Hawaii’s World

By A.A. Smyser

Tuesday, March 10, 1998

Dying with dignity laws put on hold

GOV. Benjamin Cayetano's Blue Ribbon Panel on Living and Dying With Dignity is going to miss getting its report to the governor in time for any legislative action this year. The idea of having a general election opinion poll on doctor-assisted death has not won favor with legislative leaders because there is no precedent for it and it possibly could unleash a rash of requests for other nonbinding polls in the future.

Citizen petition initiatives to put binding proposed legislation on election ballots, such as we have seen with doctor-assisted suicide in Oregon, where it won, and in California and Washington, where it lost, were nixed by our state constitutional conventions of 1950, 1968 and 1978.

It appears, however, that a majority of our 18-member panel may finally recommend some form of doctor-assisted death law for Hawaii.

Two approaches are being considered. The terms being used may become familiar.

The first is for Physician-Assisted Suicide (PAS), under which a doctor, after complying with strict controls to assure he or she is acting on informed request by an adult person facing intolerable suffering that cannot be palliated, could prescribe a potion to cause death. It would be up to the patient to take it.

The second is for Physician-Assisted Death (PAD) in which a lethal agent could be administered directly by a physician to a patient, for example a stroke victim alert enough to make the request but not capable of self-administration. Again this could be done only after a verified direct request by a competent patient reviewed by another doctor and a psychiatrist, and after compliance with strict guidelines.

Still not voted on by our panel is whether patients would have to be terminal, a narrow category now legal in Oregon, or in a broader category of facing intolerable suffering that cannot be cured or palliated.

Both PAS and PAD will be fought fiercely by Right to Life advocates, who have been represented at all panel meetings and who have a still-undetermined number of supporters on the panel.

PAS won a majority of 10 votes from 16 panel members at a Feb. 11 meeting. PAD is still pending. The delay is to assure full discussion by the panel. Members already have learned from public hearings and other input that there are strong divisions among our citizens.

Some witnesses spoke emotionally of their desire to have control over their own lives. Others with as much or more emotion said only God can decide when a person should die.

Foes also raise the "slippery slope" argument that any law may be used to kill people against their will. Quite conflicting data is being offered about experience in the Netherlands.

It is absolutely certain no recommendation will be made by the panel or no law ever passed by the Legislature without strict controls to prevent a slippery slope. Whatever the panel recommends will have plenty of time for full pro-con public discussion before anything like this becomes law in Hawaii, as I hope it will.

LIKELY to be obscured in any controversy are other far-reaching recommendations on which we have been unanimous. These are for much more effective pain control, much wider usage of comforting hospice care by terminally ill people, much more attention to spiritual and cultural concerns, a more specific law on advanced directives including living wills with greater emphasis on compliance, and campaigns for much wider public awareness of end-of-life options.

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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