The suicide of a 71-year-old Kailua man who was charged with attempted murder of his terminally ill wife is a tragic reminder that Hawaii legislators have rejected a bill that would have allowed her to die with dignity. The Legislature should revisit the issue in its next regular session and legalize physician-assisted suicide.

Robert Mitsuo Yagi had been visiting his wife, Leatrice, also 71, for weeks at Castle Medical Center and was accused of firing a flare gun loaded with a 12-gauge shotgun cartridge that apparently grazed her while she lay in her hospital bed. He carried a second similarly loaded flare gun and might have intended to kill himself.

Yagi was released from police custody last Thursday and, having been denied further access to the hospital, apparently hanged himself at his home on Sunday. His death shocked neighbors, who described the couple as “;inseparable.”;

Such a tragedy would not have occurred in Oregon, where voters approved the Death With Dignity Act in 1994 and overwhelmingly affirmed it three years later. Washington voters approved a similar measure last year, allowing physicians to prescribe lethal doses of medication to terminally ill patients who want to hasten their deaths.

A Blue Ribbon Panel on Living and Dying With Dignity, appointed 12 years ago by then-Gov. Ben Cayetano, recommended that Hawaii enact such a law. The state House approved the bill in 2002 but it was defeated by three votes in the Senate. The proposal was held back by House committees in 2004 and 2007; proponents said the measures lacked the support needed for passage.

Terminally ill patients now have access to palliative care to relieve pain and other symptoms and to provide emotional support to patients and families, often as part of hospice. Such care is so commonplace that it has become a board-certified subspecialty.

In the absence of a Death With Dignity law, Hawaii physicians should consider the options recommended by Dr. Timothy E. Quill, director of the palliative care program at the University of Rochester and a leading expert on end-of-life issues. That should assure care aimed at easing the pain of the terminally ill, even though it may hasten death, invoking a patient's right to forgo life-sustaining therapies or to stop eating and drinking.

As a “;last, last resort,”; Quill recommends sedation to the point of unconsciousness, endorsed last year by a panel of the American Medical Association.

A preferable solution would allow a doctor to prescribe a lethal dose of medicine when requested by a mentally alert resident diagnosed as having less than six months to live, following the approval of two physicians and a social worker. That is the law in Oregon, upheld by the U.S. Supreme Court, and should be enacted in Hawaii.