Hawaii’s World

By A.A. Smyser

Thursday, April 9, 1998


Hawaii poll on
physician-assisted suicide

THOSE of us who favor legalizing doctor-assisted death were immensely heartened by a poll the Star-Bulletin published March 24.

The question was: "Would you favor or oppose a law which would permit physician-assisted death under carefully controlled circumstances in Hawaii?" The results showed 67 percent in favor, 20 percent opposed and 13 percent not sure. Even with the maximum probable error of 5 percent it would have been 62-25 percent in favor.

A breakdown of the results, not previously published, shows support bridges gender, ethnic and regional lines. Men favor by 72-21 percent, women by 63-18. Favorable responses came from 77 percent of Caucasians, 67 percent of Japanese, 65 percent of full or part-Hawaiians, 64 percent of Filipinos, 55 percent among mixed and 53 percent among "other." Favorable responses from Oahu and the neighbor islands both rounded out at 67 percent.

The highest negative percentage, 45, came among the 9 percent of respondents classified as of mixed ethnicity, still 55-45 in favor. A Columbia, Md., research firm compiled the results from telephone interviews with 419 people between March 12 and 17.

These favorable results are up from 55-25 in favor shown in a Star-Bulletin poll in January 1994.

I sit on Governor Cayetano's 18-member Blue Ribbon Panel on Living and Dying With Dignity. We already have had a majority vote in favor of what we call Physician-Assisted Suicide (PAS), which, like Oregon, would permit doctors to prescribe potions that terminal patients could self-administer.

Next Wednesday we may vote on a broader category we call Physician-Assisted Death (PAD) to allow doctors to directly administer fatal injections, after very careful screening, to patients who request it and are judged by at least two physicians, a psychologist and a social worker to have intolerable suffering that can be neither cured nor palliated.

This would serve patients who might, for example, be mentally alert but disabled to the extent they couldn't self-administer a potion and would not be limited to the terminally ill.

Because groups of disabled people fear they might be forced to die against their will, our proponents have inserted in our model law the protections mentioned above. It limits both PAS and PAD to patients mentally alert enough to request help in dying on at least two occasions two weeks apart.

We advocates expect minimal use -- perhaps only 250 of the 8,000 fatalities annually in Hawaii, based on experience in the Netherlands. But we think the existence of the option would provide a high comfort level to large numbers of people contemplating their demises who would never use it. Our panel unanimously recommends most dying people consider requesting comfort-giving hospice care. We also will be unanimous in saying that PAS and PAD are options only and should not be forced on anyone, including physicians.

Oregon had its first publicized legal assisted suicide March 24. Surrounded by family members and a physician in her Portland home, a terminally ill woman swallowed a prescribed medication, fell into a deep sleep within five minutes and died very peacefully half an hour later.

ASSISTED suicide has been legal in Oregon since a court decision last October and a confirming 60-40 referendum vote in favor in November, but was delayed initially by a question, since resolved, over whether the federal Food and Drug Administration would respect states' rights. Because of privacy laws, Oregon officials will not release a report on other cases until there have been 10 deaths.

Federal funds are not available for doctor-assisted deaths but an Oregon panel in February made state funds available to the 270,000 low-income residents covered under the state's health plan.

This provoked another national outcry verbalized in a Star-Bulletin editorial page column March 4 by Cal Thomas, a nationally syndicated writer. It was headlined "Subsidies for people to kill themselves."

Hawaii will face similar pro-con arguments if a measure, as we advocates hope, gets serious consideration in next year's legislative session.



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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