The indefatigable Wesley J. Smith, the bioethics correspondent for the National Review, has noticed a significant policy recommendation in the annual report on assisted suicide to the Hawaii legislature. It passed unnoticed even in local media.
Since legalisation, a total of 59 people has died after taking advantage of the Our Care Our Choice Act: 27 in 2019 and 32 in 2020.
Hawaii reports even less information than Oregon. Nothing about the time to unconsciousness or the time to die. Nothing about the reasons for choosing assisted suicide. Nothing about who was present.
Surprisingly, despite the novelty and transcendental importance of legalised suicide, the report is extremely casual and is sloppily written. A table lists 25 cases of people who died following self-administration with some sketchy information about their age, race, sex, education, and underlying condition. The table is not labelled but presumably relates to the year 2020. However, there were 32 deaths in 2020, not 25. A note says that information from 4 people is missing. But 25 + 4 is 29, not 32. Did the other 3 die of natural causes befor they took the drug? It's not clear.
The figures can be interpreted differently. Richard Egan, an Australian observer of euthanasia trends, says, "the four people with missing data means that it is unknown whether or not they have died so it should be added to the 32 reported dead to equal 36 out of the 37 for whom prescriptions were written. It is unclear what the status of the 37th person is -- perhaps they know the person is still alive."
The Our Care Our Choice Act was not very prescriptive about how the health department was supposed to monitor deaths under the Act. An “advisory group” is supposed to “provide advice to the department” – but no board meetings were held in 2019 or 2020, according to the annual reports. Who is looking after compliance with the legislation? Is anyone?
Notwithstanding the lack of information and lack of supervision, in both years the Department of Health recommended relaxing the legislation:
In closing, the DOH recommends the following changes to the OCOCA. 1. Waiver of any waiting periods if the attending provider and consulting provider agree that patient death is likely prior to the end of the waiting periods. 2. Given access to health care providers is limited, the DOH recommends authorizing advance practice registered nurses to serve as attending providers for patients seeking medical aid in dying.
Smith’s blistering comment was: “Please understand, dear readers, that when assisted-suicide advocates promise strict guidelines to protect against abuse, they don’t really mean it. The promise’s purpose is to get the law passed, not to be kept … Calling Hawaii’s bureaucrat death-pushers the “Department of Health” is akin to the totalitarian government in 1984 calling its torture and brainwashing department the ‘Ministry of Love’.”
Given the lackadaisical standards of the Hawaii Department of Health, that seems like a fair comment.
Michael Cook is editor of BioEdge
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