We often hear from doctor-prescribed death advocates that assisted suicide legalization improves palliative care. It’s not true. Increased attention to the issue, e.g. hospice and public and professional education programs do. Indeed, about a decade ago, Rhode Island outlawed assisted suicide and also passed a law that aggressive palliation that accidentally resulted in death would not be considered a crime. The use of morphine by doctors for pain patients shot through the roof.
A new article by palliative care published in the Journal of Palliative Medicine, grades states on their hospital palliative care programs. Here is how the assessment criteria were defined. From “America’s Care of Serious Illness: A State-by-State Report Card on Access to Palliative Care in Our Nation’s Hospitals:”
Specifically, in 2011 we examine: 1. Patient access to palliative care services in hospitals; and 2. Patient access to board-certified palliative care professionals (e.g., physicians and nurses). Hospitals containing 50 or more beds are the primary focus of the 2011 Report Card.
And here are the top ten states and DC, with their percentages of hospitals that have palliative programs, along with the legal status of assisted suicide. Note that assisted suicide is illegal in the top five states. (Assisted suicide is not mentioned the article, but the following is my extrapolation:)
1. District of Columbia 100% Coverage Assisted Suicide Illegal Common Law
2. Vermont 100% Coverage Assisted Suicide Illegal Statute
3. Nebraska 93% Coverage Assisted Suicide Illegal Statute
4. Maryland 90% Coverage Assisted Suicide Illegal Statute
5. Minnesota 89% Coverage Assisted Suicide Illegal Statute
6. Rhode Island 88% Coverage Assisted Suicide Illegal Statute
7. Oregon 88% Coverage Assisted Suicide Legal Statute
8. Washington 83% Coverage Assisted Suicide Legal Statute
9. Ohio 80% Coverage Assisted Suicide Illegal Public Policy
10.New Jersey 80% Coverage Assisted Suicide Illegal Statute
Montana, where the legal status of assisted suicide is murky due to a terribly written and reasoned Montana Supreme Court decision, has 67% coverage.
The good news from the report is that palliative care is improving:
Since our last report, the overall prevalence of hospital palliative care teams among hospitals with 50 or more beds increased 13.3% in the Midwest, 21.7% in the Northeast, 23.7% in the South, and 29.3% in the West. The cumulative national average is 63% (1568/2489 study hospitals).
Clearly, there is more work to do, but things are heading in the right direction. Reality check: Legalizing assisted suicide has nothing to do with it.
