went into effect June 1, 2023, allow qualified advanced practice registered nurses to act as attending, consulting or mental health providers in aid-in-dying cases, and also expanded the definition in the law of qualified mental health providers to include licensed marriage and family therapists.

Additionally, the waiting period between a patient’s first and second oral requests for lethal medication is now five days and can be waived if the provider determines the patient won’t survive that long.

Previously, there was a 20-day waiting period between oral requests.

One of the problems facing terminally ill patients wishing to receive a prescription for lethal drugs is finding providers willing to assist in the process. The numbers appear to be going down.

According to the state Department of Health’s 2023 OCOCA Annual Report to the 2024 state Legislature, 14 attending providers wrote such prescriptions in 2023, down from 17 in 2022.

There were 21 providers in 2021 and 14 in 2020.

Of the 91 qualified patients who received aid-in-dying prescriptions in 2023, 76 died.

Of the 76, 51 died due to ingesting aid-in-dying medication.

Cancer was indicated as the underlying illness for most patients who received the prescriptions, the DOH report said.

On average, it took 38 days from the first oral request to the date of receiving the written prescription. The average waiting period between the first and second oral request was 24 days.

In 2022, 60 patients were prescribed lethal drugs. In 2021, 70 patients received prescriptions. In 2020, there were 37 patients, and in 2019, 30 patients.