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Jackie Mishler

Thursday, February 19, 2004


Physician-assisted suicide
will create a new set of victims



Advocates for physician-assisted suicide (PAS) seem modest in asking only for "open discussion" of the issues. What they don't say is that their "modesty" is from losing for four years running in fair and open political debate in legislative hearings and committees and on the floors of both the House and Senate.

For example, the Hawaii Legislature held extensive hearings on physician-assisted suicide during the 2001 and 2002 sessions, and PAS died in a Senate committee. Then, after losing in committee, today's defenders of "open discussion" used a rare parliamentary maneuver to force a vote in the full Senate, where they lost again.

I am a concerned nurse, and I have spent many dozens of hours in legislative hearings about PAS, so I don't believe in the sincerity of calls for "open discussion." What PAS advocates simply don't want to face is that they already have lost. There is no interest in PAS at the Legislature this year for one simple reason - it won't play politically because a clear majority of constituents strongly oppose PAS.

Hawaii is one of 49 states that doesn't buy PAS as a solution. Oregon alone legalized physician-assisted suicide, but only on the second try, and only when boosted by massive funding by the Hemlock Foundation. Hemlock wants Hawaii next, so there's plenty of mainland money and organization at work here now too. Hemlock names Hawaii as one of two targets in a Nov. 23, 2003 fund-raising letter, and has a goal of spending $250,000 on media advertising alone.

Physician-assisted suicide is subject to unforeseen consequences and uncontrollable abuse. So-called safeguards are window dressing, particularly in protecting the elderly from those who will benefit from their deaths.

For example, Kate Cheney and her daughter asked a physician in Oregon to prescribe pills to end her life. The physician turned them down because he noted the request came from the daughter, not the patient.

The daughter then took her mother to a second doctor, and he refused for the same reason and the mother's dementia. The daughter became angry with the doctor and called a suicide-advocacy group. She was sent to a cooperative doctor who provided the pills. Kate Cheney was put into a nursing home for a week, returned home, and died by suicide within 24 hours.

Kate Cheney is representative of the inevitable "new victims" of PAS. The New York governor's task force studied these issues for more than seven years, and, despite some strong PAS sentiment among the members, unanimously recommended against PAS.

Why unanimous? All members agreed that PAS was uncontrollable in the real world - even those who felt PAS was theoretically desirable voted against the legislation because it would cause more harm than good. Both the Hawaii Medical Association and the Hawaii Nurses Association agree, and both oppose PAS.

As a nurse, I am, of course, aware of previous inadequacies in pain-management and compassionate, palliative care. But there is new hope as medical opinion becomes more informed, as pain-control techniques are perfected and as progressive legislation addresses real issues in pain control and patient autonomy.

Let's treat pain and suffering, not bury it along with the sufferer. Let's not undermine real compassion, and take away funding for pain management as happened in the Netherlands when suicide was assisted and euthanasia made available. And let's not create new victims among the disabled, the underserved and those who can't speak for themselves. The answers are complex, and take hard work - not the magic wand of the Hemlock Foundation and its Hawaii emissaries.


Jackie Mishler is a registered nurse who managed a senior citizens' center for five years. She conducts education seminars in advance directives and other end-of-life issues. She lives in Kula, Maui.

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