May 2016 Legislative Update

Many thanks to all who took the time to contact legislators to support the Death With Dignity legislation introduced at the State Legislature. As expected, because 2016 is an election year, Senate Bill 2373 did not receive the needed committee hearings. Your effort was not in vain because we were able to show an important level of support and the feedback indicates that the senators who introduced the bill were very appreciative.

What Comes Next?

There is much to do between now and the 2017 legislative session and here’s what you can do now:

As possible, get to know your own legislators and the candidates running in your political districts. With the 2016 legislative session now over, all candidates for public office who are running for office are appearing at numerous community functions. Some will be free to the public and the usual political fundraisers are taking place. Find the latest list of all candidates running for office here. We will update this information pending the next official report.

We will be sending out as much information as possible about the dates, times and locations of these events, with the hope that our issue can be brought up directly to all of the candidates “in person.” Your phone calls or visits to their campaigns will be very important. Should you find out that a candidate is supportive or not, it would be of great help if you would let us know the results of your direct contact and interaction.

Ernest Juggie Heen

The late Ernest “Juggie” Heen

Again, “Mahalo!” for your past and future support. As the recent success in California demonstrated, Death With Dignity is very possible for Hawaii — if we build the needed political and grassroots support base. Please feel free to contact us to share information or to answer your questions.

We are naming SB2373 the “Juggie Heen Memorial Bill” in honor of the late former State Representative, Ernest “Juggie” Heen. “Uncle Juggie” has many friends still in the legislature and he worked tirelessly on our behalf. Also visit our memorial gallery honoring many who have gone before us and on whose shoulders we stand.

Scott Foster
Communications & Legislative Director

Is “It” Legal in Hawaii?

NO. It’s not legal in Hawai`i.

What really happened with Death with Dignity in 2012

In 2012, one of the two large mainland right-to-die organizations came to Hawaii in force and declared that death with dignity was already legal in our state. Compassion & Choices lawyer had based their argument upon a little-known 1909 Hawaii territorial law.

Shortly thereafter, the Hawai`i Attorney General stepped-in, issuing an opinion that writing prescriptions to hasten a competent adult’s impending death was still unlawful in Hawai`i—meaning that that such activity was still a crime and would be prosecuted as such.

After all the headline stories had died down, we found ourselves left alone fielding hundreds of phone calls from terminally ill people and their loved ones asking how they could get their prescription. We were also faced with having to rebuild our local organization’s reputation for being associated with Compassion and Choices ill fated “It’s legal” campaign.

Then in late 2015, our longtime friends at the Death with Dignity National Center (“National Center”) in Portland, Oregon, contacted us and graciously offered to again assist.

I say “again” because our close relationship with the National Center and their founding board member Eli Stutsman, JD, dates back to 2002, when our local organization came within three votes of passing a bill through the Hawai`i legislature. That year, literally with only a few days notice, Stutsman, the lead author of the original Oregon law, stepped up to the plate and his organization provided a major part of the substantial resources we needed to conduct our near-winning campaign.

Learn about the 2002 campaign HERE.

March 14, 2009, meeting with Death With DIgnity National's Eli Stutzman, Esq.

The Hawaii Death With Dignity Society meets again with Eli Stutsman (back row with lei) in Honolulu (2009)

It’s been over 20 years since “the  Oregon Bill” went into effect and it has indeed become the gold standard for the issue nationally. The National Center has played a key role in every state that has successfully passed a Death with Dignity law. While others may claim credit, the National Center’s track record speaks for itself. If we are to grow our local organization and attract the additional base of support needed to pass a bill in 2017, we want and indeed need, the National Center’s guidance and support.

Support Death with Dignity in the Aloha State

If you believe we need a local organization on the ground with a keen understanding of Hawai`i’s unique population, a local group working to see a Hawai`i Death with Dignity law passed, please consider making a contribution today to theNational Center HERE. You may also write a check payable to the DDNC and mail it to:

Death with Dignity National Center
520 SW 6th Avenue, Suite 1220
Portland, OR 97204

With your support, our work will continue in the present with a full understanding of the past and with an eye looking towards the future. We will ultimately prevail and see Death with Dignity a reality in Hawai`i nei.

Please feel free to email or call me directly for further information. As much as money, we need active participants in every corner of the state; people who are able to make a phone call, email or write a legislator or who can simply talk with and educate their relatives, caregivers and friends.

Aloha and mahalo for your kokua,

Scott Foster
Communications Director

In Memoriam Eleanor Mae “Andi” Van der Voort

Eleanor We recently learned of the October 2014 death of Eleanor “Andi” Van der Voort. Andi was the founder and the heart & soul of the Right To Die movement in Hawai`i. She was the driving force behind the original Hawai`i Hemlock Society and later aligned herself with the Final Exit Network and the Euthanasia Research and Guidance Organization (ERGO).

