A Kailua-Kona cancer patient in May became the second individual in Hawaii to take a drug — prescribed under the state’s newly implemented medical aid-in-dying law — to end his life.
Eight patients with a terminal illness — including Steve Johnson, 75 — gained access to an aid-in-dying prescription since the “Our Care, Our Choice Act,” went into effect Jan. 1, according to a progress report issued Monday by the state Department of Health.
According to the DOH, the law allows Hawaii residents 18 years old or older who are diagnosed with a terminal illness and have a prognosis of six months or less to live to obtain an aid-in-dying prescription after two separate verbal requests to a physician, a written request with two witnesses and a mental health evaluation to ensure they are capable of making medical decisions for themselves.
Health care providers also are required to educate patients about “feasible alternatives or additional treatment opportunities, including but not limited to comfort care, hospice care and pain control.”
“There was a lot of anxiety as we were going through the process, but once Steve had the medication in hand, he was at peace,” said Kathy Johnson about her husband in a written statement from Compassion and Choices Hawaii, part of a national organization that has advocated for end-of-life rights. “When his suffering was too much to bear, he planned the day. Our hospice nurse arrived, Steve took the medication, and we said our final goodbyes. Within 30 minutes he passed away peacefully in his sleep.”
According to the report, four Oahu providers wrote prescriptions between Jan. 1 and May 31.
A 73-year-old man with amyotrophic lateral sclerosis also died after taking the prescription, and a third patient died from lung cancer without ingesting the prescription, the report stated.
The process, from the first oral request to receiving the written prescription, was approximately 37 days, with the shortest period being 22 days, according to the report.
“This has been a collaborative effort and the dedication of Hawaii’s health care providers to help patients and their families navigate the system has played a critical role in successfully implementing the law,” Lorrin Kim, the DOH’s chief policy officer and legislative coordinator said in a DOH news release. “There is more discussion in the community about supportive care alternatives when curative treatment is no longer viable.”
“The state’s data show that even during the early months of the law’s implementation, the law was working and terminally ill Hawaii residents were able to access this end-of-life option,” said Samantha Trad, Compassion and Choices Hawaii state director. “We are encouraged to see that the state’s first five months of data show that four unique physicians supported their patients in this compassionate end of life option, eight patients formally qualified for medical aid-in-dying, and two of those patients peacefully ended their suffering by using the medication. We continue to work 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.”
Dr. Chuck Miller, one of the first doctors to prescribe under the new law, said in the Compassion and Choices statement that implementation continues to make progress.
“There has been improvement in patient wait times,” he said. “It took my first patient 60 days from his first request to having the prescription in hand. Now, six months later, I’m seeing patients complete the process in 21 days.”
But that can still be a hardship for patients.
“I personally had two patients die of their disease before they were able to complete the waiting period. This is not compassionate care and should be unacceptable to the people of Hawaii,” Miller said. “I look forward to the day that we can make the whole process shorter and less onerous for suffering terminally ill patients.”
In Hilo, Brenda Ho, CEO of Hawaii Care Choices, formerly Hospice of Hilo, said she didn’t know how many clients there might have sought or are seeking this option because that’s a discussion primarily between the patient and their primary care physicians.
The new law “doesn’t impact the care Hawaii Care Choice is offering,” she said.
Email Stephanie Salmons at ssalmons@hawaiitribune-herald.com.