Physician-Assisted Suicide: Hospice-Palliative Volunteers' Opinions (Research, Video 2:58)

Hospice-palliative volunteers bring a unique perspective to the ongoing debate about physician-assisted suicide. Already legal in several states (Oregon, Washington, Montana, Vermont, and New Mexico), the law requires that the terminally ill must be of sound mind when requesting assisted suicide, as confirmed by a doctor and other witnesses. The main difference between euthanasia and physician-assisted suicide is that the latter requires the patient, not a doctor or someone else, to self-administer the medication and decide when to do that. Despite fears that the assisted suicide law would be used inappropriately by many people not showing good care or judgment, that has not been the case.

Research on physician-assisted suicide included two groups consisting of Canadian in-home hospice-palliative volunteers and members of the community. Participants responded to 15 items about physician-assisted suicide. Differences of opinion were revealed in both groups. Additional questions confirmed the following about the majority of volunteers and community members:

     1)   They support legalizing physician-assisted suicide.

     2)   They would choose hospice-palliative care over physician-assisted suicide                 for themselves if they were terminally ill.

     3)   They think Canadians should place more priority on developing hospice-                   palliative care rather than on legalizing physician-assisted suicide.

In America, physician-assisted suicide has also sparked debate widely in various states. Brittany Maynard was diagnosed with terminal brain cancer. She decided to move from California to Oregon because doctors there are allowed by law to prescribe life-ending medication to patients who are older than 18 and have been given less than six months to live. She has taken that medication. This video features her story along with pros and cons of the physician-assisted suicide debate:

Frances Shani Parker, Author

Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes is available in paperback and e-book editions in America and other countries at online and offline booksellers.

Hospice and Nursing Homes Blog

Hospice and Physician-Assisted Death (Research, Video 3:13)

As more states prepare to follow Oregon, Washington, and Vermont in legalizing physician-assisted death, hospice programs continue to define ethical issues regarding this legislation. Around 90% of patients involved in using state regulated procedures to end their lives are terminally ill and already in hospice programs. The Journal of Pain and Symptom Management recently reported an analysis of research by authors who partnered with the Washington State Hospice and Palliative Care Organization in an examination of the policies developed by individual hospice organizations regarding program and staff participation in the Washington Death with Dignity Act.

Findings included hospice program differences related to the integrity and identity of hospice and hospice care. Different policies, values, understandings of the medical procedures and caregiving practices were also varied. These were some of the differences:

1)   The language used by hospices to refer to the Washington statute

2)    The values that hospice programs draw on to support their policies

3)   Dilemmas created by requests from patients for hospice staff to be present at a patient’s death

4)   Noninvolvement and participation by hospice in patients' requests for physician-assisted death

This analysis concluded with questions for developing a comprehensive hospice policy on involvement in physician-assisted death and assisting national, state, local, and personal reflection.

The following video features physician-assisted death in Vermont where the Patient Choice at the End of Life Act has been implemented, but is rarely used. Most fears and abuses of the law have not occurred. The video also includes comments from the public.

Frances Shani Parker, Author

Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes is available in paperback and e-book editions in America and other countries at booksellers such as Amazon.

Hospice and Nursing Homes Blog