Learning of Andi’s passing, her longtime friend and ally Derek Humphry wrote, “Between organizing meetings, lobbying at the legislature, or sitting at the bedside of dying members, Andi was a nonstop live-wire. You could always count on her. And her hospitality at home was famous.” Humphry founded the original Hemlock Society USA in 1980 and later, ERGO as well as authoring 14 books relating to the right to die.

Andi was a Registered Nurse and had been the Chief Medical Officer on the legendary USS Independence “back in the day.” Andi’s many accomplishments included being a loving wife and mother, a top Honolulu real estate broker, a professional clown, the president of the Hawai`i Hemlock Society, and being a longtime President and Minister with the Hawai`i Humanist Society. Andi was also a Charter Member of our organization, the Hawai`i Death With Dignity Society!

Aloha Andi! Like so many others you somehow encouraged and nurtured, we are standing on your shoulders.

Honolulu Star Bulletin: “Doctor Says 1909 Law Allows Assisted Suicide”

By Dan Nakaso

Dr. Robert “Nate” Nathanson is ready to prescribe a fatal dose of barbiturates to help any terminally ill patient in Hawaii die.

First he has to find the right person.

“If there is somebody out there that wants to avail themselves to this and they ask their own doctor to write a prescription and the doctor is not willing to do that, then I would be,” Nathanson said. “I realize I could be prosecuted for this and I’m willing to take that chance.”

Bills are once again likely to be introduced next legislative session that would make Hawaii the fourth state in the country to allow so-called physician-assisted suicides, following Oregon, Washington and Montana.

But Nathanson and his supporters at the Hawaii Death With Dignity Society insist that he does not need a new state law to legally prescribe lethal doses of medication to terminally ill patients who want to kill themselves.

An obscure 1909 law intended to ease the suffering of Hansen’s disease patients already makes physician-assisted suicides legal in the islands, said Kathryn Tucker, director of legal affairs for Colorado-based Compassion & Choices. She added that a “constellation” of other Hawaii laws “reflect the policy of the state to vest its citizens with broad autonomy over medical decision-making.”

Nathanson, 77, of Mokuleia, retired from practicing medicine in 1998 after a 37-year career with Kaiser Permanente Hawaii, working in Kaiser’s clinics in Kailua and Kaneohe.

But he’s kept his medical license over the past 13 years, hoping to ease the suffering of terminally ill patients.

Nathanson helped found Hospice Hawaii more than 30 years ago and treated dying patients every year.

“They would ask me, ‘Doc, can you help me end this? I’m miserable,'” Nathanson said.

Before he was referred to the 1909 law, Nathanson said he thought that physician-assisted suicide — or “death with dignity” in Hawaii — “was illegal and I risked losing my license and possibly going to jail.”

Joshua Wisch, spokesman for the state Attorney General’s Office, declined to comment on whether the 1909 law makes physician-assisted suicides legal in 21st-century Hawaii.

“Our department doesn’t have a position on that at this time,” Wisch said.

A law passed before Hawaii became a state in 1959 generally remains valid today, said Randy Roth, a University of Hawaii law professor.

“Unless the Legislature has enacted something that changed it or a court has made some sort of decision that affected, it would presumably be viable today,” Roth said.

Jim Pietsch, director of UH’s Elder Law Program, came across the 1909 law in 2004 while writing an article about end-of-life decisions for the Journal of Legal Medicine.

Hawaii Revised Statutes 453-1 addresses the “practice of medicine” and says, in part:

“(W)hen a duly licensed physician or osteopathic physician pronounces a person affected with any disease hopeless and beyond recovery and gives a written certificate to that effect to the person affected or the person’s attendant, nothing herein shall forbid any person from giving or furnishing any remedial agent or measure when so requested by or on behalf of the affected person.”

Pietsch said the law was written at a time when there was no known cure for Hansen’s disease, or leprosy, and other diseases such as tuberculosis and typhoid that caused “great suffering” and were often fatal.

But he said he would not recommend that any modern-day doctor solely use the 1909 law to prescribe fatal doses of medication to terminally ill patients in Hawaii.

“I would not hang my hat on one statute alone,” said Pietsch, who was a member of former Gov. Ben Cayetano’s 1998 blue ribbon panel that studied the issue of physician-assisted suicides in Hawaii. “A constellation of other statutes are also implicated. For example, one may wish to seek clarification of the provision of the penal code that says there is a prohibition against causing another individual to commit suicide. This issue is more complicated than just one statute.”

Tucker, of Compassion & Choices, said, “The 1909 law is just one piece of the picture.”

Hawaii laws already allow patients to make advanced health care directives, give them a “pain patient bill of rights” and guarantee a constitutional right to “bodily autonomy.”

