 To think tech on OC16, for what is weekly newscast on things that matter to tech, and to Hawaii, I'm Kaui Lucas. And I'm Raya Salter. In our show this week, we'll cover medical aid in dying, also known as death with dignity, a bill pending in the 2017 legislature. The proponents of this bill have been trying to advance it for 28 years, and maybe this is the year it will pass. Medical aid in dying, or death with dignity, would permit the medical establishment to aid dying patients in taking steps to end their own lives. It has been increasingly popular in the rest of the US, and many people feel that it is the humane thing, and should likewise be adopted in Hawaii. Of course, this is a sensitive issue since it effectively enables a terminally ill patient to end his or her life. At the same time, it allows that patient to die in peace, minimize pain and terminal deterioration, and the difficulties and expenses that go along with that. No one ever said that death was easy, or that ending your own life was easy, but for a person who is in the throes of death anyway, and for the family of that person, medical aid in dying can be a much better choice. No one ever said that facilitating the death of a patient was easy for a doctor either. The problem is that the causing your own death, or facilitating the death of another, is against the law in Hawaii. That makes it difficult for terminal patients to end their lives, and it makes it difficult for doctors who wish to help them. And all along the way, over that 28 years, there has been opposition to the bill, led mostly by religious organizations and individuals who see death with dignity as inimical to their own religious values. The church, particularly the Catholic Church, with its enormous resources, has mounted a continuing attack against the bill, and has prevented its passage over all these years. Inter-Senate Bill 1129, the death with dignity bill, now called Medical Aid in Dying, is currently pending in the 2017 legislature. This bill, which is well supported in the medical community, is the enlightened approach that would finally make it possible for a terminal patient to end his or her life, and for a doctor to facilitate the process. This is not the same thing as a right to die. That term applies rather in the context of directing one's own medical care. That is, refusing life-sustaining treatment, such as a respirator or feeding tubes, when permanently unconscious or close to death. You can provide your own health care decisions by completing a Hawaii Advanced Health Care Directive. No fewer than five bills related to assisted dying were introduced in the 2017 legislature. The only bill now alive is SB 1129, originally the Death with Dignity Act. SB 1129 is modeled closely on Oregon's Death with Dignity Act, which took effect in 1997. If SB 1129 passes, a patient requesting aid in dying medication will have to be at least 18 years old, a Hawaii resident, mentally capable of making and communicating health care decisions, and diagnosed with a terminal disease that will result in death within six months. The bill was sponsored by Senators Carl Rhodes, Lorraine Inouye, Michelle Kidani, and Russell Ruderman. The bill received its first hearing in the Senate Health Committee on February 15th, where it passed with amendments on a six to zero vote. On February 28th, the bill passed in the Senate Judiciary Committee, again with amendments on a four to zero vote. A great number of organizations submitted testimony in support of SB 1129 and the Senate hearings, including the Democratic Party of Hawaii, a number of religious and community organizations, unions and civil rights and consumer rights organizations, the Hawaii Psychological Association, and many others. And the Hawaii Medical Association said it would not oppose the bill. Just as the lobbying efforts of the church have been in play on abortion and LGBT issues, the church would like to impose religious principles in these and other areas of our lives, even if we do not subscribe to the religions that drive their efforts. There are many who believe that in opposing these changes, the church is out of its element under the separation of church and state in the Constitution. That is the establishment clause of the First Amendment. There are many people in Hawaii who believe that it is time for enlightenment on this issue. An October 2015 Stanford University poll found that 76.5% of Hawaii residents favor assisted dying as an end of life option. A poll by anthology research likewise found that 80% of residents favored the idea. Clearly, death with dignity or medical aid in dying is an initiative whose time has come in Hawaii. ThinkTech has covered this discussion for some time. We have had various talk shows and done various interviews examining the issues and argument taking place on the subject. Currently, there are laws that would prohibit somebody from taking their own life and rightfully so. But I think, especially for a terminally ill patient, I think there are very limited circumstances where they should be allowed to control their own destiny. So hopefully that they aren't suffering in days and weeks of inextricable pain so that they can actually enjoy a situation and be lucid enough to have those final moments with their family exactly like how you've had illustrated for us and how significant that can be. But a lot of those things can only happen if we make some changes to the current law because what we really need to do is clear the pathway so that physicians feel that they can do this and they are not going to be held legally responsible so that patients are aware that this is an option for them and how they can do it in a way that will be safe and actually will be in a manner that we can ensure there aren't going to be abuses. And so we need to find the laws that can help us get to that objective. The founder of Capital Consultants, John Radcliffe, is terminally ill and he is out in the front on this issue. Correct. What's it like working with John? Oh, John is great. He retired from Capital Consultants so he's no longer with the organization but he's still around. It kind of depends on his health, you know, it goes up and down