Melendy Lecture: The Pharmacist’s Role in Patient Self-Determined End of Life

Paige ClarkPaige Clark, director of alumni relations and professional development at Oregon State University College of Pharmacy, presented “Ethics, Policies and the Pharmacist’s Role in Patient Self-Determined End of Life” at the 2017 Samuel W. Melendy Lecture, which was held on both the Twin Cities and Duluth campuses in February.

In 1997, Oregon enacted the nation’s first Death with Dignity Act. The law allows terminally-ill Oregonians to end their lives through the voluntary self-administration of lethal medications, expressly prescribed by a physician for that purpose.

When the law was first proposed, it received a lot of scrutiny and, according to Clark, there were many extensive heated and complex conversations on individual morality, ethical and professional dilemmas, religious, medical and human rights issues. Numerous legal and religious leaders from around the world descended on Oregon to passionately share their perspectives.

“The implementation of this bill was the first time pharmacists found themselves at the nexis of a controversial issue on a national and international level,” said Clark. “Our profession was at the center of this political storm, and we chose to deal with it respectfully.”

According to Clark, it was vital for pharmacists to play an active role and have a say in the bill’s implementation.

“When Oregon’s entire health care community was directed to implement this law, that was a transformative moment for our profession,” said Clark. “That was when the media and our allied health care professionals understood that we are a partner in this, we have a role to play in this, and, in fact, we sit right in the middle of it. You can have physicians doing what they need to do, but how do you think you’re going to get these prescriptions filled? How are you going to have a successful outcome for your patient without these amazing professionals in the middle?”

Pharmacists’ specific roles include required recordkeeping and reporting of dispensing, employer notification, and complete and correct counseling of the patient, or the patient’s agent, as required on any new prescription upon dispensing of a death with dignity prescription.

Clark describes the outcomes as positive for the pharmacy profession.

“This process really was transformative for our profession because pharmacists were recognized as being an essential part of the health care team to assure patient outcome success,” she said. “During this process, it became clear to the bill’s sponsors, legislators, physicians and patient groups that pharmacists don’t just fill any prescription placed before them, nor could we be excluded from being an informed participant, and that we had a professional responsibility to assure a successful pharmaceutical outcome.”

According to Clark, Oregon’s Death with Dignity Act is a perfect example of how a state legislature mandates pharmacy practice and directs the profession, and illustrates the need for pharmacists to be engaged at the legislature.

“I implore you to participate in legislative day and other activities that bring awareness of pharmacy to state legislators,” said Clark. “It’s imperative that your generation be aware of that and participates in legislative activities when you can.”

View Clark’s entire presentation on YouTube.

The Samuel W. Melendy Lecture is named for Samuel Melendy, a staunch supporter of the College of Pharmacy in its early years, who died in 1916. Each year, a student committee composed of College Board members chooses a speaker and organizes the event, which includes the lectures and dinner.