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A better choice

February 1, 2017 - 1:12pm

The people of Hawaii have been asking for a medical aid in dying option (also known as “death with dignity”) for almost 20 years. Today, 80 percent of Hawaii residents believe medical aid in dying should be an option in our state.

Medical aid in dying is an end-of-life medical practice in which a terminally ill, mentally capable individual who has a prognosis of six months or less to live requests, obtains and — if his or her suffering becomes unbearable — self-administers medication that brings about a peaceful death.

If you ask terminally ill people how they would like to die, most will say, “I would like to die peacefully, at home, in my sleep.” As a former emergency room doctor, I can tell you that all too often, this is not the case. In their final stages, terminally ill people can be rushed to the ER repeatedly, admitted to an ICU and hooked up to ventilators, feeding tubes and IVs. Of course, if this is the individual’s wish, then every measure to sustain life should be taken. However, if this becomes a case of prolonging the dying process well beyond what the individual wants, to a stage some would call torture, we must agree it is not right.

Even terminal sedation (increasing pain meds until the patient stops breathing) might not be the ideal choice for some, who wish not to be sedated into unconsciousness and death at another’s direction and hand, but to make that final and most important choice on their own.

And we can offer that choice. A physician who practiced in Oregon, where medical aid in dying has been legal for nearly 20 years, told a story about the first person she prescribed life-ending medication to. The woman, who was dying a prolonged and agonizing death from ovarian cancer, wanted to die at home, in her own bed, with her husband holding her hand and her two dogs on the bed with her. She wanted a peaceful and meaningful end to her meaningless agony while she was still mentally intact and she achieved that goal.

Yes, palliative care and hospice are a great boon to many. But for some, they may not relieve all the physical suffering or mental agony. When people are dying, facing only agony and are ready to go, they should have the means to a peaceful passing, if that is what they wish.

How would I feel if I had a terminal illness and were in a constant unwavering pain that even the most powerful medications could not alleviate? If I had lost my bodily functions and all the skills and tools I had spent my life developing? I would be comforted just knowing a medical aid in dying option was available to me — and I certainly would not deny another the right to consider this option.

Opponents argue that people will be coerced. In fact, no doctor will be compelled to prescribe if they do not wish to, but there are many that will find it part of a difficult but profoundly meaningful part of their final duty as a physician to their patients. No person who has a religious objection — or any objection — would be pressured or forced to utilize this choice. Coercing an individual to use a medical aid in dying option would be a crime, as it is in all authorized states.

The idea that the Hippocratic oath forbids physicians to do this is ludicrous. Over 40 years ago, when I graduated from medical school, we were told that that oath was a traditional part of the ceremony but was an antiquated relic and that we should not even repeat the words if we felt uncomfortable doing so. I certainly did not repeat those words from another time and place.

The proposed law for our state, HB201 Related to Medical Aid in Dying, was introduced by our esteemed House Speaker Rep. Joseph Souki. It is designed by and for the people of Hawaii, taking into account our unique geographical needs, and is based on best practices from more than 30 combined years of safe practice in six states. The law works as intended, with none of the dire results that opponents predicted.

It is time for Hawaii citizens who want this relief to be able to get it without the disruption and stress of moving to another state.

I join Compassion and Choices Hawaii, four former governors and a supermajority of our electorate in asking for your support for this important, timely and merciful measure.

Rep. Richard Creagan, MD, is a Democrat in the state House who represents South Kona and Ka’u.

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