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DoH: Prepare Workflows for Optimal Suicide Experience Starting Jan 1
By News Release @ 2:11 PM :: 4076 Views :: Health Care, Life


News Release from DoH, Oct 16, 2018

HONOLULU — The Hawai‘i Department of Health (DOH) is advising health care organizations statewide to prepare for the Jan. 1, 2019 effective date of the “Our Care, Our Choice Act” which allows adult residents with a medically confirmed terminal disease and less than six months to live the choice to obtain a prescription for medication to end their life. The DOH, guided by an advisory group, is working with the community to establish a process which assures the patient experience is optimal and that patients and their family members fully understand all end-of-life care options.

The DOH is requesting health care providers statewide anticipate patient needs and develop policies and procedures that assure patients are fully aware and informed of alternative treatments such as palliative care and hospice care, as well as workflows that support timely referrals, effective clinical standards, clinician support, and clear communication.

Health care organizations statewide seeking assistance or more information may contact the DOH Office of Planning, Policy, and Program Development at (808) 586-4188.

About the “Our Care, Our Choice” Act

The new law will give mentally capable, terminally ill people with six months or less to live the option to take prescription medication that enables them to die peacefully in their sleep. Modeled after Oregon’s Death with Dignity Act, which has been in practice for 20 years, the Hawai‘i law establishes a regulatory process under which the terminally ill patient may choose to obtain a prescription for medication to end their life. This includes strict eligibility criteria and safeguards that ensure a safe, compassionate and patient-centered end-of-life process. Among the safeguards: the patient is required to take the medication on his/her own; two doctors must confirm the terminal illness and six-month prognosis; patients are not eligible for medical aid in dying based on age or disability; the attending physician must inform the requesting patient about all end-of-life care options including pain and symptom management, hospice and palliative care; the patient’s mental capacity must be confirmed by a mental health professional; two separate requests for medication must be made, with a 20-day waiting period between the first and second request; a written request overseen by two witnesses is also required, with one witnesses prohibited from being a beneficiary of the patient’s estate. The new law will also make it a criminal offense to tamper with a patient’s request for a prescription or to coerce a patient to request a prescription.

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End-of-Life Care Group Reaches Key Benchmarks in Helping Health Care Providers, Communities Statewide Prepare for Medical Aid-in-Dying Law

News Release from ‘Compassion’ and ‘Choices’ October 16, 2018

Compassion & Choices Hawai‘i today announced that its public education campaign about the Our Care, Our Choice Act has met several key benchmarks in preparation for the law to take effect on January 1, 2019.

Signed into law on April 5 by Governor David Ige, the Our Care, Our Choice Act authorizes medical aid in dying as an end-of-life care option to end unbearable suffering. It is the medical practice which gives terminally ill adults with a prognosis of six months or fewer to live, and who are mentally capable of making their own healthcare decisions, the option of requesting from their doctor a prescription for medication to die peacefully in their sleep.

Compassion & Choices’ Hawai‘i Access Campaign is a volunteer-led effort to educate the community, healthcare professionals, health systems and hospices to ensure terminally ill adults in Hawai‘i have access to the new law. To date:

  • The Campaign has provided hospital and hospice systems statewide with sample policy templates that can be customized to each system.
  • For healthcare professionals, the online resource features Doc2Doc and Pharmacist2Pharmacist consultation services and training videos. In addition, Compassion & Choices is working with the Hawaii Department of Health advisory group to provide in-person education for physicians and other providers.
  • Dr. David Grube, national medical director for Compassion & Choices, is in Hawaii this week presenting “Medical Aid in Dying: A Physician’s Perspective” to physician groups including the Hawaii Society of Clinical Oncologists, Castle Hospital, palliative care doctors and the Department of Health.
  • For healthcare consumers, the website features a video for residents explaining medical aid in dying, fact sheets and other important documents in English, Japanese, Tagalog, Ilocano, Mandarin, Hawaiian and Spanish.
  • A series of presentations for the community and for medical professionals will be held on the Big Island in Kona, Waimea and Hilo Oct. 23-24 (to register call the Office of Senator Lorraine Inouye at 974-5000, ext. 67335); other islands are being scheduled.
  • The Hawaii Psychological Association will provide a special focus on the Our Care, Our Choice Act and training for mental health practitioners during its annual convention, October 26-27.

Compassion & Choices has over 20 years of experience helping states successfully implement medical aid-in-dying laws.

“We know from experience that when this law goes into effect on January 1st—10 weeks from now—there will be dying patients making requests of their doctors for this compassionate end-of-life care option so medical providers need to be ready,” said Kat West, national director of policy and programs. “That’s why Compassion & Choices has begun reaching out to healthcare systems, hospices, physicians and pharmacists to help them prepare.”

Compassion & Choices’ Hawai‘i Access Campaign will continue to:

1) support local public outreach & education teams on each island;

2) provide free education and materials for doctors, pharmacists, nurses and other healthcare providers including webinars, videos and Doc2Doc consultation calls;

3) provide technical and policy assistance to hospitals, clinics, hospice facilities and pharmacies statewide; and

4) work with government agencies, medical associations, and other ancillary organizations to ensure broad understanding of the law and meaningful access for those who need it.

Educational resources for patients and providers can be found at

As always, open and proactive patient-provider discussion about all end-of-life care options is key to smooth and successful preparation to improve end-of-life care and implement the law in a timely fashion.

“We encourage residents, no matter which island they reside on, to initiate conversations with their doctors now about whether their doctor would support them if they were to become terminally ill and request medical aid in dying. We know from experience it is only way that residents can ensure that they will get the care they want at the end of life,” West said.  

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