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Death with Dignity

PURPOSE

The purpose of this policy is to provide guidelines for Island Hospital staff and providers to assist patients who have requested ‘Death with Dignity’.

SCOPE

Organization wide

DEFINITIONS

Death with Dignity Law: An adult who is competent, is a resident of Washington state, and has been determined by the attending physician and consulting physician to be suffering from a terminal disease, and who has voluntarily expressed his or her wish to die, may make a written request for medication that the patient may self-administer to end his or her life in a humane and dignified manner in accordance with this chapter. (RCW 70.245.020)

Attending physician: The physician who has primary responsibility for the care of the patient and treatment of the patient's terminal disease.

Consulting physician: A physician who is qualified by specialty or experience to make a professional diagnosis and prognosis regarding the patient's disease.

EQUIPMENT

Not applicable.

QUALITY CONTROL

This policy will be reviewed annually
        
PROCEDURE / WORK INSTRUCTIONS      
                  
1. ISLAND HOSPITAL allows its providers to participate in the “Washington State Death with Dignity Act,” if they so choose.  This means providers at ISLAND HOSPITAL may:
• Perform the duties of an attending physician;
• Perform the duties of a consulting physician;
• Prescribe life-ending medication;
• Fill a prescription for life-ending medication;
• Provide counseling in connection with the provision of life-ending medication; and/or
• Perform other duties as provided for in the Act.

2. If any ISLAND HOSPITAL provider participates in the “Washington State Death with Dignity Act” with a patient of Island Hospital, that provider must immediately notify Island Hospital’s Chief Executive Officer or designee.  It is the provider’s responsibility to ensure the correct procedures are followed and the correct documentation is completed in accordance with the Act and Island Hospital policy.  The steps included in the attached checklist should be followed carefully and documented appropriately.

3. Island Hospital administration may provide oversight and may review records to the extent necessary to ensure all the safeguards of the law have been followed and the required documentation completed and submitted to the Department of Health.

4. ISLAND HOSPITAL does not mandate that any provider participate in the “Washington State Death with Dignity Act,” nor encourage any provider to do so.  Only those providers who are willing and desire to participate should do so. 

5. While participating in the act, any provider at ISLAND HOSPITAL must ensure the appropriate standard of care is followed.

6. All providers at ISLAND HOSPITAL are expected to respond to any patient’s query about life-ending medication with openness and compassion.  ISLAND HOSPITAL believes our providers have an obligation to openly discuss the patient’s concerns, unmet needs, feelings, and desires about the dying process.  Providers should seek to learn the meaning behind the patient’s questions and help the patient understand the range of available options, including but not limited to comfort care, hospice care, and pain control.  Ultimately, ISLAND HOSPITAL’S goal is to help patients make informed decisions about end-of-life care.

LAWS/REGULATIONS

Initiative 1000/Washington Death with Dignity Act
Washington State Department of Health Regulations Chapter 246-978 WAC (Currently at CR-102 stage) and WAC 246-320-141.

Washington State RCW 70.245

REFERENCE MATERIALS

The Oregon Death with Dignity Act: A Guidebook for Health Care Professionals


Approved: 12/31/2013