PERSPECTIVES ON ASSISTED SUICIDE : Self-Determination Is Affirmed : This compassionate alternative to suffering ‘a bad death’ rests on human decency and carefully drawn laws.

When I started out in 1980 on the campaign to legalize physician-assisted suicide, I knew it would be a long-term struggle. There were plenty of cheap remarks and jibes about this being just another flaky California group.

This week, when the U.S. 9th Circuit Court of Appeals said that there was a constitutional right to this procedure, it was a major steppingstone toward national acceptance of what is, at root, just common sense behavior by one human to a less fortunate other.

But if that time span is what it takes to achieve this ultimate civil liberty, then it has been worth it. It is obvious that the ending of a human life is an awesome decision and must be approached with great caution.

By striking down Washington state’s prohibition against assisted suicides, the appellate court indirectly approved a law for the dying who express a desire to shorten their suffering with lethal drugs. These drugs are available only from physicians and there must be appropriate counseling, waiting periods and documentation to accompany the decision to die.

The assisted suicide movement never has sought approval of accelerated death for the mentally or physically handicapped, the depressed or for the poor or elderly. Let me put that canard firmly to rest. What we are now close to getting in America is choice in dying for those unfortunate few--perhaps 5% of all who die--whose suffering and/or indignities the medical profession is unable to alleviate.

Hospices will flourish, pain management will improve, medical life-support systems will be used more discreetly, as all health professionals instinctively struggle to reduce the number of requests for assisted suicide.

It is fair to ask whether pain management and hospice care would be as good as they are now if it had not been for the noisy intervention of the right-to-die movement.

Legalizing assisted dying will remove it from the present secret crime of the bedroom and enable doctors to stop acting covertly. Jack Kevorkian may be the only one who faces court trials but he is one of hundreds of American doctors who quietly assist suicides.

Even more important, doctors will be able, with legalization, to call for second opinions, get psychological evaluations and talk with the dying person’s family or spiritual advisors before prescribing the lethal drugs. Today, the help is given to the dying by one doctor acting alone without team backup, an unfair and unwise responsibility.

It may be asked if we need this procedure for only 5% of the dying population. But more than 2 million Americans die every year in the normal cycle of birth, life and death, making 5% a sizable number.

The greatest boon of legalization is the real comfort it will bring to those who are told that they are terminally ill. They will know that even if they are destined to become one of the unlucky few to meet “a bad death,” there is now a compassionate escape hatch.

Is this the start of the slippery slope toward killing off the burdensome--our expensive elder folk, our physically and mentally handicapped, our citizens on welfare? If you believe that, it would be best to leave the country now, because you have no faith in the goodness of human nature or the ability of the American democratic system to protect the weak.

Assisted dying must come into being with carefully drawn laws, accompanied by sensitive guidelines. This will be the mark of America as a great civilization: when it can allow the right to die with fairness and responsibility while at the same time saying “thus far and no farther.”