Aspen Valley Hospital hospital opts out of End of Life law for now
December 19, 2016
Aspen Valley Hospital's board of directors voted unanimously Monday to not be a facility that participates in providing life-ending options for terminally ill individuals.
Even so, the board kept the possibility open to opt into the End-of-Life Options law at a later date.
The board convened at a special meeting called by hospital CEO David Ressler. On Friday, Gov. John Hickenlooper signed Proposition 106 into law, making it effective immediately. Colorado voters passed the End-of-Life Options law measure by a 2-1 margin in November, with 85.5 percent of the Pitkin County vote in favor.
Board members spent little time discussing the decision to opt out for the time being, following a presentation by Ressler and other staff members. The law requires hospitals to either opt in or opt out.
Ressler advised them to vote against it with the intent to opt in at a later date.
"Depending on whether we opt in or out, we then have to notify our patients in advance, which means that they then would have reason to expect the services or not associated with that decision," he said, adding that "we need to make a decision fairly quickly, because we don't want to put the hospital in an awkward position, or our patients in terms of what they can expect."
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Ressler emphasized that the hospital, if it decided to opt in, was not prepared to be a participating facility because of the complexities involved. "We can't afford to have one patient have a poor experience with this," he said.
The hospital would have to create an end-of-life policy, which Ressler said he intends to work on to be prepared to opt in in the future.
Lori Malloy, the hospital's chief clinical officer, noted details would include bringing on board pharmacists, nurses, a compliance officer, ambulance services and attorneys, while also working with hospice. No individual is required to have a role in an end-of-life procedure, and Malloy noted that "it's important that we have a committed team that would support this process if we implemented this at the hospital."
"This isn't something we can just say, 'Yes, let's opt in, and let's start tomorrow,'" she said.
The hospital's Medical Executive Committee supported opting in.
"The physicians would like to recommend that the hospital opt in because of the result of the county vote and wanting to support what the community was in favor of," Dr. Catherine Bernard said. "That said, certainly it's important to remember that each individual physician can opt out, and I think a majority of these patients will be involved with hospice, their primary care physician … and at home. There are a few physicians who have expressed that they would certainly not want to be involved in this end-of-life act, and there are certainly those physicians who feel that the hospital should be there for community members that would be interested in pursuing this. But we all feel this is a very fast decision and it has to be done appropriately and for the best for patient care."
Under the Colorado End-of-Life Options Act, terminally ill Colorado residents can request medication from their physician. The patients must be at least 18 years old, have a prognosis of six months to live and have at least two physicians conclude they are mentally capable of ending their life, among other requirements. They must also self-administer the medication.