Just posted a longish piece on Slog, about how our state’s Catholic run hospices, which are the sole hospice providers in many parts of the state, not only refuse to participate in our Death With Dignity Act, but refuse to even answer patients’ questions about it: “Don’t Tell When Asked”: How Catholic Hospices Are Denying Patients’ Rights to Death With Dignity.
In fact it’s part of a much larger, and very sensitive issue that has so far escaped much public scrutiny. For all the immense amount of good our state’s Catholic hospitals and health systems do by providing quality medical care, often in otherwise under-served regions, recent expansions, mergers and affiliations have given these systems virtual monopolies throughout much of the state. And due to their requirement that doctors, nurses, counselors and other care givers adhere to Catholic Ethical and Religious Directives, this expansion has also served to restrict access to many legal medical services, including abortion and birth control, as well as end of life directives.
Anyway, this post is a good start on a complicated issue that I hope to come back to in greater detail. Read the whole thing, and let me know what you think.
What a weird mixing of religious doctrine and libertarian capitalism. It’s up to the consumer to be the expert, the corporation is under no compulsion to give all the facts.
If the church gives people the right to die with dignity, then the requisite suffering unto death won’t happen (like that guy a couple of thousand years ago). And the church can’t have that. Compassion is only for healthy young people.
I don’t have any problem with a hospital, clinic, or hospice which is under the authority of a religious order to refuse to follow practices which conflict with their religious principles.
Should a nursing home belonging to an orthodox jewish order be required to serve pork, if it doesn’t want to do so? Should Amish be required to keep their young in schools until age 16?
The problem, as I see it, isn’t that these hospices should be forced to follow these practices, whether codified in law, or not. Forcing that issue gets you into First Amendment territory, and bad cases end up making bad law which can hamstring you in future situations.
The problem, as I see it, is the lack of hospice facilities, so that residents who don’t want to follow the church’s restrictions have the option of going elsewhere.
Is the administrative bureaucracy in Catholic hospitals as expensive and overbloated as it is in hospitals in general? Do administrators of Catholic hospitals make $500K a year, like they do in public hospitals in this area?
Anyway, RHP6033 has got it right. This is a market malfunction, typical of our country having one of the most screwed up administratively health care systems in the world. Excellent medicine for many, and a total messed up system for delivering it to the rest.
In any event, there happens to be ONLY ONE hospital in all of Whatcom County — St. Joseph, which is run by a Catholic religious order. There are an estimated 200,000 people in Whatcom County.
St. Joseph was evidently established in 1891, and there is only one current hospital campus location in the county. I don’t know whether St. Joseph has always been the ONLY ONE hospital in Whatcom County, whether other hospitals became outdated and closed, or whether other hospitals were acquired by St. Joseph and their campuses shut down at some point in favor of the main campus.
End of life issues aside, if I ever end up as a patient in a hospital, and I thank God I haven’t, this Lutheran/Mormon Cultist/Jack Mormon/Gnostic (heh- depending on my mood) sure hopes to hell that it’s one that’s run by the Sisters of Providence. Of all the hospitals I’ve worked with through the years, the Sisters stand out as the classiest act of them all.
Blah, blah, blah….inferiority complex….blah….blah….hates religon…..Goldstein….jealous….blah blah….angry little whiney bald Jew….blah…blah….chronically unemployed….can’t get or keep a woman….blah…blah….ex-wife dumps his ass (can’t blame her)….blah blah….small penis and ashamed of it…blah…blah….pays no income taxes, as has no income…..begs for money under a bullshit word: “fund drive”….blah blah..hates Christianity….hates successful people that work for a living….blah blah.
The above was brought to you by the maulfuncting and repeating turntable named David “I couldn’t get laid in a whore house” Goldstein.
Get something new already douche bag, you’re not even close to being as relevant or important as you believe you are.
I heard that in Whatcom county we can be given information about end of life stuff, and have the medication administered…as long as the physician and the patient go off the property to do it. I wouldn’t go near a Catholic hospice.
