The proposed law would allow the terminally ill with less than six months to live the right to an assisted suicide

The Hawaii Senate voted overwhelmingly last week to advance a bill permitting physician-assisted suicide for terminally ill patients.

Called the Medical Aid in Dying bill, SB 1129 passed with 22 votes in favour, three against. Two of the affirmative votes were cast “with reservations.”

The bill now goes to the state House of Representatives where it will be debated and voted on in committee before going before the full body.

The proposed law would allow an adult Hawaii resident diagnosed with a terminal illness and determined to have six or fewer months to live, to request a prescription for a lethal dose of medication to be self-administered to end his or her life.

The legislation has prompted a vigorous and passionate public debate over the past few months as both advocates and opponents shared experiences of dying friends and relatives and their own illnesses.

The discussion also has included arguments over the role and responsibilities of doctors and the potential of elder abuse.

SB 1129, which is based on a law in Oregon, lists a number of “safeguards” intended to protect patients from abuse or victimisation.

These include confirmation by two physicians or advanced practice registered nurses of the patient’s “diagnosis, prognosis, mental competence and voluntariness of the request.”

The bill also requires that the patient must give both oral and written requests for the lethal medication, witnessed by two people, and that there be waiting periods between the requests and the writing of the prescription.

The Catholic Church in Hawaii has been actively opposing the bill.

In testimony against the bill dated February 24, the Hawaii Catholic Conference, the public policy voice for the Catholic Church in Hawaii, stated that legal assisted suicide “can undermine the physician’s role as healer, forever alter the doctor‐patient relationship, and lessen the quality of care provided to patients at the end of life.”

The Catholic conference pointed out the incongruity of the state promoting and facilitating suicide for one group of persons, calling it “dignified and humane,” while “recognising suicide as a serious statewide public health concern in all other circumstances.”

The conference organised a statewide petition against the measure that so far has collected more than 5,000 signatures.

Honolulu Bishop Larry Silva, in a letter to parishioners in the Diocese of Honolulu published in the February 10 issue of the Hawaii Catholic Herald, called the effort to legalise physician-assisted suicide as a “wolf in sheep’s clothing” and “another manifestation … of the ‘culture of death.'”

The bishop countered the argument that terminal illness “diminishes” a person’s dignity or “true humanity.”

“It costs a tremendous amount of time and money to care for someone who is very sick,” he said. “Yet true compassion means ‘suffering with’ someone – or allowing others to suffer with us – and while it is very humbling, the most intimate bonds of human caring can be nurtured in just such circumstances.”

Bishop Silva expressed concern that legalising assisted suicide would open the door to a “culture of euthanasia” and abuse of the elderly.

“It is certainly cheaper and easier to end a life than to care for it in the midst of suffering,” he said. “Will decisions be made on economic expediency? Will others around the patient, such as heirs, be more motivated to aid in the rapid demise of the patient for their own benefit? Will this be another weapon in the hands of those who already abuse the elders they care for, a problem that has become quite serious?”

“The suffering of others is a call to us all, not to end life by offering a lethal ‘medication,’ but to care for them in love, even when it is most difficult to do so,” the bishop said.

Testimony by Eva Andrade, president of Hawaii Family Forum, a nondenominational educational organisation, said that assisted suicide invites exploitation of vulnerable people.

“It puts the poor, elderly, sick and disabled at risk for abuse,” she said, “no matter what the proposed safeguards. With elder abuse already a major problem in Hawaii, turning the right to die into a duty to die — creating subtle pressure on the elderly to end their lives early so as not to be a burden to their families — may very well be a consequence of this law.”

Democratic state Senator Breene Harimoto gave an emotional speech March 7 on the floor of the Senate opposing S.B. 1129, recounting his fight with pancreatic cancer.

He said he was “devastated” by the grim diagnosis in 2015 that the cancer had spread.

“I broke down and cried, thinking that I would die soon,” he said. “I’m sure that if I chose not to suffer through surgeries, chemo and radiation, I would have been given just a few months to live.

“But after much prayer, my wife and I decided to have faith. I chose to fight for my life with every ounce of energy I had,” he said.

After aggressive treatment, including extensive surgery, Harimoto said his cancer is in remission.

He concluded that if assisted suicide had been legal during his illness, it is likely that he would not be alive today.

“Thinking back on this experience, I wonder what anyone who is given six months or less to live would do with those death pills,” he said. “It would be too easy and tempting in a moment of weakness and despair to reach for the pills to end it all. I’m glad I didn’t have those pills when I was suffering so much or I wouldn’t be here today.”

“We should be making laws to give people a sense of hope, not making laws that allow physicians to assist in causing death,” the senator said, calling it a “misplaced sense of compassion.”