Legal & Ethical Issues
Shangrila Hospice is committed to service, within the legal limits of California law. While some states, namely Oregon and Washington have passed Death with Dignity acts, the California legislature has yet to follow in their progressive footsteps. However, we work within our state’s legal limits to provide innovative, compassionate end-of-life care.
People can give written directions called advance directives about the type of care they do and do not want to receive when dying. Advance directives are legal written agreements that will be honored in the future when people can no longer communicate their wishes. For example, advance directives can prohibit resuscitation (the act of trying to revive a person whose heart has stopped) or tube feeding, if this is the person's wish. Advance directives may be in the form of a living will, which expresses the person's preferences for medical care; a durable power of attorney, in which the ill person designates another person to make health care decisions; or both. In most states, less formal decisions made during advance care planning among a person, family, and doctor are also powerfully helpful in shaping care to suit the person's preferences.
Suicide is Not an Option
Although very few people actually take any steps toward causing their own deaths, many dying people at least consider suicide—even more so as the public debate about assisted suicide grows. Discussing suicide with your doctor may help sort out the issues and often correct certain problems that prompted consideration of suicide.
Our Shangrila hospice team can increase efforts to control pain, depression, and other troubling symptoms. Other members of the care team, such as chaplains, social workers and bereavement counselors, can assure the person and family that they are cherished and help them find meaning.
Nevertheless, some people opt for suicide to relieve an intolerable situation or to retain control of when and how they wish to die. Most people find that they have enough control by refusing treatments that might prolong life, including feeding tubes and ventilators. Always remember that making the decision to forgo life-sustaining treatment is not considered suicide. The Shangrila Hospice team is experienced in palliative care.