Sunday October 21, 2012

BOSTON (AP) -- Leaders on opposite sides of Massa chusetts’ right to die debate are fighting for the same reason: Both have watched loved ones receive fatal diagnoses.

Dr. Marcia Angell supports the initiative. Her father shot himself to death rather than die from metastatic prostate cancer in 1988. She believes he would’ve lived longer and not turned to a pistol had assisted suicide been available.

Rosanne Bacon Meade’s sister-in-law is still fighting cancer, 18 months after doctors gave her three months to live. She opposes the measure, saying diagnoses are often wrong.

Voters will weigh in Nov. 6 on a ballot question to make Massachusetts the third state, after Oregon and Washington, to legalize physician-assisted suicide for people with terminal illnesses. Money has poured in from both supporters and opponents, many with personal stories like Angell’s and Meade’s.

The measure would allow terminally ill patients whose doctors say they have six months or less to live to obtain lethal doses of medication.

A Suffolk University/7 NEWS poll in September found 64 percent of 600 likely Massachusetts voters support legalization.

The initiative stems from a ballot petition filed by Boston-based Dignity 2012 and a terminally ill Stoughton man’s 2009 attempt to get a similar bill passed in the state legislature. Lawmakers didn’t take action, and Al Lipkind died of stomach cancer that year.

Thirty-four states prohibit assisted suicide outright, while Massachusetts and six others ban it through common law. Mon tana’s Supreme Court ruled state law doesn’t prohibit doctors from helping patients die.

"It’s not a question of life versus death," said Angell, lead signer of the petition and former editor-in-chief of the New England Journal of Medicine. "It’s a question of what kind of death."

Religious and medical groups and advocates for the disabled are the measure’s primary opponents. They’ve raised more than $1.6 million so far, compared with nearly $500,000 for supporters, mostly patients’ rights and AIDS groups.

Opponents say the bill is open to abuse. Patients may be influenced by family members, they say, or go from doctor to doctor until they find the required two to confirm they are terminally ill, not depress ed and voluntarily requesting the prescription.

They say terminally ill patients are often depressed and may irrationally choose to end their lives even though misdiagnoses are common.

A diagnosis is a "crude estimate," said Dr. Richard Aghab abian, president of the Massa chusetts Medical Society, which opposes the initiative.

Supporters say the law has effective safeguards, including prohibiting doctors from prescribing the drugs to people with depression or impaired judgment. It would require patients to make two oral requests at least 15 days apart, then a written request signed by two witnesses.

Doctors would have to notify patients of alternatives like hospice care and wait 48 hours before writing prescriptions.

In Washington, 103 people requested the prescriptions in 2011 and 71 used them. In Oregon, 114 people obtained prescriptions and 70 used them.

Most Oregon residents who used the assisted suicide law took fatal doses of secobarbital, often 100 or so pills emptied into a glass of water. About one-third chose another barbiturate, pentobarbital. Patients typically slip into a coma and die within 25 minutes, though death sometimes took up to two days.

Loss of autonomy, dignity and decreased ability to engage in activities that make life enjoyable were the top reasons Oregon residents choose to obtain the prescription.

John Kelly, director of a disability rights group against assisted suicide, said many terminally ill people choose to die when the lives they face look like his as a quadriplegic. The bill is "based on judgments on the quality of people’s lives," he said.

The Rev. Tim Kutzmark of Reading, a Unitarian Univer salist, was staunchly against physician-assisted suicide while studying at Harvard Divinity School. 

Then he "entered the real world," visiting dying parishioners and talking with congregants who sought information about the underground networks of medical professionals who advise patients on ending their lives.

He watched his close friend and mentor, theater critic Arthur Friedman, slowly die from Parkinson’s disease in 2002. Friedman waited for the moment when he could no longer swallow and could refuse food and water, effectively starving himself to death.

Kutzmark said the experience "rocked my world." He now believes prohibiting assisted suicide violates the sanctity of life.

"These are profound, the most profound questions that an individual can wrestle with," Kutzmark said. "They’re so profound and hard."