Hawaii’s World




By A.A. Smyser

Thursday, March 6, 1997


Better to call it
doctor-assisted death

MANY reports on the momentous case before the U.S. Supreme Court say it is about doctor-assisted suicide. To talk of doctor-assisted death would be better.

Suicide is a loaded word. It brings up images of jumping off high places, shooting oneself, drinking insecticide, drowning, setting oneself afire, hanging, putting a plastic bag over one's head or furtively assembling a concoction of drugs that may only make things worse.

To say "suicide" muddies the important distinction between what is before the Supreme Court and the methods of death I mentioned above.

The right-to-die movement wants to save very ill people from awful alternatives if they prefer death. It wants to end their need to be furtive and alone in their final moments.

It wants to allow them to have loved ones on hand, even to have a farewell party.

It wants to allow them to be reasonably sure death can be achieved with dignity and little discomfort.

Is this too much to ask in a society that considers itself humane and accords humane deaths even to many sentenced murderers? I think not.

My views on this have appeared in this column numerous times. They often been reprinted in the Hawaii Medical Journal. I have been disagreed with but usually respectfully. Words of support are far more numerous.

Nationally syndicated columnist Ellen Goodman seems to be on to something when she describes this as an issue that can be discussed with civility, in contrast to the high and sometimes violent emotions over abortion.

Why the difference? Goodman noted that pregnancy and abortion are strictly a woman's issue whereas Justice Sandra Day O'Connor described dying as "an issue that affects every one of us, young and old, male and female."

In any event civility over assisted death is very welcome.

The U.S. Supreme Court may not find a right to die in the U.S. Constitution the way it found a right to abortion. But it already has recognized a right to refuse medical care, a step along the way to doctor-assisted death.

The court possibly will leave this up to the states. Most now have laws against assisted death but public opinion is moving the other way. In an untested statute Hawaii makes it the crime of manslaughter to intentionally cause another person to commit suicide. If there were a test, there could be quite a debate over what "cause" means.

Nevertheless, rules like this inhibit humane help in dying. They deter doctors.

Gov. Ben Cayetano has appointed an 18-member Panel on Living and Dying With Dignity. He has balanced it with people of diverse perspectives including a Catholic nun, a Jewish rabbi, a former Buddhist bishop and even me.

WE have chosen a highly respected chairman, Hideto Kono. He grew up in a plantation community on the Big Island, was a U.S. Army interpreter in World War II, held business positions in Japan and Honolulu, then headed what is now the state Department of Business, Economic Development and Tourism and the Public Utilities Commission before going on to be president of the Japan-America Institute of Management Science.

Catholics started Hawaii's hospice movement nearly 20 years ago. Eight hospices now assist in bringing comfort and dignity to about 1,300 dying people statewide every year. It is a wonderful movement. Still, some of us think there are people who lie outside its scope, maybe 200 or 300 a year, who may want doctor-assisted deaths.

This is one of the key things the commission will be seeking information on as we work up to making recommendations. Our final report may come at year-end. The U.S. Supreme Court should render its verdict by June. That will guide us. I expect we can be unanimous in quite a few areas but will be divided on a crucial one or two. I hope we and the community can retain our civility as we debate.



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




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