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Monday, March 8, 2004



Proposal seeks the
right to death

Lawmakers anticipate a battle
over the issue of doctor-assisted
suicide later this week


Two years after Hawaii came within just three votes of becoming the second state to allow doctor-assisted suicide, the emotional issue has surfaced at the Legislature once again.

But while the proposal being considered is much the same as the one in 2002, some of the policy-makers who will decide its fate are different.

The bill would allow a terminally ill, mentally competent adult to obtain a lethal dose of medication from a doctor for the purpose of ending his or her life. It specifically prohibits mercy killings, lethal injections and active euthanasia and requires patients to obtain informed consent.

Sixteen of the 51 House seats have changed hands since the chamber approved a similar proposal by a 30-20 vote in 2002. The House Judiciary Committee has recommended approval of the current measure, with the second of three required votes by the full chamber scheduled tomorrow.

If approved, a final House vote would take place Thursday.

The bill needs approval from a simple majority for it to advance to the Senate, where seven members of the 2002 body that defeated the proposal by a thin 14-11 vote are no longer in office.

Senate leaders say it is too early to tell how the vote might go. Four of the seven senators no longer in office had voted against the so-called "Death with Dignity" proposal two years ago.

Leaders say the seven new senators might go the same way.

"I believe those seven (new) members would probably be split on it as well," said Senate President Robert Bunda (D, Kaena-Wahiawa-Pupukea). "It depends. It depends on the debate as well. This is a very emotional issue."

While the 2002 measure passed through the House in customary fashion, there was more drama in the Senate.

Then-Senate Health Chairman David Matsuura opposed the bill and refused to even hold a hearing on it. With three days to go in the regular session, Senate members revived the House-backed proposal, only to have it defeated by the 14-11 vote on the final day.

The issue proved to be a political liability for Matsuura, whose opposition played a role in the Hilo lawmaker's loss to Sen. Lorraine Inouye in the Democratic primary later that year.

Of the seven new senators, Sens. Willie Espero (D, Ewa-Ewa Beach-Lower Waipahu) and Paul Whalen (R, Milolii-Waimea) were members of the House in 2002 and voted against the measure.

Three new members -- Sens. Rosalyn Baker (D, Honokohau-Makena), Shan Tsutsui (D, Wailuku-Kahului) and Gary Hooser (D, Kauai-Niihau) -- said last week that they would wait to see the contents of the House bill before deciding their positions.

Sen. Melodie Aduja (D, Kahuku-Kaneohe) did not return a telephone message seeking comment Friday. Sen. Gordon Trimble (R, Downtown-Waikiki) said he opposes the legislation.

"My sense is that it is inappropriate for government to be taking an action like this," said Trimble. "It's saying that this alternative, and involving doctors, is an acceptable process."

Senate Judiciary Chairwoman Colleen Hanabusa supports the legislation but said regardless of how others feel, it is important to have the public debate.

If the bill passes the House and ultimately gets referred to her committee, Hanabusa said she will hold a hearing.

"Hopefully, if it gets down to the floor, it will have all the senators weighing in and expressing their views on it -- whichever side it is they're on," said Hanabusa (D, Nanakuli-Makua). "My recollection is, one of the best debates we've ever had on the Senate floor since I've been elected has been on death with dignity.

"I think the public benefits from that debate, irrespective of what their view is on it."


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‘Death with dignity’ bill
is still controversial


Question: What is the "death with dignity" bill?

Answer: It is a measure that would allow terminally ill, mentally competent adults to obtain a lethal dose of medication from a doctor for the purpose of ending their lives. It specifically prohibits mercy killings, lethal injections and active euthanasia and requires patients to obtain counseling before making the request. It also would allow an alternate doctor to prescribe the drugs if a patient's primary physician declines.

Q: Isn't this doctor-assisted suicide?

A: The proposal allows a doctor to prescribe medication, but the doctor would not be allowed to help the patient take the medication. The patient must take the medication independently.

Q: Who would be allowed to ask for the lethal dose?

A: Terminally ill adult patients who are deemed mentally competent would be allowed to ask their doctor for the dosage. Under the proposal, terminally ill is defined as someone diagnosed with an incurable and irreversible disease that has been medically confirmed and who has less than six months to live. Nobody would qualify based solely on age or disability.

Q: Will people start coming to Hawaii to die here?

A: Under the bill, patients making the request must be residents. That is defined as a patient who has been living in Hawaii or has been physically present in the state for a continuous period of at least six months before making the request to their doctor, or can show other proof of Hawaii residency.

Q: Who supports "death with dignity"?

A: Among the groups that testified in support of the proposal were the American Civil Liberties Union of Hawaii, Compassion in Dying of Hawaii, Death with Dignity Hawaii Coalition, Hawaii Physicians for Assisted Dying, Interfaith Alliance and Planned Parenthood of Hawaii. Supporters argue that a family member with a terminal condition should not have to suffer in the last days of life and that everyone should be able to have the choice to end their life.

Q: Who opposes it?

A: The American Cancer Society, American Center for Law and Justice of Hawaii, Roman Catholic Church in the State of Hawaii, Hawaii Family Forum, Hawaii Medical Association, Healthcare Association of Hawaii and Hospice Hawaii were among the groups that submitted opposition to the bill. Opponents say that allowing assisted suicide will put Hawaii on a "slippery slope" that ultimately would lead to euthanasia and mercy killings, turning the so-called "right to die" into a "duty to die" by making elderly residents feel like a burden. Others also contend that there are not enough safeguards to ensure that abuse will not take place.

Q: Have other states approved this?

A: Only Oregon. The Hawaii proposal is patterned after the Oregon law, which was approved by voters in 1994.

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