Bill to let dying patients take own lives is deferred

March 24, 2017

Bill to let dying patients take own lives is deferred
By Sophie Cocke

A bill that would allow terminally ill patients to obtain prescriptions for lethal doses of medication is dead for the year after the House Health Committee deferred the measure, saying, in part, that there were too many kinks to be worked out before the legislative session ends in May.

The measure, which was a top priority of the Democratic Party this session, attracted the support of both the House speaker and Senate president, and was passed by the full Senate on a vote of 22-3 earlier this month. Gov. David Ige indicated earlier this year that he supported the concept of the bill, and the measure was backed by former Hawaii Govs. Neil Abercrombie, Ben Cayetano, John Waihee and George Ariyoshi.

But the proposed legislation also attracted an upwelling of opposition from religious and disability rights groups, many of whom crowded Thursday’s emotional, three-hour hearing clad in shirts that read, “There’s no aloha in suicide.” The local health care community was also split on the measure.

In recommending that the measure be deferred, Health Committee Chairwoman Rep. Della Au Belatti (D, Moiliili-Makiki-Tantalus) said that “our community is divided on the issue.”

“I think what we found is that people needed to have this discussion. We’ve had it,” she said. “We are going to have to balance the right to choose and our duties and obligations to protect those who are most vulnerable.”

The other six members of the Health Committee said they supported Belatti’s recommendation to defer the bill.

Rep. Chris Todd (D, Hilo-Waiakea-Keaukaha), who is serving his first term in the Legislature, said that he was initially intent on supporting the bill but changed his mind over the course of the session.

“While I’m definitely in support of the concept, I don’t believe this bill is ready, and I think we don’t have enough time left in this session to fix it,” he said.

Rep. Marcus Oshiro suggested that there weren’t adequate provisions in place within the bill to protect “the elderly, the frail, the weak” from foul play or pressure to end their lives.

Throughout the hearing, some lawmakers questioned whether it was fraudulent to list the underlying medical condition, such as cancer, as the cause of death on one’s death certificate, as opposed to a lethal overdose of drugs, as stipulated in the bill. They also raised concerns about the requirement for patients to have only six months or less to live, questioning how accurately doctors can predict that and raising concerns about the misdiagnosis of illnesses.

Rep. Andria Tupola (R, Kalaeloa-Ko Olina-Maili) also said she was worried that the bill didn’t specify which medications should be used and at what doses.

It had been 15 years since the state Legislature has seriously debated legislation that would allow terminally ill patients to end their lives through prescription medication. In 2002 Hawaii came within three Senate votes of passing a bill that had gained approval in the House. Subsequent bills got little to no traction.

This year the measure had an influential champion in longtime Hawaii lobbyist John Radcliffe, who was diagnosed in 2014 with incurable colon cancer that has spread to his liver. He’s undergone more than 40 rounds of chemotherapy.

Radcliffe showed up at the state Capitol early in the morning Thursday to testify on Senate Bill 1129 but told committee members that he wouldn’t be staying through the hearing’s duration. He had just had his “chemo pump” removed after three days, and his body was in shock.

“I’m here to testify for justice for doctors and by doing so permit already terminally ill adult patients with less than six months to live, like myself, and who are mentally competent, like myself, to control the time and place of their own death without having their physician having to face criminal charges and sanctions,” he told the committee. “That is what this bill does.”

Radcliffe was cut off from continuing his testimony. As with the dozens of other people who showed up to speak on the measure, he was allowed only one minute.

The hearing grew emotional at times throughout the morning as people on both sides of the issue discussed their own illnesses, the death of a loved one and patients they had treated who suffered greatly near the end of their lives.

Committee members seemed particularly swayed by input from Rae Seitz, a doctor specializing in palliative care. She said that she supported the option of lethal medication for terminally ill patients, but cautioned lawmakers that Hawaii’s health care community wasn’t prepared to responsibly implement the measure before them.

“It’s easy to write a prescription. It really is,” she told the committee. “But all of the work done to reach a decision about what is appropriate and what is an authentic decision on the part of an individual, that is a long and hard process, particularly at the end of life.”

Mary Steiner, Hawaii campaign director for Compassion and Choices, a national group that advocates for legislation on medical aid in dying, said after the hearing that she was “extremely disappointed” in the committee’s decision to defer the bill.

“I think that there was a lot of misunderstanding and misconceptions about what is inside the bill, and people just don’t understand who is eligible for medical aid in dying, and then there were a lot of red herrings that were thrown in as well,” she said.

SB 1129 was modeled after Oregon’s “Death With Dignity Act,” enacted in 1997. Since the law was passed, more than 1,100 terminally ill residents have taken lethal doses of prescription drugs to end their lives, according to a report from the Oregon Health Authority. Most of those who took the medication had cancer and chose to die at home.