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for Translation of the Kaiser Papers RESEARCH GUIDES BY SUBJECT | A READER'S GUIDE | This is a press release sent out by: Physicians for Compassionate Care P.O. Box 6042 Portland, Oregon 97228 (503) 533-8154; Fax (503) 533-0429; www.pccef.org PRESS RELEASE
HMO SEEKS OUT ASSISTED-SUICIDE DOCTORS
In an electronic memorandum dated August 6, 2002,
Kaiser Permanente NW, an HMO in Oregon where assisted suicide has been
legalized, claimed it is difficult to find doctors to give lethal overdoses
to patients. So Janet
P. Price, representing Northwest
Permanente, sent a memorandum to 829 recipients requesting that all doctors
willing to overdose
patients give their name to Doctor
Robert Richardson of the Ethics
Service or to another Kaiser administrator.
The memorandum complained that Richardson’s Ethics Service could not find a doctor to give deadly drugs to a patient who was “suffering” and dying for three weeks. The communication did not explain why the patient’s suffering was not adequately treated and relieved for three weeks or what Kaiser Permanente proposes to do to improve its pain treatment and palliative care. Doctor Richardson is the same doctor-administrator who approved the overdosing of HMO patient Kate Cheney, despite the fact that Mrs. Cheney had been determined to be demented, under pressure from her family, and therefore not eligible for assisted suicide. Some individuals have speculated that cost savings could be one motivating factor stimulating HMO administrators to provide so much support for assisted suicide. The entire contents of the original memorandum follow: “Kaiser Permanente Northwest Division ELECTRONIC MEMORANDUM Sent: 06-Aug-2002 01:21pm PDT From: Janet P. Price PRICEJANETP Dept: Northwest Permanente Tel No: 49-2657 TO: See Below Subject: Oregon Death with Dignity Act: Physician Participation IF YOU ARE NOT INTERESTED IN PARTICIPATING PLEASE DISREGARD THIS E-MAIL OREGON DEATH WITH DIGNITY ACT: PHYSICIAN PARTICIPATION KPNW has complied with implementation of the Oregon Death with Dignity Act (for Oregon residents ONLY) since it became law. The use of this law by KPNW patients and physicians has been administered by our Regional Ethics Service. Recently our Ethics Service had a situation where no attending MD could be found to assist an eligible member in implementing the law for three weeks, during which time this person was suffering and actively dying. Participation by physicians is completely voluntary. At times
a member’s primary care or specialist physician is
unwilling to participate in this process. If this happens, the Ethics Service approaches the Chief of the primary or specialty care service involved with this member, to identify another physician willing to participate. Significant time is often lost because some Chiefs do not know which of their physicians are willing to volunteer. This can be very distressing to critically ill patients and their families.
THE RESPONSIBILITIES OF AN ATTENDING PHYSICIAN: Using questions required by the law, interview the patient to determine whether he or she is appropriate to proceed with a request for medication to end life (a clinic or home visit is usually necessary for this) . There must be a second discussion with the patient in person or by phone a minimum of 15 days after first request confirming this request. If the attending physician agrees to support the request, the Ethics Service will arrange an appointment with a non Kaiser physician to independently evaluate the patient and his or her request. If the attending and the consulting physician agree that the request is reasonable, the Ethics Service will arrange for a designated Kaiser Pharmacist to assist the attending physician in writing the prescription for appropriate medications. The pharmacist will dispense and explain their use to the patient and caregiver. A representative of the Oregon Health Division will contact by phone the attending physician after the patient’s death to confirm the process and the manner of the patient’s death. This takes about 10 minutes. The Ethics Service guides Physicians through this process and makes all necessary arrangements for other requirements of the law. QUESTIONS TO PHYSICIANS: Are you willing to act as the Attending Physician under the law for
YOUR patient?
Are you willing to act as the Attending Physician under the law for members who ARE NOT your patients? IF YOU ARE WILLING TO PARTICIPATE IN EITHER # 1 AND/OR #2, Please e-mail or call Marcia L. Liberson, MPH (LIBERSONMA, 49-3781) or Robert H. Richardson, MD (503-904-7978), KPNW Ethics Service. For questions please contact either Marcia or Robert. Thank you. IF YOU ARE NOT INTERESTED IN PARTICIPATING PLEASE DISREGARD THIS E-MAIL. TO: 829 addressees CC: 2 addressees”
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