Real benefit may be in breaking a taboo: talking about death

This editorial appears in the March 5, 2009, Yakima Herald-Republic.

The fact that hospitals in Yakima County will not participate in the state's Death with Dignity Act comes as no surprise.

The hospitals properly concluded the new law -- which goes into effect today -- doesn't reflect the values of most of those who live in their communities. That was clearly expressed in the results last November when Yakima County residents voted 58 percent to 42 percent against the measure. Statewide, the results were just the opposite, with 58 percent voting in favor.

The last two hospitals to weigh in on the measure were the county's largest -- Yakima Valley Memorial Hospital and Yakima Regional Cardiac and Medical Center. They announced earlier this week they will prohibit their physicians, pharmacists, nurses and employees from helping terminally ill patients end their lives in hospital-owned or leased facilities.

This decision by Yakima Regional also affects Toppenish Community Hospital. Both are owned by Health Management Associates of Naples, Fla.

Sunnyside Community Hospital had already decided against taking part in the Death with Dignity provisions, similar to the stance taken by neighboring Prosser Memorial Hospital in Benton County.

The hospitals have the right as employers to make this decision for those whom they employ, regardless of what an individual physician or pharmacist or nurse may otherwise believe.

Even though these hospitals opted out of participating, under the law they still are required to inform the public so patients seeking to end their lives, and who might need to be hospitalized, can plan an alternative.

Patients also are required to get a medical opinion from two doctors verifying they have less than six months to live and are competent to make a decision about ending their life.

And one last point -- only the terminally ill patient can administer the lethal dose.

Though we endorsed Initiative 1000 last fall, we did so with some reservations, in particular the six-month time frame, which seems too long and may actually lead patients into taking their lives too prematurely.

We do not expect widespread use in this state. Oregon is the only other state in the nation with a similar law. There, since being allowed a decade ago, end-of-life decisions have totaled only 341 through 2007.

The importance of this law may very well be in what it promotes -- a vigorous discussion about death. Our society has, for too long, shielded itself from the realities of death and the loss of loved ones. The Death with Dignity Act helps set the stage for patients who are critically ill to openly talk about their death, not only with their physicians but also with family members.

We certainly hope hospice care becomes a central theme in these discussions. Too little is publicized about the benefits of hospice care, how dedicated professionals and volunteers help ease the fears of those who are dying and how grieving family members and friends are brought closer together at this most critical time.

If the new law encourages this type of openness, then its passage will have added meaning, especially in parts of this state like ours where voters cast ballots of doubt or disdain.

* Members of the Yakima Herald-Republic editorial board are Michael Shepard, Barbara Serrano, Spencer Hatton and Karen Troianello.