‘Death with dignity’ can come without medication

Supporters are saying House Bill 2739 provides more protections for terminally ill patients than any other state.

You’ll have to decide for yourself if that’s a good thing.

The House Health and Human Services Committee and Judiciary Committee on Wednesday passed the “Our Care, Our Choice Act.”

The bill now goes to the full House for a second reading.

Here’s what it does: Allows qualified patients in Hawaii with a medically confirmed terminal illness with less than six months to live and possessing decision making capacity, to determine their own medical care at the end of their lives.

The bill establishes a regulatory process under which an adult resident of the state with a medically confirmed terminal disease may choose to obtain a prescription for medication to end their life. The bill also imposes criminal sanctions for tampering with a patient’s request for a prescription or coercing a patient to request a prescription.

So, in reality, this will allow people fitting certain criteria a legal way to chose to try to end their life with the state’s blessing. If that sounds harsh, our apologies. But isn’t that what we’re talking about? And this has, not surprisingly in this day and age, gained a lot of support.

Here are what some officials had to say about the “Death with Dignity” bill:

w “It’s time for this bill to become law. Mentally competent, terminally ill people who are in pain and who are suffering should be given the choice to end their lives with grace, dignity and peace. I would be proud and honored to sign this bill into law if our state legislators pass this measure this session.” — Gov. David Ige.

w “The Legislature has carefully examined this issue over the past two decades. During the interim, we looked closely at what other states have done and heard the public’s concerns. This bill provides strong protections for terminally ill patients and their families while allowing patients to exercise their end-of-life choices.” — House Majority Leader Representative Della Au Belatti (Makiki, Tantalus, Papakolea, McCully, Pawaa, Manoa).

w “The Governor’s Office believes this bill is important to allow terminally ill patients to decide for themselves when and how their lives should end. We believe HB 2739 is well-drafted in a context of a robust continuum of palliative and hospice care, and provides sufficient safe-guards for both patients and doctors to minimize abuse.” — Administrative Director Ford Fuchigami.

More than 100 people recently testified at the State Capitol and more than 600 submitted written testimony to the House Health and Human Services Committee and Judiciary Committee on House Bill 2739.

Hawaii will not be the first to pass such a bill and likely won’t be the last. At least 30 states have either enacted or considered enacting similar aid-in-dying bills, which are passed with good intentions.

And Hawaii’s includes safeguards, including:

w Confirmation by two health care providers of the patient’s diagnoses, prognosis and medical competence;

w Two verbal requests from the patient, separated by not less than 20 days, and one signed written request that is witnessed by two people, one of whom must be unrelated to the patient;

w Counseling required for all qualified patients with a psychiatrist, psychologist or clinical social worker to determine that the patient is capable of making an informed decision and is not suffering from under-treatment or non-treatment of depression or other conditions that interfere with their ability make an end-of-life choice;

w Allowing counseling to be done via telehealth; and

w The patient retains the right to rescind the request for life-ending medication.

That sounds like this bill has certainly been vetted well. And we don’t question the sincerity or the intentions of its supporters. Some have watched loved ones died slowly and painfully over months and they don’t wish others to endure the same thing. As well, supporters believe strongly in personal choice and it’s no one else’s business.

While it seems that a person with a medically confirmed terminal illness with less than six months to live and possessing decision making capacity should be able to end their life as they see fit, there are some concerns to consider.

Let’s start with labeling this bill as “Death with Dignity.” Certainly, a person facing a terminal illness can have death with dignity without taking their own life. Many people facing their final days have been a blessing to those around them. They died with peace and dignity.

There are people with a terminal illness who have lived longer than medical professionals expected. Some have lived well for years and again, been a blessing to their loved ones. Who, on this Earth, can say with absolute certainty someone has less than six months to live? Even doctors will tell you predicting how long a terminally ill person has to live is not an exact science. Sometimes, we give ourselves too much credit.

And there are people facing terminal illness, in great pain, who have rallied; who, through explained and unexplained reasons, have returned from what some assumed was their death bed, to live well.

Things can go wrong. Let’s say a person takes a prescribed medication to end their life, and it doesn’t work as designed. They are still breathing. Still alive. Still there. They linger on and can no longer take any medication on their own. What then?

This is a sensitive area. We know this. It is difficult to watch our loves ones suffer in their final days. We don’t want them to go through it. We want to give them a way to end their pain. That’s understandable. But that doesn’t make it right.

Supporters will argue this is about choice. But we would argue this isn’t a choice a terminally ill person should be expected to make, even if of their own accord. We need to give them a better choice.

If we want to be sure people can have death with dignity, let’s lift them up, let’s encourage them, let’s stand by their side, let’s be strong and courageous with them, let’s give them hope and faith and love, while they are alive. We’re not saying that’s going to be easy. It will be hard. But we need to ask if we can’t do better than passing laws so our terminally ill loved one can chose to take medication in effort to end their life. We can do better for people who are ill and suffering than to give them the right take their own life. Is that really the best we can offer?

We urge our legislators to consider carefully the ramifications of House Bill 2739, “Our Care, Our Choice,” before they vote on it.