Suicide Aid Focus Turns to California

The narrow defeat of a Washington state euthanasia initiative did little to tone down the growing national debate over physician-assisted dying, the focus of which shifted Wednesday to a California plan to put the issue on the November, 1992, ballot.

Proponents of the Washington initiative, which would have allowed doctors to help terminally ill patients end their lives, expressed optimism because the measure failed by as few votes as it did. Opponents, meanwhile, marveled that the initiative had failed at all.

“I think this is actually the beginning,” said Margaret Battin, a University of Utah philosophy professor and initiative supporter. “This is likely to be the major social movement of the next decade. I fear it will become as polarized as the abortion issue.”

Initiative 119 was defeated with 56% of the voters opposed in nearly complete results--699,564 votes against and 604,494 in favor. Washington would have become the first state--or Western government--to legally sanction physician-assisted death for the terminally ill.

Both sides traced the defeat, which defied the predictions of pollsters, at least in part to the way the initiative was written. They said it lacked safeguards against abuse by unscrupulous doctors and others, which supporters pledged to write into future attempts.

For example, the California initiative now in circulation would require a waiting period between a person’s request for aid in dying and their death, as well as a method for informing family members of the request, and, if necessary, a psychological evaluation to ensure the patient’s competence.

“I do not interpret this vote as saying that physician-assisted suicide is not acceptable to Americans,” said Arthur Caplan, a University of Minnesota bioethicist and opponent of legalized physician aid in dying. “I interpret it as saying a poorly written, confusing, easily abused referendum . . . is not going to make people secure enough to vote for it.”

The debate over whether to legalize assisted suicides--which many say are increasingly common as medical technology prolongs dying as well as life--picked up steam in 1988 when an anonymous physician confessed in a medical journal to having helped a patient die.

Since that time, Dr. Jack Kervorkian has helped three terminally ill women in Michigan commit suicide, another physician has come forward to confess in the New England Journal of Medicine, and a how-to book on suicide, “Final Exit,” has soared to the top of bestseller lists.

In California, a group calling itself Californians Against Human Suffering began circulating petitions Oct. 15 in an attempt to collect the 385,000 valid signatures required to get the so-called Death With Dignity Act initiative on the ballot.

An earlier attempt by the same group failed to collect enough signatures to qualify for the 1988 ballot. But organizers say the group is now more sophisticated and better funded; they expect to spend $350,000 on the signature drive alone.

“For the average California voter, (the Washington vote) won’t make any difference at all,” said Jack Nicholl, the California campaign director. “People will go to the ballot box and . . . will apply (the question) to their own life and family situation.”

Elsewhere, the Hemlock Society of Oregon is attempting to form a coalition to try to put a similar initiative on the 1994 ballot. In Florida, the society is trying to build up membership and funding for an attempt to do the same there, perhaps in 1996.

In Michigan, the Legislature is considering appointing a commission to come up with a proposal for a right-to-die law--a response to a legislative logjam over whether to make assisting in a suicide a felony punishable by four years in prison or whether to legalize it.

“What happened yesterday was a disappointment,” conceded Derek Humphry, founder of the Hemlock Society. “We had hoped for a victory. But it will not stop the impetus of this movement. We shall lick our wounds and learn our lessons and go on again.”

In general, the issue tends to pit the Hemlock Society, activists for the elderly, AIDS groups and liberal and libertarian organizations against medical and hospital associations, anti-abortion groups, nursing homes, fundamentalist religious groups and the Catholic Conference.

“Prior to this time, all we knew was there were public opinion polls that suggested the public wanted to go for this,” said Roger Purdy of the California Medical Assn., which, like the American Medical Assn., opposes assisted suicide.

“Now it appears . . . it may not be as simple as the Hemlock Society might have thought,” said Purdy, manager of ethics and aging programs. “. . . So I think the chances of an initiative passing in California look a lot slimmer today than they did yesterday.”

While some observers suggested that the Catholic Church may have been more active in opposing the initiative in Washington than it is likely to be in California, others predicted that California’s larger low-income and minority populations are likely to oppose the measure.

“I saw no support (in Washington) among minorities and the poor,” said the University of Minnesota’s Caplan. “. . . I never saw a person of color who lacked medical insurance stand up and say, ‘Yeah, what I’m looking for is the right of the doctor to kill me.’ ”

But supporters of the concept maintained that eventual passage is inevitable.

“I think this is an idea and a movement whose time has come,” said Bo Bodenschatz, president of the Hemlock Society of Oregon. “If it doesn’t happen in Washington this year, it will happen in California next year or some place soon.”