HMA shifts toward accepting end of life legislation

The Hawaii Medical Association will not oppose passage of a “death with dignity” bill this legislative session.


The Hawaii Medical Association will not oppose passage of a “death with dignity” bill this legislative session.

The association has gotten more comfortable with the idea of such legislation, although it has yet to offer direct support.

“Historically, we’ve been opposed to this,” said Executive Director Dr. Christopher Flanders.

But, with the development of hospice care, the addition of safeguards to bills under consideration and the ability of doctors to opt out, Flanders said, “sometimes the writing’s on the wall, and we have to accept that.”

Flanders himself recently experienced a loved one’s end of life journey, and he is particularly appreciative of hospice services.

“There aren’t enough o’s in the word ‘good’ to describe the care,” he said.

Hospice helps with patient comfort and coaches loved ones during the dying process and after a hospice patient dies. But it’s not a repository for people wishing rapid death due to discomfort.

Rather, hospice provides “palliative care,” a term used to describe services to make the person as comfortable as possible — and to provide as high a quality of life as possible — during the dying process.

Some HMA doctors are comfortable with death with dignity legislation that would make prescriptions for life-ending medicine legal. Terminally ill patients, with a prognosis of less than six months to live, would request the medicine and self-administer it to avoid prolonged, unbearable pain.

While some doctors would not want to participate if a bill passes, Flanders said, many are beginning to come around to the idea of speaking openly with their patients about the final stage of life.


“We’re going to try to stay neutral on it,” Flanders said, emphasizing, “that doesn’t mean we don’t care.”

Email Jeff Hansel at

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