Courses and Information

Non-oral Self-Administration: A guide for bedside clinicians managing the procedure

The Academy has gathered data showing that rectal, feeding tube, or ostomy administration of aid-in-dying medications is safe and effective when patients are carefully screened, prepared, and supported. Clinicians can minimize potential complications by specific evaluations and preparations.

The Academy highly recommends that all patients considering aid in dying enroll in hospice care, especially those who may need support for non-oral self-administration. Terminally ill patients’ conditions can change rapidly, and good palliative care and realistic contingency plans are essential.

Monitoring and preparing patients for non-oral routes of administration requires expert clinical attention and collaboration between attending/prescribers and bedside clinicians. Non-oral routes of self-administration require a doctor or (hospice) nurse to be present to manage this more complex medical procedure. End-of-life doulas can provide additional and often essential support but are not licensed to help with this procedures. Some hospices permit and train their nurses to insert rectal catheters when needed and ordered by a provider.

Please use this link for referrals to hospices or other providers who can manage non-oral routes.

The patient must self-administer the aid-in-dying medications to themselves by pushing the medications into their GI tract using a feeding syringe or by releasing a clamp orally or manually. As a reminder, per the laws, the patient must have mental capacity on the planned day of death and must depress the feeding syringe plunger or release the clamp without assistance.

Detailed Information and Guidance for Clinicians:

Data on Efficacy of Rectal Self-Administration

Data

Teaching and supporting best practices for the care of patients considering or completing medical aid in dying.

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