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October 21, 2000
Column #999


     The most important ballot initiative in the upcoming election is in Maine where voters will decide whether to become the second state (after Oregon) to permit physician-assisted suicide.

     The proposal sounds harmless: ''Should a terminally ill adult who is of sound mind be allowed to ask for and receive a doctor's help to die.'' 

     Initial polls found the public supported the measure by almost 3-1. But a remarkably diverse coalition that includes the state's governor, legislature, its physicians, hospitals, nurses, hospices, and religious denominations - have unanimously opposed the measure and raised $1 million to air a series of TV spots that have reduced the margin of support to 53 percent in favor.

     Dr. Laurel Coleman of the Maine General Medical Center appears in one of them, saying:  ''The bill to legalize physician-assisted suicide, may sound reasonable, but if you read the 11-page bill, you'll see it's dangerous.'' She notes there is ''no direct state supervision to prevent abuse.'' 

     ''No family notification is necessary. So a loved one can commit suicide without you even knowing. That's why every major medical association opposes Question 1.'' 

     Kandyce Powell, who runs the Maine Hospice Council, asserts in another ad: ''Some people want you to believe the only way to relieve pain and suffering is through death and suicide. That is not true...Through new medications and medical advances, pain can be managed effectively to ensure comfort. So people can live their lives with grace and dignity.''

     The largest contributor for the ads running in Maine is the Catholic Diocese. Why? Bishop Joseph Gerry told Catholics, ''If physician-assisted suicide were adopted in Maine, a terrible message would be sent to the terminally ill. Mainers would be saying that we as a society are more interested in ending their lives than in adequately attending to their pain. The terminally ill, in turn, could easily come to judge that they were a burden and that they should end their life.''

     Indeed, in one Oregonian case, a mother committed suicide after her daughter told her, ''If you don't do this, I will put you in a nursing home.''

     Even more grim, HMOs would have an incentive to encourage patients to cut their lives short, since $35 of pills to end life is a lot cheaper than medications and treatment.

     On the other hand, ads promoting assisted suicide feature people asking, ''Do you want to control your destiny? Don't let anyone tell you what to do.'' These ads, which appeal to independent Mainers, are sponsored by such groups as The Hemlock Society. Interestingly, 95 percent of their funding has come from outside Maine, while virtually all of the funds to fight the measure have been raised locally.

     ''Maine has been targeted by The Hemlock Society,'' says Michael Heath of the Christian Civic League of Maine, with a sense of resentment. Why? Maine is a relatively small state, which makes it far cheaper to put the issue on the ballot and to pay for TV advertising. Their hope is to succeed in a second state on the East Coast, creating a ''pair of bookends'' that will make it easier to bring the reform to many states in between.

     The law is almost a carbon copy of the one in Oregon which passed by a 51-49 percent margin. It has no safeguards for the patient. For example, there are no provisions to insure that the patient is competent at the time the overdose is taken, that the patient is not pressured into taking the drugs, or that the final dose was not given to the patient against his or her will.

     In fact, ''The Oregonian'' reported that a woman suffering from early dementia was denied a lethal prescription by her own physician. Her daughter took her to a psychiatrist who also said she was not eligible since she was not pushing for it, while the daughter was coaching her to do so. Finally, the persistent daughter found a managed care ethicist to OK it.

     Oregon physicians didn't take a stand against the measure as they have in Maine. For 2,400 years physicians have taken a Hippocratic Oath, ''I will neither give a deadly drug to anybody if asked for it, nor will I make a suggestion to this effect.'' The measure would erode the doctor's role as healer. If patients see doctors as executioners, how can they be trusted?

     Finally, experience in The Netherlands is chilling. What began as assisted physician suicide became a slippery slope toward widespread euthanasia. A government study found doctors killed 2,300 patients at their request. Incredibly, 1,000 patients who did not request it, were euthanized by their doctors, and another 23,000 lives were cut short by purposeful drug overdoses.

     Is this the future that Maine wants?

Copyright 2000 Michael J. McManus.

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