Posted on: Sunday, January 30, 2005

EDITORIAL
We should care about death with dignity

While physician-assisted suicide is conspicuously absent from the legislative agenda thus far, the debate over how Hawai'i can best serve the terminally ill continues in the community and on our op-ed and letters pages.

Clearly, this is a matter that profoundly affects the dying, the elderly and their caregivers, whether the Legislature plans to address it or not.

Physician-assisted suicide is a compassionate alternative for those who have exhausted all other avenues and want to end their life on their own terms, and with dignity.

That said, any law that allows a physician to assist in these cases by writing a lethal prescription must be tightly restricted to protect both those who do or don't choose this option. As it is, many elderly and disabled folks worry that such a law would pressure them to prematurely end their lives and relieve the burden on others.

That is a good reason to examine Oregon's death with dignity law. It is restricted to those who have less than six months to live and are mentally competent and not clinically depressed. It includes numerous safeguards against abuse.

It's important to note that a vast majority of the 170 Oregonians who have chosen to end their lives this way since the law was enacted in 1998 cited loss of autonomy and dignity as their motivation, not pain.

Still, pain, particularly in the final stages of a terminal disease such as cancer, does factor into the decision to take one's own life, which also raises the issue of the need for improved end-of-life care.

Those who receive the best pain management and palliative care tend to be those with resources and strong advocates. Moreover, not all physicians are required to get training in end-of-life care. That must change, and top-notch palliative care should be available to all.

As important as it is, however, palliative care is not a substitute for having control over the time and place of one's death, including who should be present (with an unassisted suicide, any friends and relatives present can be considered aiders and abetters).

Let's continue to work on legislation that addresses this issue.