End-of-Life Care: Medical Aid in Dying.

Medical aid in dying (MAID) is a practice in which a physician provides a competent adult with a terminal illness with a prescription for a lethal dose of a drug at the request of the patient, which the patient intends to use to end his or her life. MAID currently is legal in nine states and the District of Columbia. The most common concerns leading to requests for MAID include loss of autonomy, loss of ability to participate in activities that make life enjoyable, and loss of dignity. MAID remains controversial. Physicians can choose not to participate in MAID and many are prohibited from participating by their employers. Family physicians should have the knowledge and skills to respond to inquiries about MAID in a compassionate, patient-centered manner. Clinicians should be familiar with the legal status of MAID in the state in which they practice, understand eligibility requirements for participation, have access to resources to support patients and clinicians, and be able to apply various communication strategies to MAID discussions. A thoughtful exploration of what led the patient to inquire about MAID will allow the physician to better understand and respond to patient concerns regarding the final months of life

Options of Last Resort: Palliative Sedation, Physician Aid in Dying, and Voluntary Cessation of Eating and Drinking.

Some patients with terminal and degenerative illnesses request assistance to hasten death when suffering is refractory to palliative care, or they strongly desire to maximize their autonomy and dignity and minimize suffering. Palliative sedation (PS), voluntarily stopping eating and drinking (VSED), and physician-assisted death (PAD) are possible options of last resort. A decision to choose PS can be made by an informed surrogate decision maker, whereas intact decision-making capacity is required to choose VSED or PAD. For all palliative treatments of last resort, the risk of harm is minimized by the use of checklists, and establishment of policies and procedures

Webinar: Palliative Care and COVID-19: Implications for Clinical Practice, Part Three

The Catholic Health Association and the Supportive Care Coalition co-hosted this one hour webinar for palliative care teams being impacted by COVID-19. This is a continuation of our presentations on March 26th and April 2nd and discusses the ongoing challenges being faced by palliative care teams during the COVID pandemic

Medical Aid in Dying: Challenges and Solutions

Medical aid in dying (MAID) is currently legal in ten US states and the District of Columbia. The most frequent reasons for requesting MAID are typically loss of autonomy, decreasing ability to participate in pleasurable activities, impaired quality of life, and loss of dignity. As of 2021, nearly 20% of hospital beds in community settings nationally are provided by a religiously affiliated healthcare organization. In Washington State, over 45% of Washington state\u27s hospital beds are in facilities that are under religious directives, In most of faith based systems, developing a compassionate and appropriate response to patients who request MAID has been challenging, raising both clinical and public health challenges and concerns regarding how health care providers, institutions, and medical systems will handle requests for AID. This webinar will present the current landscape of MAID in Washington state and use case studies from three different faith based systems to explore these challenges and suggest some possible strategies and solutions. Panelists include: Hilary Walker, Advance Care Planning Coordinator, PeaceHealth Judy Kinney, Executive Director, End of Life Washington, Seattle, Washington Gregg Vandekieft, Executive Medical Director, Palliative Practice Group and TelePC, Providence Institute for Human Caring, Olympia, Washington Barbara Morris, Geriatrician at STRIDE Community Health Center, Denver, Colorado and will be moderated by Devyani Chandran, Director, Palliative Care Institute, Western Washington University, Bellingham, Washington Accreditation Statement: This activity has been planned and implemented in accordance with the accreditation requirements of the Washington State Medical Association through the joint providership of PeaceHealth St. Joseph Medical Center and Western Washington University Palliative Care Institute. PeaceHealth St. Joseph is accredited by the WSMA to provide continuing medical education for physicians. PeaceHealth St. Joseph designates this live activity for a maximum of 2 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. This activity meets the criteria for up to 2 hour of Category I CME credits to satisfy the relicensure requirements of the Washington State Medical Quality Assurance Commission