Gathering Place

Roland Halpern

Hawaii patients deserve
to choose death -- or life

Regarding your editorial supporting physician-assisted dying ("Give terminally ill option of doctor's aid," July 26): A study among Hawaii's physicians published in the December 1996 issue of the Hawaii Medical Journal revealed that of the 1,028 respondents, 60 percent supported assisted dying. The study further noted that 4 percent acknowledged having helped a patient hasten his or her death.

It is interesting to note that in Oregon, where assisted dying has been legal for more than five years, the percentage of hastened deaths is just 0.09 percent.

Why are the assisted deaths in Oregon so much lower than those in Hawaii? Part of the explanation may be the Oregon Death With Dignity Act, which contains numerous safeguards that must be followed as a condition of seeking a hastened death.

For example, a patient's terminal diagnosis must be confirmed by two physicians. Should either believe the patient's request is motivated solely by depression, coercion or incompetence, a psychological evaluation is required.

Other safeguards include a minimum 15-day waiting period, a signed written request witnessed by two parties known to the patient, and the physician's recommendation that a family member be included in the decision.

Under Oregon's law physicians must counsel patients on alternatives to a hastened death, including pain management, hospice and palliative care. Not surprisingly, after such counseling almost half of those initially seeking a hastened death pursue an alternate end-of-life plan.

Additionally, more than half of those actually receiving the prescription never use it. They are able to experience a "natural death," comforted by knowing that if all else fails they still have an option.

By keeping assisted dying illegal in Hawaii, those wishing to hasten their deaths must do so in secrecy. Absent the benefit of second medical opinions or counseling on alternatives, many will continue to end their lives prematurely, and often by violent means including handguns, jumping from buildings or suffocating in plastic bags.

Unfortunately, as is so often the case, it seems our elected officials are more concerned about their own political careers than passing laws to relieve the suffering of the terminally ill. Perhaps if they were to accompany me when I visit the dying and really listen to the concerns being expressed, they would change their minds. I have offered, but so far there have been no takers. Out of sight, out of mind. Politics.

Roland Halpern is executive director of Compassion In Dying of Hawaii, which counsels terminally ill and competent adults on their end-of-life options, including physician-assisted death.


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