Our Care, Our Choice Act (End of Life Care Option)

What is the Our Care, Our Choice Act?

The Our Care, Our Choice Act (OCOCA) is a Hawaii law that permits eligible adults to access medical aid in dying. Hawaii’s Our Care, Our Choice Act went into effect January 1, 2019.

What is Medical Aid in Dying (MAiD)?

Medical aid in dying is a practice in which a mentally capable adult with a prognosis of six months or less to live may request a prescription for medication which they can choose to self-ingest to control the time, place and manner of their passing.

Patient Eligibility Requirements

  • Terminally ill with a prognosis of 6 months or less to live
  • Adult, 18 years or older
  • Hawaii state resident
  • Found to be competent to make informed health care decisions by a licensed mental health provider
  • Capable of self-administering the medication

Eligible Providers

The Our Care, Our Choice Act requires patient consultation with three healthcare providers. As of June 1, 2023, Medical Doctors and qualified Advanced Practice Registered Nurses (APRNs) are authorized to serve as Attending or Consulting Providers. Advanced Practice Registered Nurse (APRN) with a psychiatric or clinical nurse specialization, Psychiatrists, Psychologists, Licensed Clinical Social Workers, and Licensed Marriage & Family Therapists are authorized to serve as Mental Health Providers (Counseling Provider).

Provider Collaboration and Engagement

The Department urges interested patients to begin conversations with their healthcare provider as early as possible. The Department also encourages patients and providers to explore the supportive continuum of end-of-life care including hospice and palliative care.

Participating in the Our Care, Our Choice Act is strictly voluntary for healthcare providers; however, the Department of Health urges all providers to anticipate patient needs. Given a participating provider’s right to privacy, the Department of Health does not maintain a list of participating providers or provide referrals.

Extensive Outreach Efforts
Community educational webinars for healthcare providers were produced by Compassion & Choices (C&C) a not-for-profit entity with no affiliation with the Department of Health. Webinars may be accessed here. But note that the information and opinions presented are not those of the State of Hawaii.

Session 1:  Roles & Requirements of the Law : https://youtu.be/r-JQ6pL7G0o

Session 2:  The Mental Health Evaluation and the Medication Process:  https://youtu.be/Mv6lM8fizGU

Session 3:  How OCOCA Works – Case Studies & Care Surrounding the Patient:  https://youtu.be/fhYIDAdo_cw

Required Forms, Web Resources
The Our Care, Our Choice Act requires participating providers to submit DOH required forms to the Department of Health for annual reporting. Downloadable forms and online resources are available for both providers and patients; refer to the applicable links on the right side of this webpage.

View the Our Care, Our Choice Act in its entirety here.