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OMC ponders Death with Dignity

People served by Olympic Medical Center will learn a week from tonight whether the hospital will choose to participate in assisted suicides that voters legalized in Initiative 1000.

Hospital commissioners will vote at their next meeting, March 4, whether to "opt into" Death with Dignity procedures.

If approved - at the unanimous recommendation of OMC's Ethics Advisory Committee - the hospital's role would be minor.

Judging from Oregon's 11-

year Death with Dignity experience, few patients request the lethal dose of drugs that, once swallowed, ends life within a minute or two.

Even fewer take the suicide dose and almost all of those take it in their homes.

Furthermore, under Initiative 1000, OMC cannot prohibit its doctors, nurses and pharmacists from assisting a patient's suicide.

OMC merely can refuse to allow such aid in its flagship Port Angeles hospital or its clinics in Sequim and Port Angeles.

Whether on or off the medical center's property, providing a patient with a Death with Dignity dose is hedged about with stringent requirements for informed consent, the patient's mental health, repeated requests for the drugs and waiting periods.

Commissioners received a preliminary presentation on the issue at their Feb. 18 meeting, hearing from Donna Davison, OMC administrative director, and Dr. Sandra Tatro, chairwoman of the medical center's ethics panel.

Both women noted that Initiave 1000 passed with a 58-percent majority statewide but with a 61-percent edge in Clallam County.

People are afraid, Davison said, of a prolonged and painful death with no hope of accelerating the end.

They want at least the option of controlling the ends of their lives, she said.

Tatro added, "People want their health care providers to help them die with dignity.

"I really think this is what it's all about. It's about how do we take care of folks at the end of life."

Tatro and Davison listed six points the ethics group cited to allow Death with Dignity procedures at OMC:

The 61-percent approval of Initiative 1000.

OMC's role as the district's sole public hospital.

A call by the community for more information on pain management and comforts that are available during the end-of-life period.

The fact that no one will be forced or obligated to participate in implementing the Death with Dignity Act.

The need for OMC to implement policies, procedures and education for providers so they understand the requirements and guidelines of Initiative 10000.

Similar education for patients and their families related to end-of-life care.

"We all have probably underutilized" other alternatives to assisted suicide, said Dr. Mark Fischer, medical chief of staff.

He said a straw poll of OMC's doctors revealed "about an even split" over whether they would assist a patient's Death with Dignity.

Primary care physicians, however, mostly said they were disinclined to do so, Fischer said.

Tatro said, "It's an exciting opportunity to address this issue. Only good can come from it, really - any avenue we can use to help people understand what actions they have available at the end of their lives."

In other action at the Feb. 18 meeting, hospital commissioners:

• Learned that federal economic stimulus funding could support about half the $2.5 million cost of electronic medical records at OMC clinics.

Linda Brown, chief information technology officer, said installation of the system hardware would begin in April or May, with software installation scheduled from May to October and "going live" set for 2010.



Death/Dignity decision

Who: Hospital District 2 commissioners.

What: Decision whether or not to participate in assisted suicides known as Death with Dignity procedures.

When: 6 p.m. Wednesday, March 4.

Where: Linkletter Hall in the basement of Olympic Medical Center, 939 Caroline St., Port Angeles.

How to learn more: A slide show by the Washington State Hospital Association can be viewed at www.wsha.org/page.cfm?id=webcasts and the state Department of Health's Death with Dignity rules can be seen at www.doh.wa.gov/Rules/0906010 DeathwithDignity.pdf.



Reach Jim Casey at editor@sequimgazette.com.



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