but he has been a great, great champion and advocate for this issue. We have a situation in which medicine has become better over the years to such a degree that we can be kept alive indefinitely for a very, very long time anyway with nothing else going on than artificial stuff keeping you going. That we can do but we still have a prejudice against allowing people to control their own lives at the end. That is just a prejudice that is in the medical field. I understand it. It comes with the Hippocratic Oath. Do no harm. But, you know, a little common sense would be useful. The legislation, you have to be of sound mind. You have to have less than six months to live and there have to be two doctors that have to say that. You've got to have, you know, two doctors willing to say that they're, go ahead with this. There's all sorts of safeguards in it if you believe that you have a right to determine under certain circumstances your own method of death because of pain and suffering and things that cannot be otherwise prevented. If you believe in that, then you've got to organize and you've got to get down to the legislature and you've got to make a scene. I urge every single person out there watching this, if you know a legislator, call a legislator. We all know people who have died long, extended, protracted deaths when they were in agony. They had clearly said to themselves and to others that they've had enough. They don't want to keep on going. And yet consistently, there were no heroic measures were taken and yet they kept on living and living long past the point where there had been endless suffering and sometimes depletion of monetary resources from the family as a result of what had happened. Suicide as you take your own life, when you talk about the difference with that and what's going on with this particular issue, it's that there's a human intervention and the human intervention can either be humane or inhumane and humane is giving the person the medication that they need and if that leads to their death, then that was a merciful thing to do. The inhumane is causing the suffering to go on indefinitely to have all the pain and agony as well as the loss of human dignity which John Radcliffe is very, very concerned about and doesn't want to lose his and then those are the differences between the two. Some human intervention. We married not just because of that, but and then just shortly after we were married, she was diagnosed with what turned out to be terminal cancer. Now when I met you, you were caring for Lenny. Yes, I was her caregiver at home. We did have hospice Hawaii, which was a wonderful thank the good Lord for the hospice systems because Lenny was able to pass in her bed in her little bedroom in our apartment with me holding her hand. So I've seen it all. Was there was was she comfortable with her struggle with his last few? We had heavy meds, IV meds, and she had what's called a pick line, which was a easy way to give an injection in her arm and I was taught the process. So I was because I was there 24 hours a day. She was very comfortable. Now that was unfortunately having that pick line in her at home was after a series of what the doctors call a breakthrough pain attack. And that's when her pain reached such a level that I had to rush her to the hospital screaming with pain and agony. And this was after two major surgeries and chemo and radiation and all of the heroic efforts that if I had to do it over again, I would encourage her not not to have done all that. But I demanded that I be in control of her meds. And that's something that people need to understand. They are in control of the conservative fundamentalist religions, primarily the Catholic Church. They'll fight tooth and nail to stop this. And they are the ones that when we nearly passed the bill in Hawaii in 2002, it was killed dead and I'm not being no pun intended. The bill, the death of Digny Bill was stopped in its tracks. We lost it by three votes in 2002. And that was because the Bishop of Hawaii had a personally written letter hand delivered to all of the Catholic state representatives and senators. And we lost that bill. That, unfortunately, that loss since 2002 has caused tens of thousands of horrible, painful, protracted deaths since 2002. Someone who hasn't been in touch with the family or is living on the mainland or simply has a different, maybe a set of religious values and beliefs, which are different from the patient and the rest of the family. So if anything, by the time the conflict has arisen, though, I'm almost guaranteed that this conflict has surfaced before, right? But they've never really had the time or desire to address it. So by now, though, it just becomes, I would say, one of those opportunities for great courage on everyone's part and an opportunity for great healing and reconciliation. But it takes a commitment on everyone's part to kind of move through some of the differences. It's OK to have differences, but how can we still work together for the well-being, again, focusing on the needs of the patient? They call it the sister in California syndrome. You have people here. No mom has her advanced direct living will and they're following it. Sister comes swooping in from California saying, oh, no. They haven't seen mom since she was. Yes. OK, so now they see her and she's pale and she's incapacitated. They freak out and then it's I know what's best for mom. You guys aren't doing anything. She would never be in this situation if you guys hadn't dropped the ball. I'm taking over now. Excuse my language, but to help with the advanced directive and go straight to the doctor and tell him this is not what we're doing. Doctors are afraid of getting sued. So they'll back up and then you have all kind of things done to this person that was against their wishes. There is a point that I believe each person reaches in her or his life where their health may be degraded to a point where they are incapacitated. They may be in very much pain. And what I think we as a society have as an obligation is to provide them as much comfort as possible during that. Let's talk about that joy and pain and grief and dealing with that. Yeah, that's a I think I ended