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Hospice and Physician-Assisted Death: Collaboration, Compliance, and Complicity An examination of fifty-five Oregon hospices reveals that both legal and moral questions prevent hospices from collaborating fully with physician-assisted death.

According to data collected by the Oregon Department of Human Services, 88.2 percent of terminally ill patients who from 1998 to 2009 used the state’s Death with Dignity law to end their life were enrolled in hospice care. This figure climbs to 95.1 percent in the two most recent years of available data. Two significant points are suggested by these ratios. First, terminally ill patients seeking physician-assisted death are receiving high-quality palliative care. Second, hospice programs are regarded as an important societal mechanism to assure that physician-assisted death is practiced responsibly.

During 2009, in order to assess the extent to which Oregon hospice programs participate in physician-assisted death, we requested policy statements, program guidelines, and staff education materials that had been developed by sixty-four hospice programs affiliated with the Oregon Hospice Association to address patient inquiries about the Death with Dignity Act. We received forty documents representing fifty-six programs. Our examination of these documents suggests that individual hospice programs generally assume a minor role in the decision-making process of patients who exercise their rights to physician-assisted death—a role largely confined to providing information about the law in a “neutral” manner. Moreover, hospices claim they will not assist with providing the medications necessary to hasten a patient’s death. This limited role indicates that questions of legal compliance and moral complicity inhibit hospice collaboration with patients seeking physician-assisted death. 

According to data collected by the Oregon Department of Human Services, 88.2 percent of terminally ill patients who from 1998 to 2009 used the state’s Death with Dignity law to end their life were enrolled in hospice care. This figure climbs to 95.1 percent in the two most recent years of available data. Two significant points are suggested by these ratios. First, terminally ill patients seeking physician-assisted death are receiving high-quality palliative care. Second, hospice programs are regarded as an important societal mechanism to assure that physician-assisted death is practiced responsibly.

During 2009, in order to assess the extent to which Oregon hospice programs participate in physician-assisted death, we requested policy statements, program guidelines, and staff education materials that had been developed by sixty-four hospice programs affiliated with the Oregon Hospice Association to address patient inquiries about the Death with Dignity Act. We received forty documents representing fifty-six programs. Our examination of these documents suggests that individual hospice programs generally assume a minor role in the decision-making process of patients who exercise their rights to physician-assisted death—a role largely confined to providing information about the law in a “neutral” manner. Moreover, hospices claim they will not assist with providing the medications necessary to hasten a patient’s death. This limited role indicates that questions of legal compliance and moral complicity inhibit hospice collaboration with patients seeking physician-assisted death. 

Courtney S. Campbell and Jessica C. Cox, "Hospice and Physician-Assisted Death: Collaboration, Compliance, and Complicity," Hastings Center Report 40, no. 5 (2010): 26-35.