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Hawaii’s World

By A.A. Smyser

Thursday, September 28, 2000


Assisted death
is on the ballot
in Maine

TUESDAY I wrote favorably about Hawaii's ballot question No. 1 for Nov. 7 -- whether to insert into our state Constitution a provision that the University of Hawaii shall have autonomy over its own affairs. The state of Maine's ballot question No. 1 also may have long-term significance here. It is on allowing terminally ill patients to opt to shorten their lives with self-administered medications.

Supporters are optimistic of a victory but say they expect the Catholic Church to spend large amounts to defeat it. That spending will be focused on the remaining 40 days. Oncologists, who treat cancer, also are advertising against it.

The cause gained a prestigious endorsement from the editor of the influential New England Journal of Medicine, Maria Angell. She stated that relieving suffering is more important than extending life.

The Maine legislature refused to put the assisted death question on the ballot, but it got there by way of a citizen initiative that collected some 52,000 signatures, about 10 percent more than required.

The city editor of the newspaper in Maine's biggest city, Portland, is Linda Fullerton. She notes that by-passing the legislature with a ballot initiative has had previous successes in Maine, most recently to legalize marijuana for medical purposes.

Should a yes vote prevail in Maine, America then will have two states where assisted death is legal -- Oregon and Maine. Usage in Oregon has been for far less than 1 percent of all deaths -- by 16 persons in 1998, by 27 in 1999. Figures are announced only after a year ends. Names are confidential.

With East Coast and West Coast states as anchors -- should Maine say yes -- the assisted-death movement would be in a good position to offer examples that should encourage more states to follow.

Governor Cayetano formed a panel in 1996 that in 1998 recommended Hawaii also allow assisted death. I was in the 11-7 majority that would provide it, under strict controls, to persons with intolerable suffering that can neither be cured nor palliated.

We left out the "terminally ill with less than six months to live" requirement that is law in Oregon and proposed for Maine. We joined with a national blue-ribbon panel that considered unrelievable intolerable suffering deserving of the option of death even if the patient is not terminal.

COMMITTEES in both houses of the Hawaii legislature heard our proposal but never brought it to a floor vote.

A victory in Maine might reinvigorate us for another try in 2001. Governor Cayetano is in favor. Opinion polls show a comfortable margin of public support. The Catholic Church will remain our major roadblock. It works to have strong influence with key legislators.

In Oregon, in the Maine referendum and in the Hawaii proposal the safeguards are many-tiered.

The Maine initiative requires two physicians to certify terminal status, an opinion by a physician familiar with the patient's disease, consultation with both a palliative care specialist and a licensed counselor, two personally communicated requests from the patient plus one written one, a 15-day waiting period plus a final 48-hour waiting period. Phew!

The proposal for Hawaii is similarly wrapped in provisions to prevent abuse. My long-term hope is that experience will allow these to be simpler in the spirit of mercy.



A.A. Smyser is the contributing editor
and former editor of the the Star-Bulletin
His column runs Tuesday and Thursday.




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