up in that area because I had that experience of my sister and how that impacted me for her to be cared for but also the pain that I experienced. And we know that there are stages of grief and they're not simply easily laid out. Like you say, well, there's denial, there's bargaining, there's anger, there's acceptance and they don't always flow in order. So what happens quite often is that you have this point of life where now you realize that this person is gone but you don't want it to be real so that denial sets in. Usually that one is right up front that it's like, well, wait a minute, wait a minute. They're not really gone. They're not really gone. So you kind of shut down, you become numb, find yourself waking up in the morning thinking that that was just a dream. So that's one of the ways you might experience it. And then the other is this bargaining, the bargaining of saying, if I could just do this, then maybe I could heal from this and it won't happen. Every person experiences it differently. I had a very, very close friend of mine who was in the exploring process with you on Sunday one day on Wednesday was in the hospital and never left and did not know that he was ill. And in that process it started to happen, the bargaining with God that, boy, when I get better, I'm going to do this with the church or in the community or, boy, when I've done a lot with God, I don't understand why this is even happening to me. Why would this be? So I think that it's each individual then towards the end, sometimes healing takes place in ways that we don't understand, like healing with family members. Family members come from far away that maybe you hadn't talked to in a while. And in this person's case it was. A family member came, they had a great conversation, kind of a reunion. And they'd been estranged from each other 10 or 15 years. So there's this healing sometimes that takes place that we can't understand. It's not physical. 80% of our Hawaii residents support the measure. And so she did take a poll and she will be hearing this measure. And she's looking at putting on the agenda SB 1129 on Senator Rhodes' bill. However, the discussions that I hope that the community and people who want to see us make decisions this year, please come and support Senator Baker's bills that she is going to introduce. We want people to come out and please send in your testimonies in support, give the senator and her committee an opportunity to hear from your experiences out there and to ensure that something passes for the first time and make sure that we have good discussions and that it passes the Senate. Make sure that there's something that goes over to the House and have their discussions. What this, at least from my point of view seems to allow, which I find, you know, actually quite acceptable is the idea that I can actually not have to starve to death. I can actually die with dignity because it's my choice, however the procedure is. And I'm not going to be just removed from my support. I'm going to actually, you know, get something that'll put me to sleep. To me, you really need a fourth option. In an option, not to be starved, eat brain dead forever or have somebody else choose for you. If you look at the side effects on some of the medications that doctors prescribe every day and one of them says death, what in the world, how can they say, well, we take an oath not to do any harm? Doctors are already prescribing as a necessity for health reasons, very dangerous things anyway. And so, but this will not, this does not, your bills or what you're supporting does not require them to administer. No. As a matter of fact, all it, in fact, the doctor has to be, has to agree that you're a terminal. So that's actually a protection. Right, two doctors, two doctors. Okay, so two doctors will say you're terminal and that's all they do. Tell your legislators, those you know personally, whether you see them in the supermarket or anything like that, tell them that, that's the thing that the legislation, that legislation which, you know, choices for the retro is talking about, go with that. I do not want to die, but I'm dying. Until now, the bill has had no success. But this year it appears to have attracted broad grassroots support and notable champions among the legislators. It has had hearings which evidenced abiding interest and support. And there seems to be a fair chance that it can pass, and that's encouraging. SB 1129 was to have been put to a full vote in the Hawaii Senate on Tuesday, March 7th, and that vote will be a turning point in Hawaii's efforts to pass this legislation. You can read the text of the bill on the Hawaii Legislature website. You can also visit the websites of the Hawaii Death with Dignity Society and the Death with Dignity National Center, and for information about appointing a healthcare agent and expressing your wishes for medical care at the end of life. See your attorney or visit NOLO.com, among other sites. Medical aid and dying has been regularly discussed on Think Text Weekly, Navigating the Journey series, where host Marcia Joyner explores the options and choices of end-of-life issues from religious, cultural, medical and legal perspectives. You can see these shows on ThinkTekHawaii.com or on YouTube. They are uploaded as podcasts on iTunes, and you can listen to them here. Of course, it's not over until it's over, and it remains to be seen whether and when the bill will pass and be signed into law. It is in any event an important bill for us to follow, right down to the governor's signature. ThinkTek will be there, so stay tuned for more. And now, let's take a look at our ThinkTek calendar of events going forward. There's so much happening in Hawaii. Sometimes things happen under the radar, and we don't hear much about them. But ThinkTek will take you there. 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Thanks so much for being a part of our ThinkTek family and for supporting our open discussion of tech, energy, diversification, and global awareness in Hawaii. You can watch this show throughout the week and tune in next Sunday evening for our next important weekly episode. I'm Kaui Lucas and I'm Raya Salter. Aloha everyone.