About once a week, healthcare providers call the 24-hour palliative-care hotline at the University of Vermont Medical Center with the same basic question: How should they respond to patients who want to take advantage of the state's new law allowing physicians to prescribe lethal drugs to terminally ill patients who want to die?
Dr. Diana Barnard, the hospital's interim medical director of palliative-care services, sees it as an opportunity to help doctors explore their dying patients' concerns. She says the law has raised awareness about improving end-of-life care. The 2013 law “brought with it a whole parallel movement to try to more broadly look at the needs of people facing serious illnesses at the end of their lives,” said Barnard, a proponent of physician aid in dying.
Many healthcare professionals and patient advocates, regardless of their stance on the emotionally charged issue, hope the recently reignited national debate over physician-assisted suicide will boost awareness and use of palliative care and hospice care. Palliative care is patient- and family-centered care in which an interdisciplinary team focuses on easing patient suffering; hospice is palliative care delivered near the end of life.
Some think public discussion about legalization of physician-assisted suicide has led to the expansion of palliative and hospice care. Others don't see any connection.
Between 1994 and 2013, hospice use surged, with 1.5 million Americans receiving hospice care in 2013, compared with only 246,000 in 1994, according to the National Hospice and Palliative Care Organization. But barriers to more widespread use of hospice and palliative care remain, including what experts say is insufficient Medicare reimbursement for palliative care and rules that hinder patient referrals to hospice.