“Plus you have the fact that there is no prohibition on aid in dying,” Tucker said.

Hawaii’s manslaughter laws make it a crime “to cause someone to cause a suicide,” Tucker said. “If a physician wrote that patient a prescription, it would be a huge stretch to say that the doctor was causing anything. In Hawaii, physicians can feel safe in providing this — to bring about a peaceful death — to mentally competent, terminally ill patients. It would be a tremendous stretch to find any basis in law in Hawaii that would support that kind of prosecution.”

HOUSE MAJORITY LEADER Blake Oshiro (D, Halawa-Aiea) has introduced “death-with-dignity” bills modeled after Oregon’s law every year since 2002 and plans to do it again next session.

“It is an uphill battle,” Oshiro said. “It is certainly a controversial issue. And with a lot on the plate to deal with — the economy and protecting jobs — by no means is this the first and highest priority issue. Nonetheless, it’s an important issue that we as a community need to have more discussion and debate around.”

Oshiro said he would prefer to see a law that requires patients to have two separate diagnoses of terminal illness in which death is likely within six months. The patient would have to be of sound mind and not suffering from depression or any other condition that might influence his or her decision, Oshiro said.

The patient would then likely have to get approval from the state Department of Health in order to have a doctor prescribe medication “to take their own life if and when they choose to do so,” Oshiro said.

The idea of physician-assisted suicides continues to be opposed by powerful forces in the islands, including the Catholic Church, one of several groups that pushed legislators to defeat a 2002 bill.

After intense lobbying, the bill died by a vote of 14 to 11 at the end of the 2002 session.

“Suicide is wrong,” said Patrick Downes, spokesman for the Catholic Diocese of Hawaii. “You don’t take your life or anyone else’s life. Life is precious and not yours for the taking. The same principle that forbids abortion would forbid suicide or anyone helping to commit suicide.”

In a statement, Bishop Larry Silva said that Hawaii’s 1909 law was not intended to help terminally ill Hansen’s disease patients end their lives “but rather to permit unapproved and untested drugs to be administered with the hope of healing or at least giving palliative relief, even if it would in fact — though unintentionally — result in the hastening of death.”

People have been killing themselves “quite autonomously for millennia, without the help of physicians,” Silva said. “The fact that the proposed law (or the supposed law already on the books) requires informed consent before a lethal dose can be prescribed indicates to me that in the depths of their hearts people know that suicide is wrong. They seem to want a way to convince themselves that it is acceptable by having a ‘higher authority’ authorize it.

“If physician-assisted suicide is sanctioned by the law,” Silva wrote, “soon all physicians will be required to serve it up, no matter their personal religious convictions; and employers who are fundamentally opposed to the procedure may be forced to fund it in their benefits packages.”

BUT DR. NATHANSON REMAINS ready to help a terminally ill patient in search of a doctor just like him.

“I have already been asked by a couple of people, but they were as healthy as can be,” Nathanson said. “They were just advanced age and wanted it (barbiturates) on hand in their medicine cabinet.”

If he found the right patient, Nathanson said, he would contact their doctor and confirm their terminal diagnosis and mental competency. He would then have the patient sign a document in front of witnesses saying he or she understands the consequences of Nathanson’s prescription and that there is no requirement to have the prescription filled.

When the time is right, Nathanson said, he would offer to be present, preferably surrounded by the patient’s friends and family.

He said he hopes the patient would say his or her goodbyes, take a fatal dose of Seconal or Nembutal, then fall asleep within 30 minutes.

Death would arrive within two to three hours.

“It’s like going to sleep,” Nathanson said.

His wife, Donna, and their four daughters support Nathanson.

Helping a terminally ill patient die in their own way would be the culmination of Nathanson’s career, “the crowning piece, if you will, after a long, successful, satisfying medical career,” Donna said.

If Nathanson were to be arrested, Donna said, she would bail him out of jail. If he were to be convicted of a crime and sent to prison, “He would get through it and I would get through it and the whole family would support him,” Donna said. “It’s not a scary thing for me.”

If he does end up in jail or prison, Nathanson said, he does not want to be held up as a martyr for the death-with-dignity movement.

“I am no hero,” Nathanson said. “But there is a risk and I am willing to take it.”

Senate panel fails to advance Death With Dignity bill

HONOLULU (HawaiiNewsNow) – After listening to hours of testimony, state lawmakers decided to hold a bill that would legalize physician-assisted suicide. The vote by members of the Senate Health Committee essentially kills Senate Bill 803 relating to death with dignity. The proposed legislation would allow a terminally ill, competent adults to receive a lethal dose of medication. More than 150 people signed up to testify. The testimony was overwhelmingly against the bill, but emotions ran high on both sides.

