Yesterday's U.S. Supreme Court decision on physician-assisted suicide throws the issue back to the states. And Maryland is already one step ahead.
Staff members at the state attorney general's office and the Johns Hopkins University Bioethics Institute are teaming up to investigate local and regional influences on the care of the dying.
Through community meetings and focus groups, they will create a forum to look at physician-assisted suicide, but also at the larger, complex web of issues surrounding end-of-life care. They will examine everything from hospital policies to state regulations relating to pain medication.
"Maryland is taking the lead on this," said Ruth Gaare, associate director of the Bioethics Institute and a hospice-trained educator and volunteer.
While legislative proposals on both sides of the issue have been made in the past few years, Maryland has no state law on assisted suicide.
Maryland's primary state law applying to terminally ill patients was passed in 1993. Among other items, the Health Care Decisions Act empowers families to make decisions and recognizes the rights of physicians not to provide medically ineffective care at the end of a patient's life.
For their project, state and university officials are developing a standard way to interview health workers in Maryland about why so many people die in needless pain, why patients don't discuss preferences for end-of-life care with their physicians, and a host of other issues. They are to collect data that eventually, along with a state advisory board and public conference, will help guide decisions.
"We're going to try to make sure that nothing in Maryland law is standing in the way of excellent care at the end of life and to try and find ways in which the legal system can support the caregivers who are trying to provide the excellent care," said Jack Schwartz, chief counsel for opinions at the attorney general's office, who is coordinating the project along with Gaare.
Schwartz said yesterday's high court ruling, which emphasized the value of palliative care, underscores the value of their project.
Pub Date: 6/27/97
