Real-world lessons on integrating medical aid in dying into health care

How do health care organizations support terminally ill people seeking medical aid in dying?

Compassion in Practice, a new initiative from Compassion & Choices, explores this question through examples from health care systems, hospices, residential care facilities, pharmacies, and care coordination services. These profiles highlight the challenges organizations face, how they’re addressing them, and what they are learning along the way.

Hospice is one of the primary settings where people receive end-of-life care and may pursue medical aid in dying. Topkare Hospice in San Diego, California, is a provider that has integrated medical aid in dying into its work — from creating a thoughtful process for responding to patient requests to effectively training staff.

In their Compassion in Practice profile, Topkare offers guidance for other hospices: “I think the key thing that hospices need to think about is their patients’ autonomy, independence, and respecting that they have a choice.”

Hopewell House, a residential care facility in Portland, Oregon, shares this commitment to patient-directed care. As they explain, “When it comes to medical aid in dying or any kind of care at the end of life, […] ensure that the resident is at the center of the conversation.”

Compassion in Practice also highlights systems and organizations that don’t directly participate in medical aid in dying, but see the value of developing policies around it.

After medical aid in dying was authorized in New Jersey in 2019, Memorial Sloan Kettering Cancer Center (MSK) decided not to provide this end-of-life care option to patients. However, it soon recognized the need for a clear process to respond to patient questions and requests.

Our profile of MSK explores how the policy was developed, what it includes, and why having one matters. Even though MSK physicians don’t prescribe aid-in-dying medications, their patients are still able to understand their care options at the end of life.

Visit the Compassion in Practice hub to explore more examples of how care systems and providers are supporting people on the end-of-life journey.