HMO query reignites assisted-suicide controversy

Oregon's Kaiser says it needs referrals for patients who ask about suicide. Anti-suicide advocates say the HMO wants to save money on long-term care.

By Andis Robeznieks, AMNews staff. Sept. 9, 2002.

An e-mail sent to some 740 Oregon physicians affiliated with Kaiser Permanente NW is being cited by an anti-assisted suicide organization as proof that HMOs would rather offer patients help committing suicide than pay for palliative care.

The e-mail, sent out Aug. 6 by Kaiser Permanente NW's regional ethics service, asks doctors who are willing to act as attending physicians if a person requests assisted suicide to notify Kaiser Administrator Robert Richardson, MD. According to the e-mail, Kaiser needs the information because a patient had asked about assisted suicide and no physician could be found to process the request.

"Recently our ethics service had a situation where no attending MD could be found to assist an eligible member in implementing the law for three weeks, during which time this person was suffering and actively dying," the e-mail stated.

According to the e-mail, participation in physician-assisted suicide is voluntary, and when the patient's primary care or specialist physician is unwilling to participate, it is up to the chief of the physician's primary or specialty care service to find someone who will.

"Significant time is often lost because some chiefs do not know which of their physicians are willing to volunteer," the e-mail stated. "This can be very distressing to critically ill patients and their families."

The president of Physicians for Compassionate Care, Gregory Hamilton, MD, a Portland psychiatrist, said he was glad the HMO had such a difficult time finding a doctor willing to participate in an assisted suicide -- even though it's allowed in Oregon if a patient has been diagnosed by two doctors as mentally competent and having less than six months to live. [...]