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Hawaii’s 2022 Annual Report on Assisted Suicide
Issued July 1, 2022
Although the report on the “Our Care Our Choice Act” is to provide information about the status of patients who die from assisted suicide under the law, there is a great deal that is not known.
The executive summary notes that the status of twenty-one patients who died were not received since a followup form was not received by the Hawaii Department of Health. The reason? Follow-up forms are dependent upon the patient’s designee to return the form to the attending physician who then mails the form to the Department as report #2. [Those reports were apparently not made or mailed.]
“Lawmakers Fail to Expand Access to Assisted Suicide in Hawaii”
(Honolulu Civil Beat — May 4, 2022)
“A bill [HB 1823] that sought to expand access to medically assisted death in Hawaii failed to advance to a final vote after lawmakers stumbled over the role of advance-practice registered nurses and physicians assistants.”
Rep. Troy Hashimoto, one of the legislators who introduced the bill, said he will reintroduce the measure next legislative session. He said, “We’re not going to quit because these unnecessary barriers are forcing people to have tragic deaths.”
[Note: Advocates for assisted suicide in Hawaii never give up. They first introduced an assisted-suicide bill in 1998. It did not pass. Between 1998 and 2018, 39 different to pass such a bill failed until 2018 when a bill permitting physicians to prescribe a lethal dose of drugs passed. And now, they are attempting to expand the law, saying the existing law’s “safeguards” are “barriers.”]
“Has Hawaii forgotten that it legalised assisted suicide?”
(BioEdge — September 5, 2021)
“[W]hen assisted-suicide advocates promise strict guidelines to protect against abuse, they don’t really mean it. The promise’s purpose is to get the law passed, not to be kept.”
Hawaii’s 2020 Annual Report on Assisted Suicide — Issued July 1, 2021
The report included the Department of Health Legislative Recommendation: “Given access to health care providers is limited, the DOH recommends authorizing advance practice registered nurses to serve as attending providers for patients seeking medical aid in dying. (Pg. 6, Legislative Recommendation #2.)
2021 bill
SB 323 would have permitted advanced practice registered nurses to prescribe drugs for assisted suicide. It would also have reduced the waiting time between requests and waived the waiting period for some individuals. The bill passed in the Senate but failed in the House.
“Legislation proposing amendments to aid-in-dying law stalls”
(West Hawaii Today — March 24, 2021)
Hawaii’s 2019 Annual Report on Assisted Suicide — Issued July 1, 2020
Between January 1, 2019 through December 31, 2019, 30 patients received prescriptions for the lethal drugs.
In the first half of 2020 (from January 1, 2020 through June 26, 2020), a total of 24 such prescriptions were written — almost as many as for the entire prior year.
The most common prescription was for DDMP2.
[DDMP2 contains diazepam, digoxin, morphine, and propranolol.]
2020 bills
Two bills to expand Hawaii’s law permitting assisted suicide were introduced in January 2020:
SB 542 would require reimbursement for prescriptions pursuant to the “Our Care, Our Choice Act” [Hawaii’s law permitting assisted suicide] regardless of the prescription drug coverage provisions of the patient’s health insurance. It would also establish penalties for pharmacies and pharmacists, or their agents, that refuse to honor prescriptions issued under the “Our Care, Our Choice Act.”
SB 2582 would authorize advanced practice registered nurses, in addition to physicians, to practice medical aid in dying [assisted suicide] in accordance with their scope of practice and prescribing authority. It reduces the mandatory waiting period between oral requests from twenty days to fifteen days. Waives the mandatory waiting period for those terminally ill individuals not expected to survive the mandatory waiting period.
………………….
In Hawaii, attempts to legalize doctor-prescribed suicide, using a model based on Oregon’s law, took place for more than 20 years. Those bills failed but assisted-suicide advocates vowed to continue introducing legislation until they succeeded, no matter how long it took.
On Thursday, April 5, 2018, Gov. David Ige signed Hawaii’s doctor-prescribed suicide bill (HB 2739 as amended) into law. The law went into effect on January 1, 2019.
Text of Hawaii Bill as passed and signed by governor.
Frequently Asked Questions about Hawaii’s law permitting doctor-prescribed suicide.
(Hawaii State Department of Health — January 1, 2019)
2018
The 2017 bills have been held over in 2018. In addition, the following new bills have been introduced:
Hawaii HB 2739 has now been amended
Text of HB 2739 HD 1
Text of amendments to HD 1
HB 2739, titled the “Our Care, Our Choice Act” as originally proposed
Text of bill
Analysis of bill
……….
HB 2736, also titled the “Our Care, Our Choice Act”
Text of bill
HB 2218, titled “Voluntary Assisted Dying”
Text of bill
SB 2727, titled “Medical Aid in Dying Act”
Text of bill
“Medical Aid in Dying Dealt Another Blow in Hawaii”
(Big Island Video News — July 15, 2017)
They failed at the legislature this year, and now a court dismissed a lawsuit, but advocates have not given up.
