Huntington Hospital leaders voted behind closed doors recently for the facility's hundreds of doctors and affiliated personnel to opt out of California's assisted-suicide law, which goes into effect June 9.
If the proposed amendment to the hospital’s medical rules is approved by the board of directors on May 26, Huntington will become one of the largest non-religious medical institutions to reject the new California law.
It’s unclear at this point if Huntington will be an exception or representative of a wave of opt-outs to be revealed by month’s end.
Huntington spokeswoman Eileen Neuwirth said that Huntington, a non-religious facility, respects the rights of patients and their families to make decisions regarding end-of-life care and also respects the rights of independent physicians and pharmacists to decide whether they will participate in the process. Hospital officials are evaluating whether or not the inpatient setting is the appropriate location to deliver end-of-life care.
Huntington will permit doctors to furnish patients with information about the act and/or to provide referrals to healthcare providers who may participate in activities authorized by the act outside of Huntington Hospital, in response to patient requests for such information.
Insiders at Huntington say many doctors opposed the hospital's end-of-life amendment. However, such opposition wasn't enough to change the executive committee's thinking.
Many local doctors with their own practices might be unwilling to jeopardize their access to Huntington by assisting terminally-ill patients under the terms of the law. Doctors will be limited to what they can do even in their own office.
Spokespersons for some of California's biggest medical facilities — including Kaiser Permanente, Sutter Health and UCLA — said they will comply with the law on an institutional basis, while respecting the right of individual doctors to opt out.
Many secular hospitals are taking a patient-first position, respecting that some terminally ill people desire this choice.
There is no estimate for the number of institutions considering a similar move, according to a Los Angeles Times article.
Kaiser spokeswoman Amy Thoma said, “With every person who wishes to exercise their right, we will have a patient coordinator to guide the patient through every step.” In the case of physicians who choose not to participate, their patients can be referred to another doctor willing to prescribe, she said.
Sutter Health is supportive of helping its patients explore all of their end-of-life options, which can include palliative care, home health and hospice, and its Advanced Illness Management program.
Other hospital systems, including Catholic-affiliated Dignity Health, are not participating in end-of-life options because the practice goes against their religious values.
Providence Health & Services, which operates six medical centers in Southern California, said it would be opting out because assisted suicide is incompatible with the system's Catholic beliefs.
Patricia Aidem, a Providence spokeswoman, said, "We are committed to providing appropriate support for dying persons and their families through the final stages of life.” Aidem said they will not be present if a patient chooses to ingest life-ending drugs, but they will work with the patient and loved ones to discuss the plan of care.
In May the California Medical Association, which opposed past bills, became the first state medical association to officially take a neutral position on aid-in-dying legislation.
Senate Bill 128, known as the End of Life Option Act, will give terminally ill Californians access to life-ending medication. Modeled after Oregon’s Death with Dignity Act, this is the first legislation of its kind in the country. If approved, the law will give some terminally ill patients the ability to get a doctor's prescription for lethal medication.
The End of Life Option Act allows doctors, medical groups and hospitals to opt out of the law's guidelines for assisting the terminally ill to achieve a dignified end.
SB 128 would extend lethal medication only to terminally ill patients who have less than six months to live — as confirmed by two physicians. The patient must be of sound mind; must make two verbal requests at least 15 days apart and sign a written request in the presence of two witnesses; and is required to be the one to administer the medication. Under the proposed law, coercion is a felony, while the assisting physicians, pharmacists and healthcare facilities are insulated from criminal liability.
Aaron Kheriaty, MD, director of the medical ethics program at the UC Irvine School of Medicine, testified that the law could result in unequal treatment for people with mental illnesses. “Assisted suicide is discriminatory,” he told the committee, explaining that under the law he would be forced to intervene to save the life of a depressed and suicidal patient, but could assist a patient facing imminent physical decline.
Both the Southern and Northern California oncologist organizations have reaffirmed their strong opposition to an assisted-suicide bill in any form, because of the many dangers it would pose, as well as do harm to the doctor/patient relationship.
Gallup polls show a majority of Americans have supported physician-assisted euthanasia for terminally ill patients for the past 20 years.