The Senate is likely to act soon on a bill providing end-of-life choices for the terminally ill. The stark divisions existing among legislators and the public on the issue could be seen in the unusual path the bill has taken to the Senate floor. The Senate Health and Welfare Committee approved the bill unanimously. On Friday the Senate Judiciary Committee sent the bill to the floor recommending that it be defeated.

Even the terminology to describe the bill reflects those divisions. Opponents say the bill would authorize physician-assisted suicide. Supporters say it allows death with dignity by providing choices at the end of life. Both circle around the stark fact of mortality and how best to respect life in its final moments.

End-of-life choices have been available in Oregon for 15 years and in Washington state for four years following voter approval in both states. In 80 percent of the cases in Oregon, the people making use of the law have had disseminated cancer or Lou Gehrig’s disease or end-state emphysema. The law is not used with great frequency, accounting for only 0.2 percent of deaths.

The idea of helping a loved one obtain a lethal dose of medication fills most people with horror. But the idea of a loved one wracked by incurable pain and robbed of a sense of autonomy is another form of horror. People who can end that ordeal a few days or a few weeks sooner than it might otherwise end are often comforted by the existence of that option even if they don’t employ it. The law is said to be widely popular in Oregon and Washington.

Opponents of the bill argue that state support of physician-assisted suicide devalues life — sends a message that some people are expendable, that we might as well be rid of them. They suggest that family members might pressure someone to bring things to a quick end.

These are valid concerns. But it appears that the experience of Oregon tells us that the law tends to improve the care of people at the end of life. Most people who receive help dying are already in hospice, and hospice services in Oregon have become generous and widespread. Palliative care at the end of life is often advanced as an alternative to suicide. But improved palliative care seems to have followed passage of the death-with-dignity law in Oregon.

Support for a law in Vermont has been persistent and heartfelt in recent years. Often it is driven by experience. The fact of difficult deaths is not going to go away, and the compassion of family members accompanying them on the journey cannot be expected to flag.

Passage of a death-with-dignity bill is not a message to anyone that they ought to avail themselves of the opportunity to end their lives. People want to live, and they will hang on as long as they can. But there comes a time for a small number when life is no longer endurable. That is for them to decide. Maybe they will continue to endure it anyway. But even without a law, some will see the need to end it. The law makes that passage happen outside the shadow of illegality.

Opponents of the law are motivated by respect for life and love for afflicted family members. So are supporters of the law. In the case of supporters, love of the afflicted makes them accept the difficult choice made by the dying person, asks them to honor the person’s wish. The law would put in place a process to make sure that wish is a legitimate choice, arrived at with sound mind and without coercion.

It appears the Senate has recognized that the time has come to pass this bill. It is not a happy topic, but facing the facts of life and death squarely means allowing the living the comfort of choices as death closes in.





More letters appear today on B3.