Hawaii latest state to say “NO” to assisted suicide
(May 4, 2017)
Although assisted-suicide activists had poured hundreds of thousands of dollars into Hawaii in their attempt to transform assisted suicide into a medical treatment, not one of the five bills proposed in the state this year passed by the May 4 adjournment.
In addition, House Speaker Joe Souki is expected to lose his post which may be, in part, because of his push to legalize assisted suicide.
2017 Bills — None of the 2017 bills passed
S.B. 357
Text of bill
Analysis of bill
H.B. 201
Text of bill
Analysis of bill
S.B. 1129
Text of bill as amended on 2/15/17
Analysis of bill
The House Committee on Health decided not to advance the proposal on 3/23/17. (See articles below.)
H.B. 150
Text of bill
H.B. 550
Text of bill
2017 Law Suit
“Cancer-stricken lobbyist Radcliffe files right-to-die suit”
(Star Advertiser — January 11, 2017 — Hawaii)
State political lobbyist John Radcliffe, Dr. Charles Miller, and Compassion & Choices [the former Hemlock Society] are suing to prevent Miller from being prosecuted if he prescribes a deadly overdose of drugs to Radcliffe.
Last month Attorney General Douglas Chin offered an opinion that a physician who prescribes a lethal dose of drugs could be charged with manslaughter.
2017 Draft Bill
The “Hawaii Patient Choice at End of Life Act of 2017” is a draft bill to permit doctor-prescribed suicide. It has been circulating in the lead up to Hawaii’s 2017 legislative session.
If passed as written, Hawaii could easily become a national suicide destination where patients could obtain the prescription for a lethal dose of drugs on the same day they receive the diagnosis of a terminal condition.
The draft bill follows a blueprint recently laid out by Kathryn Tucker in Jurist magazine. Tucker served for many years as legal director for Compassion and Choices (the former Hemlock Society) and has been the chief litigator in failed cases throughout the country challenging the constitutionality of laws against doctor-prescribed suicide.
Text of draft bill
Analysis of draft bill
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Background
In Hawaii, attempts to legalize doctor-prescribed suicide, using a model based on Oregon’s law, have taken place for more than 20 years. Those bills failed but assisted-suicide advocates vowed to continue introducing legislation until they succeeded, no matter how long it took.
Current law regarding assisted suicide
A person commits the offense of manslaughter if the person intentionally causes another person to commit assisted suicide. [Haw. Rev. Stat. § 707-702 (1) (b)]
2016 Failed Legislation
S.B. 2373
Text of bill
Analysis of bill
2015 Failed Legislation
HB 1255 is also styled after Oregon’s doctor-prescribed suicide law and, as with the 2013 proposal a patient must be at least 50 years of age to qualify for assisted suicide.
2013 Failed Legislation
HB 606 was styled after Oregon’s doctor-prescribed suicide law. However, to qualify for assisted suicide under the measure, the patient must be at least 50 years of age.
2009 and 2011 Bills
In 2011, Hawaii had three bills to permit doctor-prescribed death under consideration in the legislature – SB 803, its companion bill HB 1383, as well as HB 1165. The bills, as introduced, would have permitted both assisted suicide and euthanasia.
On 2/7/11, SB 803 was defeated in the Senate Health Care committee.
In 2009, three bills were under consideration in the legislature – HB 587, HB 806 and SB 1159 – all titled “Death with Dignity.” The bills were virtually identical and, as introduced, would permit both assisted suicide and euthanasia. On Feb. 18, 2009, House Judiciary Chairman Rep. Jon Riki Karamatsu announced that the House of Representatives would not hold hearings that year on an assisted-suicide bill.
Analysis of 2009 bill (HB 806) View HTML Version; View as PDF
Attorney General’s Analysis of Section 453-1 (HRS)
Hawaii Attorney General Issues Opinion Rejecting Claim by Compassion & Choices That Assisted Suicide Is Already Legal. (December 8, 2011)
Articles
“Hawaii law allowing medically assisted suicide takes effect”
(Associated Press — January 3, 2019)
Hawaii’s new medically assisted suicide law has gone into effect, but few doctors and pharmacies are willing to prescribe and dispense the life-ending medications.
“Hawaii’s New End-of-Life Law: Do Additional Safeguards Withstand Scrutiny?”
(The Hastings Center — May 4, 2018)
[Hawaii’s law requires “counseling” which can be just one consultation to determine that the patient knows what he or she is requesting]
“Under Hawaii’s law, however, a patient may obtain a consultation via telehealth.”
“Circuit Court Dismisses Medical Aid-in-Dying Case”
(Maui News — July 16, 2017)
On Friday, July 14, one day after a hearing in the case on Thursday, July 13, First Circuit Court of Hawaii Judge Keith K. Hiraoka ruled the case did not pass the legal requirements to proceed.
“Medical Aid in Dying Dealt Another Blow in Hawaii”
(Big Island Video News — July 15, 2017)
They failed at the legislature this year, and now a court dismissed a lawsuit, but advocates have not given up.
