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A 2nd State Lets Doctors Lend Help in Suicide
By WILLIAM YARDLEY
Published: March 4, 2009
SEATTLE Assisted suicide becomes legal in Washington on Thursday, but dozens of hospitals are not expected to participate, and even supporters of the law say they do not foresee a rush of requests for lethal drugs.
Washingtons law is essentially identical to the one in Oregon, the only other state that allows doctors to prescribe lethal medications. It is the first in the country since the Supreme Court ruled in 2006 that states had a right to adopt such measures.
The law, approved overwhelmingly by voters last fall, allows terminally ill patients who are 18 or older, and who have been found mentally competent, to self-administer lethal drugs under the prescription of a doctor. An opt-out provision for hospitals was included, partly for the sake of health care providers affiliated with religious groups like the Roman Catholic Church, though many nonreligious hospitals have also invoked it.
I dont think its necessarily a faith-based decision, said Julie Petersen, the administrator of one public hospital that will not participate, Prosser Memorial, in a rural area of eastern Washington. I think its probably more a reflection of the community.
Individual hospitals position on the issue has taken on special importance because, health officials say, an increasing number of doctors are employed directly by them or rely on them for office space. So hospital policies that are particularly restrictive could limit the number of doctors who prescribe lethal drugs.
The laws supporters, though, voice confidence that eligible patients will have access to enough doctors willing and able to write prescriptions. Patients and health care providers will approach assisted suicide cautiously because of its very nature, the supporters say, not because of a particular hospitals policy.
A hospitals decision doesnt make any difference, said Terry Barnett, president of the board of Compassion and Choices of Washington State, the group that led the effort to pass the ballot initiative.
In Oregon, Mr. Barnett noted, terminally ill patients typically obtain the drugs outside the hospital setting, and nearly all the 401 people who have used that states law over the last 11 years to hasten death have died at home. The Oregon law, which took effect in 1998, was later amended to specify a right of hospitals, doctors, pharmacists or others to choose not to participate.
The Washington law requires hospitals to publicize a decision not to participate and, if they do so decide, to allow members of their staff to refer a patient to another health care provider.
It was unclear on Wednesday how many of the states 97 hospitals would choose not to participate.
Several boards were having meetings about this last night, some today, said Cassie Sauer, a spokeswoman for the Washington State Hospital Association, which, Ms. Sauer said, takes no position on the law.
Ms. Petersen, of Prosser Memorial Hospital, said her hospitals board, publicly elected, had made its decision not to participate on the basis of the response it received from the medical staff.
Theyre the ones that would actually prescribe the drugs in this case, she said, and they did not have an interest in participating in that.
Ms. Sauer said the law was confusing but seemed to allow hospitals three options: full participation, complete withdrawal and a middle ground like allowing doctors who have privileges at a hospital but are not employed by it to write prescriptions on their own time, as long as the prescription is not for a patient admitted at the hospital.
She speculated that as many as two-thirds of hospitals might opt out completely or partly.
http://www.nytimes.com/2009/03/05/us/05suicide.html?_r=1&emc=tnt&tntemail1=y
By WILLIAM YARDLEY
Published: March 4, 2009
SEATTLE Assisted suicide becomes legal in Washington on Thursday, but dozens of hospitals are not expected to participate, and even supporters of the law say they do not foresee a rush of requests for lethal drugs.
Washingtons law is essentially identical to the one in Oregon, the only other state that allows doctors to prescribe lethal medications. It is the first in the country since the Supreme Court ruled in 2006 that states had a right to adopt such measures.
The law, approved overwhelmingly by voters last fall, allows terminally ill patients who are 18 or older, and who have been found mentally competent, to self-administer lethal drugs under the prescription of a doctor. An opt-out provision for hospitals was included, partly for the sake of health care providers affiliated with religious groups like the Roman Catholic Church, though many nonreligious hospitals have also invoked it.
I dont think its necessarily a faith-based decision, said Julie Petersen, the administrator of one public hospital that will not participate, Prosser Memorial, in a rural area of eastern Washington. I think its probably more a reflection of the community.
Individual hospitals position on the issue has taken on special importance because, health officials say, an increasing number of doctors are employed directly by them or rely on them for office space. So hospital policies that are particularly restrictive could limit the number of doctors who prescribe lethal drugs.
The laws supporters, though, voice confidence that eligible patients will have access to enough doctors willing and able to write prescriptions. Patients and health care providers will approach assisted suicide cautiously because of its very nature, the supporters say, not because of a particular hospitals policy.
A hospitals decision doesnt make any difference, said Terry Barnett, president of the board of Compassion and Choices of Washington State, the group that led the effort to pass the ballot initiative.
In Oregon, Mr. Barnett noted, terminally ill patients typically obtain the drugs outside the hospital setting, and nearly all the 401 people who have used that states law over the last 11 years to hasten death have died at home. The Oregon law, which took effect in 1998, was later amended to specify a right of hospitals, doctors, pharmacists or others to choose not to participate.
The Washington law requires hospitals to publicize a decision not to participate and, if they do so decide, to allow members of their staff to refer a patient to another health care provider.
It was unclear on Wednesday how many of the states 97 hospitals would choose not to participate.
Several boards were having meetings about this last night, some today, said Cassie Sauer, a spokeswoman for the Washington State Hospital Association, which, Ms. Sauer said, takes no position on the law.
Ms. Petersen, of Prosser Memorial Hospital, said her hospitals board, publicly elected, had made its decision not to participate on the basis of the response it received from the medical staff.
Theyre the ones that would actually prescribe the drugs in this case, she said, and they did not have an interest in participating in that.
Ms. Sauer said the law was confusing but seemed to allow hospitals three options: full participation, complete withdrawal and a middle ground like allowing doctors who have privileges at a hospital but are not employed by it to write prescriptions on their own time, as long as the prescription is not for a patient admitted at the hospital.
She speculated that as many as two-thirds of hospitals might opt out completely or partly.
http://www.nytimes.com/2009/03/05/us/05suicide.html?_r=1&emc=tnt&tntemail1=y