“This bill is very scary because I think that over the course of my employment, I have also witnessed many people with terminal illness and they have outlived the six months to a year the doctors had given them,” Raelene Souza, an employee at Hawaii Centers for Independent Living.

“I’m in support of this bill because I am 75 years old, and it is nobody’s business whether I choose to live or die. It is my life. It is not theirs, it is not some religion’s, it is my life,” said Marcia Linville, a supporter of the bill.

Similar proposals have been introduced in the House. The Senate bill was based on Oregon’s Death With Dignity law.

Assisted suicide bill stalls

Emotional testimony fills a hearing on voluntary end of life

By B.J. Reyes

After citing numerous examples of loved ones who outlived a doctor’s terminal diagnosis or of their own victory over suicidal depression, opponents of a proposal to legalize physician-assisted suicide in Hawaii applauded as a Senate committee defeated the measure last night.

The Senate Health Committee heard more than 4 1/2 hours of often-emotional public testimony before voting 4-0 to hold the bill in committee.

“After considering the large body of testimony presented to us, I have determined that community sentiment here today has been overwhelmingly opposed to moving this measure forward in its present form,” said Sen. Josh Green, committee chairman. “There is truly compelling testimony on both sides of this matter — for and against — but from my perspective, for an issue of this magnitude, I believe we need to have more agreement as a community.

“So for now we need to find other ways to support those dealing with end-of-life decisions, with the greatest possible compassion and respect.”

Senate Bill 803 would have allowed a terminally ill, competent adult to receive medication to end life. The bill specifically prohibits mercy killings, lethal injections and active euthanasia, and requires patients to receive informed consent.

Alternate doctors would be allowed to substitute for those who decline to participate, and the law also would have provided immunity from civil and criminal liability for acts taken in good faith.

Most of the testimony in opposition came from health care providers, disabled individuals, religious organizations and senior advocate groups, who likened the proposal to state-sponsored killing and arguing that many seniors would feel a “duty to die” to ease the burden on family members charged with their care.

“If we should kill anything, it shouldn’t be our kupuna, it should be this bill,” said Allen Cardines Jr., executive director of the Hawaii Family Forum.

Martin Riggs, who uses a wheelchair, said he had no feeling in his hands or legs but showed up to testify against the proposal to prove a point to doctors and others who have told him he could not do things.

“You never know — if you died today, they might find a cure tomorrow,” said Riggs, 59, of Pearl City.

The proposal was patterned after Oregon’s 1997 landmark Death with Dignity Act, which made it the first state to allow doctor-assisted suicide. But opponents also raised the case of Oregonian Barbara Wagner, a cancer patient whose health insurer refused to cover costly treatment drugs, but instead told her it would cover less expensive lethal drugs.

Supporters urged lawmakers to advance the proposal to bring it to the Senate floor for a vote.

Although proposals have been floating in the Legislature since 1999, it has not faced a full floor vote since 2002, when the Senate voted it down 14-11 on the final day of the regular session.

Among those in support of the proposal was Marsha Joyner, who said she values life but does not want to spend her final days in a hospital hooked up to various machines.

“Is it dignified to die in a hospital with strangers and all that equipment?” Joyner said. “Is that dignity? Is that quality when you could be at home with your loved ones?”

Green (D, Milolii-Waimea) was the last committee chairman to hear it in either chamber, doing so as the House health chairman in 2005 and 2007. The bill failed to make it out of his committee both years.

Green, a doctor, said that with so much turnover in the Legislature — and the Governor’s Office — he felt it was healthy to have fresh debate on such a difficult social issue.

Kailua Hawai`i suicide, Dec 14, 2009 – Husband’s suicide resurrects right to die debate

By Tim Sakahara

KAILUA, HAWAI`I – Days after allegedly shooting his dying wife, in an attempt to put her out of her misery the medical examiner confirms Robert Yagi has taken his own life. Police are tight-lipped tonight on why Yagi, who was apparently suicidal, was allowed to post bail Friday and go home.

View video story and read complete text here.

Legalize aided suicide

HSB_MastheadDec 15, 2009 – EDITORIAL

The suicide of a 71-year-old Kailua man who was charged with attempted murder of his terminally ill wife is a tragic reminder that Hawaii legislators have rejected a bill that would have allowed her to die with dignity. The Legislature should revisit the issue in its next regular session and legalize physician-assisted suicide.


Kailua Case Ignites Physician-Assisted Suicide Debate

khonDec 14, 2009

Reported by: Ron Mizutani

The Honolulu Medical Examiner confirmed Monday the man who tried to kill his terminally ill wife in her hospital bed last week has committed suicide. 71-year-old Robert Yagi was found dead Sunday in his Olomana home. Autopsy results show Yagi died from asphyxiation due to hanging. Yagi was free on bail after being charged with second-degree attempted murder, for shooting his wife with a flare gun last Tuesday night at Castle Medical Center.