DOH Releases 2020 Report on Our Care, Our Choice Act
Dept. recommends Legislature improve access by reducing waiting period and allowing qualified APRNs to serve
July 7, 2021
HONOLULU — The Department of Health has released its annual report detailing usage information during the first two years of the Our Care, Our Choice Act (OCOCA) (Jan. 1, 2019 – Dec. 31, 2020). The law gives mentally capable, terminally ill adults with six months or less to live the option of medication they can decide to take to die peacefully in their sleep.
The state’s 2020 data show the following: 37 prescriptions for medical aid-in-dying medication were written by 14 unique doctors (of these, 11 were located on Oahu, two on Maui, one on Hawaii Island and none on Kauai); and 25 of the terminally ill patients used their medication. This is common, says Compassion & Choices Hawaii State Director Samantha Trad. “Nationwide, about one-third of people who go through the 13-step process to access the law never actually take their medication, but having it on hand gives them a huge sense of relief to know it’s available if their suffering becomes unbearable.”
Additionally, 28 of the 37 patients were enrolled in hospice, which is encouraged by the DOH and non-governmental advocates including Compassion & Choice Hawaii.
The report reiterates DOH’s 2019 recommendation to the legislature to amend the OCOCA by allowing qualified Advanced Practice Registered Nurses (APRNs) to participate; and by waiving the waiting period between the state’s mandated first and second verbal requests if doctors determine the patient will not survive it, as Oregon has done with their medical aid-in-dying law which Hawaii’s is modeled after. In fact, Hawaii has the longest mandatory minimum waiting period between the two required oral requests (20 days), with New Mexico having the shortest waiting period (2 days).
The mandatory minimum waiting period has proven to be a traumatic barrier to patient access to the law. Data from Kaiser Hawaii show that up to 30 percent of their terminally ill patients who want the peaceful option of medical aid in dying do not survive the waiting period.
Laura Arcibal, State Telehealth and Health Care Access Coordinator, said, “Hawaii continues to face physician shortages across the state, especially in primary care, according to the latest University of Hawaii Physician’s Workforce Report. Neighbor island patients not only face the challenge of finding a physician in a doctor shortage, but finding that one physician who can bring relief and support them in ending their suffering. The Department highly encourages the utilization of telehealth for both patients and physicians and maintains its recommendation which is the same as last year’s report.”
“We are encouraged to see that the OCOCA is working and that many terminally ill residents have been able to access this compassionate end-of-life option,” said Trad. “However, we continue to get calls from dying patients who struggle to access the law, especially those in rural areas and/or who are extremely ill. We fully support DOH recommendations to improve access.”
Hawaii is one of 11 jurisdictions where medical aid in dying is authorized. Other states that have authorized medical aid in dying are California, Colorado, Maine, Montana, New Jersey, New Mexico, Oregon, Vermont and Washington, along with the District of Columbia, together representing more than 20 percent of the nation’s population.
Compassion & Choices provides education to the public and medical professionals through its Access Campaign to ensure that every eligible terminally ill person in Hawaii has access to all end-of-life care options, including hospice, pain control, palliative care and medical aid in dying. Educational resources for patients and providers are at compassionandchoices.org/hawaii; to request a community or medical provider presentation call 808-664-5794 or email [email protected]
Compassion & Choices Hawaii is the local affiliate of Compassion & Choices, the nation’s oldest, largest and most active nonprofit organization committed to improving care and expanding choice at the end of life. For more information call 808-282-8247 or visit www.compassionandchoices.org/Hawaii