Hospices in Oregon, where physician-assisted suicide is legal, rarely participate in the practice, according to a recent survey.

Among 55 hospices surveyed for the Oregon State University report, all reported prohibiting staff members from helping patients obtain or take fatal doses of medication. Roughly 27% reported referring patient questions about the assisted suicide law to physicians and lawyers, while 25% reported no involvement in the matters whatever. Hospice staff cited both moral and legal concerns as reasons to stay away from the law. Some felt the practice ran counter to the hospice mission of not hastening or delaying death, the Los Angeles Times reported.

The OSU authors say that hospices are the appropriate setting to ensure that physician-assisted suicides are carried out properly. The hands-off approach taken by the state’s providers could be problematic for patients wishing to avail themselves of the law, according to the study published in Thursday’s Hastings Center Report.