@6 If Goldy’s that pathetic, what does that make you, who keep slavishly reading him?
Don’t like his site, stop reading it. You could start your own, but there’s the minor problem of readers. How can you get any, when you have nothing to say that’s of any use to anyone else?
Oh. I get it. Become a troll on someone else’s blog. Someone with actual content. Exploit their audience.
How silly of me.
Goldy
Good balanced post, and so far, good discussion.
I suspect that at least part of the issue is with how the DWD is written. As I assumre you know very few pts here orin Oregon (similar laws) use this service and most docs, Catholic or not, will not participate because of the way the thing is written.
For example, under law, an Alzhemer’s pt who has utterly lost her identity (soul?) could not get surcease this way because her life span can not be determined to be six months. Same is for a pt with terminal ms or Parkinson’s.
This law was, unfortunately, written by fanatics and really does little to solve any real problem.
A few issues with the SLOG post:
This is difficult to imagine. Hospitals certainly can and do set THEIR policies as to procedures carried out in the hospital. I find it very unlikely that nay hospital EVER dictates what a PRIVATE physician recommends outside the hospital. I suspect any such action would lead to a law suit PDQ.
Any documentation?
A sensible law would recognize that ALL hospitals should recognize the right of physicians to administer pain relieve (even for esophageal Ca) when and if the pain and suffering requires, even though that pain relief is going to end life. The ethics and morals of that judgement are, too say the least, difficult but I do not think ANY hospital would tolerate keeping a patient in pain out of some messianic ideals. Again, doyou have any evidence for this?
A FAR more common issue is the terminal patient who is NOT served by this law. Many people spend YEARS in pain or psychic isi9lation due to diseases like Gherig’s, Parkinson’s, Alzheimers, stroke .. diseases that rob all dignity and even communication. The problem is not limited to the elderly. Some children are born with such severe defects that they can only suffer. We have NO law dealing with this horrid problem and, unfortunately, the answer comes down to intentional neglect of care. This law, however, does nothing to assure that these people who REALLY do need help, can get it.
Rob Miller of Compassion and Choices agrees, if
This is one reason I opposed I-1000. Contrary to what you are saying here. Miller IS advocating the elimination of the opt-out provision. A well written law would have avoided these issues easily by not trying to legislate what a doctor can do, esp. if the issue is a violation of the Hippocratic oath.
@9
They’d also be unable to request it or to consent to such a thing. Maybe I’m missing something, but this seems like an odd example.
@11 Michael
True, except that Alz (and many of these diseases) takes a LONG time to leave a pt this incapacitated. It seems to me that before that time a patient should be able to commit to an end of life when, for example, they are no longer able to communicate.
Other folks in this category may not lose all ability to communicate. I suspect that a number of desperate terminal ms, Gherig’s disease and even spinal injury pts are helped to make such a choice now. Although this is done in an unofficial way, my guess is that the current policies may be more fair then the practices that could be abused if we tried to hard to regulate things.
There are many tricky issues n creating such a law .. I doubt our rough and ready initiative process could do it right. For example, there would need to be some way to assure that the decision was not biased by some over eager relative (of course the reverse can be true as well, some brain dead people are kept alive long after this makes sense by relatives who have certain needs or beliefs).
As a physician I also would like to see some way of this decision NOT being the responsibility of a doctor, other than to certify that Mr or Mrs is in the state that was predefined.
I also think thought has to be given to preventing insurance companies from encouraging death as a way of cutting end of life costs. This issue has arisen even with the I-100 type law in Oregon and is a real danger when you consider that end of life costs can run into the 6 figures.
Finally, given the legal burden created by I-1000 and the tiny number of flolks using it, I suspect that the cost in cover-my-ass compliance by the health care community may be way out of wack. One thing that REALLY ticks me off is that the proponents of laws like this seem to slink back into the mouse holes after the laws are passed, leaving the rest of us to figure out where the cheese went.