Finally, popular opinion and legislative intent appear to be aligning when it comes to medical aid in dying in Hawaii.

At least four measures have surfaced as viable pieces of legislation this session. Of these, House Bill 2739 appears to be the best vehicle.

Among its strengths is that it was introduced by House Majority Leader Della Au Belatti and is co-authored by Speaker Scott Saiki, Finance Committee Chairwoman Sylvia Luke and Judiciary Committee Chairman Scott Nishimoto.

House Legislature editorial meeting with Speaker Scott Saiki and Majority Leader Della Au Belatti.

House Majority Leader Della Au Belatti is the author of a bill calling for allowing medical aid in dying. House Speaker Scott Saiki is a co-author.

Cory Lum/Civil Beat

HB 2739 adopts language from a Senate bill that overwhelmingly passed that chamber in 2017 but stalled in the House.

The Senate bill, which carried over to the 2018 session and could still be heard, is modeled on the law in Oregon, the first state to legalize medical aid in dying in 1997. But the House measure is the stronger piece of legislation.

HB 2739, which also includes provisions from the somewhat more restrictive California law that took effect in 2016, acknowledges the national movement toward allowing “mentally competent adult residents who have a terminal illness to voluntarily request and receive a prescription medication that would allow the person to die in a peaceful, humane, and dignified manner.”

Recent polls have found nearly two-thirds of Hawaii voters in favor of medical aid in dying,

The authors of the House bill say that at least 30 states have either enacted such laws or are considering it.

“Each of the states that have grappled with this issue has done their best to address the concerns of the impassioned voices on each side of the debate,” says HB 2739.

The Senate bill died in the House health committee, chaired at the time by Belatti, in part because there was a concern about lack of safeguards for patients. The House bill calls for stringent protections:

  • confirmation by two health care providers of the patient’s diagnoses, prognosis and medical competence, and that the patient’s request was made voluntarily;
  • two verbal requests from the patient (separated by not less than 15 days) and one signed written request witnessed by two people (one of whom must be unrelated to the patient);
  • an additional waiting period between the written request and the writing of the prescription; and
  • the creation of strict criminal penalties for any person who tampers with a person’s request for a prescription or coerces a person with a terminal illness to request a prescription.

“These rigorous safeguards would be the strongest of any state in the nation and will thoroughly protect patients and their loved ones from any potential abuse,” the House bill reads.

HB 2739 also recognizes an important fact: that residents of Hawaii “should have the fundamental right to determine their own medical treatment as they near the end of life, including the right to choose to avoid an unnecessarily prolonged life of pain and suffering.”

Needless Suffering

Hawaii data from 2015 shows that, of the nearly 11,000 deaths that year, more than 2,400 people died of cancer, primarily of the colon, pancreas, breast, cervix, prostate and lung, or leukemia.

A similar number died of heart disease, while over 2,000 died from diseases including tuberculosis and HIV. These can all be horrible deaths.

Consider a just-released report from Colorado, where voters approved medical aid in dying in 2016.

Data from the first year of the program (2017) show that the underlying terminal illness or condition among the 69 patients prescribed life-ending medication was most often cancer. Amyotrophic lateral sclerosis (also known as ALS or Lou Gehrig’s disease) and heart disease were the next-leading reasons.

Of the 56 Colorado patients who died after receiving aid-in-dying medication, nearly 80 percent were at least 65 years old. Most of them died at home and under hospice care.

Clearly, the Colorado law — as is also the case in Oregon, California, Vermont and Washington state — is being used by very sick people who want to end their suffering. It is not being misused, as some have feared, to take the lives of the unwilling.

We implore Hawaii legislators to do the right thing and send a medical aid in dying bill to the governor’s desk in 2018.

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