by
Brendon Nafziger, DOTmed News Associate Editor | March 20, 2011
From the March 2011 issue of HealthCare Business News magazine
“In Oregon, there weren't fewer terminally ill patients nor fewer of these patients wishing to control the end of their lives in 1998,” she wrote. “Rather, there was a slow rate of learning about and understanding the law by patients and physicians.”
But will outreach and education swell the ranks of participating physicians, or are there fundamental obstacles to doctors’ involvement?
The hospice movement
The relationship to the DWDA with the entire medical community, and not just physicians, has been curious. One of the most striking findings is that hospice involvement has been modest.
Although, according to the state, a full 88 percent of patients dying under the DWDA are enrolled in hospice care, a study by the Hastings Center, a bioethics research foundation, found hospice participation was fairly mixed.
“When you ask the individual hospices, they are all over the map,” Courtney S. Campbell, the study co-author and a professor of religion and culture with Oregon State University in Corvallis, tells DOTmed News. “That was a little bit surprising. We knew that religiously affiliated hospices, primarily in the Catholic tradition and the [Seventh Day] Adventist tradition, [would not participate], which is their right under the law, but there were others that were just not willing to provide staff support or referrals.”
About one quarter of hospitals don’t participate at all according to the report, released last year and prepared by Campbell with Jessica Cox. And only 9 percent of hospices fully participate – meaning they discuss the issue with their patients and refer them to Compassion & Choices. (However, hospices almost never let the institution’s physician get involved with the actual prescribing themselves).
Nonetheless, the Oregon Hospice Association disputes what counts as “participation.”
“We take exception to his definition,” Deborah Whiting Jaques, CEO of the association, tells DOTmed News. “The definition that the Courtney camp used in his study for ‘participation’ is a pretty limited use of the word. What the Oregon Hospice Association knows is that the vast majority of hospices do participate in the Death with Dignity Act, in that hospices refer patients to Compassion and Choices,” she says.
“If you look at 52 hospices in the state of Oregon, and 65 deaths that occur [under the act each year], for a hospice to have specific experience about dealing with Death with Dignity Act patients – certainly Compassion & Choices has more direct experience helping people through the Death with Dignity process.”
