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The Honolulu Advertiser
Posted on: Wednesday, March 3, 2004

Hearing set on 'death-with-dignity' bill

By Lynda Arakawa
Advertiser Capitol Bureau

The House Judiciary Committee will hear a controversial bill tomorrow that would allow terminally ill patients to end their lives.

House Bill 862, which carried over from last session, would allow terminally ill, competent patients to obtain a lethal dose of medication that they would take themselves. It was introduced last year by Reps. Blake Oshiro, D-33rd (Halawa, 'Aiea, Pearlridge); Eric Hamakawa, D-3rd (Hilo, Kea'au, Mt. View); Scott Saiki, D-22nd (McCully, Pawa'a); Marcus Oshiro, D-39th (Wahiawa); and Sylvia Luke, D-26th (Punchbowl, Pacific Hts., Nu'uanu Valley).

The hearing will be held at 9 a.m. in the auditorium of the State Capitol.

"The death-with-dignity legislation raises multifaceted issues, and it may be a good time for the Legislature to publicly discuss those issues," said Saiki, House majority leader. "I realize that it's an emotional issue, but there is a significant number of residents who support this legislation and they should be heard."

But it's unclear whether this highly emotional and divisive bill has a chance of becoming law, particularly in an election year.

Saiki estimated the bill has a "50-50" chance of passing in the House, and that its chances in the Senate are probably lower.

Also, Gov. Linda Lingle said during the 2002 gubernatorial campaign that she is against physician-assisted suicide, calling it a "slippery slope" that could lead to euthanasia.

Supporters of the bill say patients have a right to end their lives with dignity and that it will improve end-of-life care. Opponents, however, say it will open the door to abuses and put pressure on patients to commit suicide.

Kane'ohe resident Ruth Nakagawa, who watched her 45-year-old son suffer from cancer before dying in 1993, supports the bill.

"He used to ask me, 'Oh, Mom, I wish Dr. Kevorkian was here to help me ease the pain,' " Nakagawa said. "But there was nothing I could do. ... My son really went through pain."

Dr. Jack Kevorkian, who is serving a 10- to 25-year sentence for helping a terminally ill man die in 1998, has said that he has assisted in more than 130 suicides.

Nakagawa said policymakers should leave the decision up to patients and their doctors.

"It's not for somebody to dictate to us what should be done and what should not be done," she said.

But allowing for physician-assisted suicide would remove focus from improving end-of-life care, said Eva Andrade, Hawai'i Family Forum communications director, who added that there are better medical alternatives

"We believe that the practice of doctor-assisted suicide creates a duty to die," she said. "We think that death would become a reasonable substitute to treatment and care. ... With today's pain management techniques, we believe that up to 99 percent of patients can receive treatment so that they don't suffer needlessly. We also believe it would destroy the delicate relationship between a doctor and a patient."

Andrade also said such a law would open the door to abuses and that safeguards cited by proponents will not work.

The bill prohibits mercy killings, lethal injections and euthanasia and requires physicians to counsel patients on alternatives, including comfort care, hospice care and pain control.

Patients who also suffer from a mental illness would not be allowed to receive the lethal medicine.

Qualified patients also would be required to make an oral request and a written request to their physicians, and would also have to ask the physician again at least 15 days after their initial oral request.

Roland Halpern, executive director of Compassion in Dying of Hawai'i, said end-of-life care has improved in Oregon, the only state where terminally ill patients can legally obtain lethal prescriptions from their doctors. He said the House bill is modeled after Oregon's law.

The Oregon law has survived a federal court challenge and a repeal effort, and was supported by a 1997 U.S. Supreme Court ruling that said that there is no constitutional right to assisted suicide but that states have the authority to pass such a law.

The New England Journal of Medicine has reported that doctors wrote 58 prescriptions in 2002 for terminally ill patients who qualified under the voter-approved Oregon law, and 38 committed suicide. Most of those who ended their lives were older, well-educated cancer patients, and assisted suicides accounted for 0.1 percent of deaths that year.

The state House in 2002 passed a similar assisted suicide bill backed by then-Gov. Ben Cayetano but the measure failed in the Senate in the final days of the session.

Reach Lynda Arakawa at larakawa@honoluluadvertiser.com or at 525-8070.