Hospice AND medical aid in dying should be available to all Americans
I am responding to Rev. Daniel Warriner’s opinion piece, “Physician-aided death is not health care.” He starts by saying “As someone who works within a healthcare setting, I would like to know who in our hospitals is asking for this…….I don’t hear anyone in the hospital asking for this bill…”
Could people be afraid to mention it to Rev. Warriner because they know his position? For decades people from all walks of life across our country have asked for assistance ending their lives in humane fashion when they have refractory suffering from a terminal condition. That is why multiple states, representing more than a quarter of the U.S. population have passed medical aid in dying (MAID) laws. These laws allow terminally ill patients to request medications from their physicians to keep in their homes, to use if and when they decide to end their suffering. There are decades of experience in other states to support these practices.
I am a board-certified Hospice and Palliative Care physician working in a New York State hospice for two decades. I completely agree that hospice care should be available to all persons for all the reasons Rev. Warriner point out. The hospice organization where I work in New York cares for over 1,000 patients a year. I and my physician partners care for people who have refractory symptoms, working with the hospice nurses, social workers, home aids, volunteers, and chaplains. In the vast majority of cases, hospice multidisciplinary care can relieve suffering that might otherwise lead to a person’s wish to end their lives prematurely.
Most people want to live as long as possible. But there will always be a few for whom all the efforts to relieve suffering at end of life are not enough. Our medical system is built on patients making their own decisions on medical care with informed consent and autonomy. That should include the time of death. The experience in Oregon, the state that pioneered MAID, is worth reviewing. Their Annual Death with Dignity Reports, easily available online, shows after 22 years, only 2,518 Oregonians have requested medications to end their lives. Of those, only a little over half actually used the medications provided. That represents only 5 out of every 1,000 deaths in Oregon and 90% of them were already using hospice services.
Widespread use of hospice services does not negate the need for medical aid in dying. Both should be available to every American and I continue to support such legislation in New York State. I hope Connecticut citizens soon have this right.
Judith Setla, MD, MPH, Syracuse, N.Y.
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