COLUMBUS, Ohio (WCMH) — Doctors can provide comfort care to patients in pain even if it may appear to increase the risk of the person’s death if it’s done in good faith according to Ohio laws.
Comfort care is a central point in the trial of Dr. William Husel, 46, who is facing murder charges in the deaths of 14 patients under his care at the former Mount Carmel West hospital from 2015 to 2018. He has pleaded not guilty to all charges.
The law (sections 2133.11 and 2133.12 of Ohio Revised Code) protects medical staff when giving treatment “for the purpose of diminishing the qualified patient’s or other patient’s pain or discomfort and not for the purpose of postponing or causing the qualified patient’s or other patient’s death.”
A doctor who works in Oregon, where they have medical-aid in dying, spoke with NBC4 about comfort care and how his state’s laws help to clarify comfort care, protecting and supporting patients.
Dr. Nick Gideones is an associate professor of family medicine at Oregon Health and Science University. He’s been in practice for 27 years and currently works as a hospice medical director.
NBC4: What is a doctor’s responsibility to offer comfort care, and does that vary state by state?
Gideones: Yes, and there’s a variety of factors that will impact that, like various board findings in your individual state or laws. But generally, we have the duty to relieve suffering when able.
There are certainly constraints on using medications that can have bad side effects or unintended consequences. For example, we have very specific federal regulations around using opiates for pain relief.
Balancing those interests is always an individual decision with a physician and a patient, but again, we have the in-general principles. We have the duty to do the least harm possible, the first do no harm, and the duty to relieve suffering.
NBC4: What is medical aid in dying? Can you explain that, please?
Gideones: It’s where a prescription is specifically written to end suffering, where it’s going to be a lethal dose of medication that the patient will self-administer or self-ingest. These laws vary somewhat state by state, and the general trend is to relax restrictions.
But generally, there is some need for a repetitive request, maybe a waiting period. The patient absolutely needs to have a terminal illness already. In other words, they are already dying.
And to be autonomous in their decision making, and competent in their decision making, fully understanding the risks and benefits of using medicine in this way to relieve suffering with a physician’s order.
One of the great advantages we’ve seen in states with this law is a decrease in suicide rates among patients who are in palliative or terminal care, for example, or complex situations with physicians where it’s unclear what their intent has been.