Survey shows why
the ill really choose
death with dignity


A report in a medical journal indicates that patients sought help in ending their lives to control their circumstances.

OPPONENTS of physician-assisted suicide typically portray mentally depressed patients being pressured by relatives to submit to lethal prescriptions to end the financial burdens being placed on their families. Hospice nurses and social workers in Oregon, the only state where it is legal, say patients who asked their doctors to help them commit suicide generally were neither depressed nor worried that they could become a burden to their families. That is why the law in Oregon is appropriately called the Death with Dignity Act, and why a similar law should be enacted in Hawaii.

According to a survey of 306 nurses and 91 social workers, the most important reason for terminally ill patients to request help in ending their lives was to control the timing and manner of their death. Depression, lack of social support and fear of being a financial drain on family members were the least important reasons, according to the survey.

"It's surprising how we found so little variation with regard to this characteristic, almost as if the nurses and social workers were all seeing the same patient," said Dr. Linda Ganzini, an Oregon Health & Science University psychiatry professor who led the study, published in the New England Journal of Medicine.

More than 90 terminally ill patients, most with cancer, have used the Oregon law since it went into effect in 1997. A similar bill in Hawaii was approved by this year's House but narrowly rejected by the Senate.

Rep. William Stonebraker (R, Hawaii Kai) suggested enactment of the measure would lead to elderly patients feeling they have "a duty to die" to avoid hardship on their survivors. Sen. Norman Sakamoto (D, Salt Lake) argued that the bill would "equip everyone in this state with the trigger," allowing them to tell suffering loved ones, "Pull the trigger."

The survey of the Oregon hospice workers shows that such statements do not reflect the real concerns of the terminally ill about losing control in their final days.


New rules may save
ancient building craft


Maui County drafts building codes to govern construction of grass huts.

PRESERVING the craft of assembling grass dwellings and encouraging the growth of native plants used in them are worthy goals in Maui County's plans to allow construction of Hawaiian huts. Although meshing traditional methods and materials to modern building codes may be difficult, the effort could result in perpetuating a form of architecture linked historically to the islands.

To complete the codes and set requirements, the county needs to conduct engineering studies and will ask the state Legislature to approve a $23,000 appropriation for them. Lawmakers should do so; the small amount of money is well worth sustaining building techniques that experts say could be lost in another generation.

The county, which began exploring the concept more than two years ago when the Maui Council approved a bill to develop codes for such structures, has drafted rules that would eliminate time-consuming variance requests for the dwellings that are indigenous to Hawaii.

Building codes and requirements for construction materials are in place primarily for safety reasons. The county has had to adapt its rules to include plant products, but because there are no standards or determinations of the strength and durability of grass and woods commonly found in Hawaii, it will have to conduct studies. Although the studies may benefit only Maui initially, Hawaii and Kauai counties also have indicated interest in the results as officials there consider similar allowances for grass huts.

Because of safety concerns, the grass and wood buildings on Maui would be allowed for limited purposes, such as sleeping and storing canoes, and be restricted to a maximum of 30-by-60 feet. Anecdotal evidence holds that native structures can withstand storms and hurricanes as well as or better than Western structures, but no one has been able to substantiate this.

That aside, the new codes would enable public works projects to incorporate some native designs that would appeal to visitors and residents alike. They could stimulate a demand for plant materials used in the structures, such as pili grass, which is now scarce in the islands.

No one expects that new neighborhoods of grass huts will be the result. Constructing a grass house is an arduous, labor-intensive, expensive endeavor. Lashing poles for the frame and tying on thousands of bundles of grass is an intricate task that fewer and fewer people have mastered. All the more reason for Maui to move ahead.


Published by Oahu Publications Inc., a subsidiary of Black Press.

Don Kendall, Publisher

Frank Bridgewater, Editor 529-4791;
Michael Rovner,
Assistant Editor 529-4768;
Lucy Young-Oda, Assistant Editor 529-4762;

Mary Poole, Editorial Page Editor, 529-4790;
John Flanagan, Contributing Editor 294-3533;

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