A series of free presentations planned around the Big Island intend to educate residents and health care professionals about the “Our Care, Our Choice” Act, which goes into effect Jan. 1.
House Bill 2739 was signed into law by Gov. David Ige earlier this year.
The new law, which was modeled after Oregon’s Death with Dignity Act, gives mentally capable, terminally ill people with six months or less to live the option to take prescription medication that would allow them to end their lives, and establishes a regulatory process under which the patient may do so.
Compassion & Choices Hawaii will present programs on the topic this week in Kona, Waimea and Hilo for both the community and health care professionals.
The presentations are “very similar to help educate people about the law and how it works,” said Samantha Trad, access campaign director for Compassion and Choices, a national organization that has advocated for end-of-life rights. “There’s a lot of misunderstanding sometimes about what the law is and how medical aid in dying works.”
Additionally, Trad said they also want to let people know that medical aid in dying is just one of many palliative care options available, and start conversations about end-of-life choices.
“In our culture, death is a taboo topic and it’s important to have those conversations and think about what a person wants at the end of their life,” she said.
Trad said she will talk about patient rights and patient advocacy to “make sure you know what all your options are.”
“I think it’s important and the culture is changing towards … listening to the patient and honoring the decision they have when it comes to end-of-life (choices),” she said.
It’s also important for people to start asking their doctors now if they would honor their end-of-life decision, said Trad.
It can be a difficult thing to talk about, she said, but easier for everyone when the conversation has been had “and you know what your loved one wants for the end of their life. A lot of physicians don’t even think about this until they are faced with it and have a patient (seeking) medical aid in dying.”
As the Jan. 1 deadline approaches, the state Department of Health is also encouraging health care organizations across the state to prepare for the start of Our Care, Our Choice.
“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 work flows that support timely referrals, effective clinical standards, clinician support and clear communication,” the DOH said in a news release earlier this week.
Lorrin Kim, chief of the DOH Office of Planning, Policy and Program Development said the bill is a “strange piece of legislation” because it puts the department in charge of implementing the law, but the majority of the process occurs in the private sector and the DOH was not given any legal authority in the matter.
“The main idea is that this department believes this is a private matter between a patient and a doctor, like all medical care, and we do not want to insert ourselves in any kind of regulatory manner,” he said. “… That being said, we are still trying to figure out how to implement this when we don’t have any legal authority.”
According to Kim, most decisions will be made in private health care. Doctors and providers are able to opt out and the department cannot “force anyone to do anything.”
The department is doing what it can to help the provider and patient communities prepare for the legislation’s implementation, he said. That includes doctor conferences, community meetings and meetings with law enforcement and insurance carriers.
While the department acknowledges “this is (patients’) right to require life-ending medication,” Kim said they want to make sure other options are known, too.
DOH knows this is a “very meaningful right” for patients with not long to live, he said.
“We are doing our best to make sure the rest of the health care system are aware of what they need to do.”
In Hilo, some local care providers are still working to develop policies.
“We did get the communication from the Department of Health and we are in high level discussions with our leadership to discuss a course of action in preparation for the law to come into effect at the beginning of the year,” Hilo Medical Center spokeswoman Elena Cabatu said.
Brenda Ho, CEO of Hawaii Care Choices, formerly Hospice of Hilo, said her organization has not yet finalized its process for how such requests would be facilitated, but said there’s not a lot that will change in what they do.
Hawaii Care Choices will continue to care for patients and families “like we always have and will continue to do,” she said.
“We’re not going to change that based on this new law. We’re going to continue to make sure we take care of our community just like we have before.”
Coordinated by the Hawaii County Office of Aging, state Sens. Lorraine Inouye and Russell Ruderman, and state Reps. Cindy Evans and Joy San Buenaventura, the Compassion and Choices Hawaii presentations are free and open to the public.
Community presentations are planned for 10-11:30 a.m. Tuesday at the West Hawaii Civic Center Council Chambers, 74-5044 Ane Keohokalole Highway, Kailua-Kona; 4-5:30 p.m. Tuesday at Tutu’s House, 64-1032 Mamalahoa Highway, Suite 305, Waimea; and 10-11:30 a.m Wednesday at Hilo Aging and Disability Resource Center, 1055 Kinoole St., Hilo.
Additional programs are being held specifically for medical, health and human services professionals and are set for 2:30-4 p.m. today at the West Hawaii Civic Center Council Chambers and 12:30-2 p.m. Wednesday at Hilo ADRC.
Registration, which is helpful but not required, can be done by calling 974-4000, ext. 67335.
For more information about Compassion and Choices Hawaii, visit compassionandchoices.org/in-your-state/hawaii/.
Email Stephanie Salmons at ssalmons@hawaiitribune-herald.com.
