Get to work
Why on earth aren’t county employees taking pay cuts?
Every industry has taken pay cuts except for government employees. They were able to move ahead of the most vulnerable citizens to get the COVID-19 vaccine and still don’t go to work!
Why isn’t the DMV open along with all of the schools?
It’s beyond ridiculous that we have reduced government services, and they are talking about a pay raise!
Hawaiian Paradise Park
Listen to the patient
After 30 years of bedside nursing, one mission upon retirement was to bring Oregon’s law about death with dignity to Hawaii.
Our state and AMA need to take heed of their aging citizens that compose a third of the population, despite COVID-19. In 2018, after two decades, we helped the Hawaii state legislators pass a law called Our Care, Our Choice Act, but only to be stalled again in East Hawaii, where no physician or state institution will support the law with the exception of Kaiser Permanente and Hawaii Pacific Health!
And, yes, these private institutions have helped set the new gold standard for that open conversation about planning for death and opening the door to possible choice in the matter, if OCOCA parameters are met.
May I elaborate on my experience with hospitalized patients at the end of their lives. As a novice nurse, one day my patient asked me to “release’” her, and I jovially responded that it was her choice — only to be surprised by her death, the very next day. This showed me the power of self-determination and the importance of always listening to the patient.
Through the years as an ICU nurse, I have witnessed many examples of death, both good and bad, for the patient and their families. My simple definition of a good death is quick, painless and peaceful at home with supportive family.
Oxford’s definition of a good death is “one that is free from avoidable distress and suffering, for patients, family and caregivers; in general accord with the patients’ and families’ wishes; and reasonably consistent with clinical, cultural and ethical standards.”
In contrast, my simplistic definition of a bad death is prolonged, agonizing and restless in a strange bed where no one knows me.
I’ve witnessed all extremes and once had a patient say, “Death was not an option” — so I felt that I needed to withhold sedation because it could hasten their death!
Obviously, there are many barriers in a hospital setting, especially when most patients would rather die at home when death is imminent within six months.
So, why not listen to patients and consider answering those who fit the strict qualifications for OCOCA to go home with the choice of medical aid in dying? Ultimately, it is the patient’s choice to use — or not use — this option.
The process can be initiated with documentation of the patient’s request and a flier that explains the (online) support of Compassion &Choices that has patient navigators who help monitor the process. Also, a hospice program could facilitate a smoother transition from hospital to home with continued support.
In closing, my point is that the medical community in East Hawaii could make a difference for OCOCA patients who want the choice of self-determination at the end of their lives. It’s about control, comfort and self-dignity.