Hawaii latest state to say “NO” to assisted suicide
(May 4, 2017)
Although assisted-suicide activists had poured hundreds of thousands of dollars into Hawaii in their attempt to transform assisted suicide into a medical treatment, not one of the five bills proposed in the state this year passed by the May 4 adjournment.
In addition, House Speaker Joe Souki is expected to lose his post which may be, in part, because of his push to legalize assisted suicide.
“Most Hawaii House Members Won’t Say Where They Stand on Aid in Dying”
(Civil Beat — April 6, 2017)
The overwhelmingly Democratic chamber’s power brokers decided it was too soon for Hawaii and had concerns about adequate safeguards to prevent abuse.
Rep. Andrea Tupolo said, “I was concerned with the bill because of issues with death certificate accuracy, no mandate that the medication be taken in a controlled environment with a witness, lack of enforcement and no definition for ‘self-administration.'”
“Hawaii Lawmakers Kill Bill to Offer Medical Aid in Dying”
(U.S. News and World Report — March 23, 2017)
Critics raised concerns that ill people might choose suicide to relieve family burdens.
“Hawaii Balks At ‘Death With Dignity'”
(Civil Beat — February 22, 2016)
Senate Bill 2373 died in the Consumer Protection and Health Committee, chaired by Sen. Roz Baker. A similar measure that was introduced last year in the House and was still alive this session also failed to get a hearing.
“AG denounces Aid in Dying ad”
(Hawaii News Now KGMB and KHNL — September 24, 2013)
A nationwide non-profit created an ad claiming that doctors could write prescriptions for suicide in Hawaii. The state attorney general stated, “What they’re saying is false, misleading and deceptive.”
“Law, Morals and Likely Abuse Trump ‘Compassion'”
(Hawaii Reporter — July 8, 2013)
Advocates of death say that they’re helping people plan and achieve a good death. They say that it’s just a small number of people they’re killing. Well, all government-backed programs start small.
“Hawaii Medical Association Opposes Physician-Assisted Suicide”
(Honolulu Civil Beat — December 10, 2012)
The words of ethicist Hans Jonas summarize well the consequences of embarking upon the dangerous path of legalized physician-assisted suicide: “The role of taker of life must never be assigned to the physician; in any case, the law must never permit him to perform it, for this would jeopardize and perhaps destroy the physician’s role in society. A patient must never have to suspect that his physician might become his executioner.”
“New Aid-In-Dying Service Getting Inquiries”
(Honolulu Civil Beat — October 5, 2012)
Compassion & Choices Hawaii, a nonprofit organization working to improve care and expand choice at the end of life, received 31 local inquiries in its first year of service. The figure comes from an annual report released by the Physician Advisory Council for Aid in Dying or PACAID, a group of local doctors that collaborates with Compassion & Choices Hawaii and can prescribe life-ending medication if necessary.
“5 Hawaii doctors offer assisted suicide to terminally ill patients”
(American Medical News — April 17, 2012)
A group of Hawaii physicians is offering to write lethal prescriptions for terminally ill patients in a bid to test whether doctor-assisted suicide is allowed under state law. “I’m retired.” said Dr. Robert “Nate” Nathanson. “I think the worst that would happen is that they’d take my license away. I don’t think I’m going to put in any jail time…My livelihood doesn’t depend on it, so I can be very brave.”
“Native Hawaiians will fight against Assisted Suicide”
(Hawaii Free Press — December 10, 2011)
Panel refutes claims that 1909 law permits assisted suicide, noting that assisted-suicide activists have been trying to legalize the practice for years.
Hawaii Attorney General Issues Opinion Rejecting Claim by Compassion & Choices That Assisted Suicide Is Already Legal. (December 8, 2011)
“Hawaii Physicians Rally Against Assisted Suicide”
(Hawaii Free Press — December 2, 2011)
The Senate Health Committee heard a physician-assisted suicide (PAS) bill at the 2011 session and voted not to send the bill any further. That should have ended consideration of the issue for 2012 also, but indications are that advocates of PAS may engage in unusual maneuvering to have PAS heard again in the 2012 session.
“Hawaii Legislature scuttles assisted suicide” ( CNBC – – February 8, 2011 )
A Hawaii legislative panel on Monday unanimously voted down a bill that would have legalized physician-assisted suicide. Kevin Inouye who spoke in opposition to the bill from his wheelchair wore a yellow sticker saying, “No doctor prescribed death.”
“Assisted suicide bill stalls”
( Star Advertiser – – February 8, 2011 )
After citing numerous examples of loved ones who outlived a doctor’s terminal diagnosis or of their own victory over suicidal depression, opponents of a proposal to legalize physician-assisted suicide in Hawaii applauded as a Senate committee defeated the measure last night.
“Hawaii – Robert Yagi Dead, and Assisted Suicide Advocates Continue to Exploit the Tragedy”
( Not Dead Yet News Commentary – December 14, 2009 )
71-year-old Robert Yagi committed suicide after attempting to kill his wife with a flare gun loaded with a shotgun shell. According to assisted-suicide advocate Andi Van der Voort, the law should be changed to permit assisted suicide. “I think it’s awful that someone has to shoot you,” she said.
Comment: Apparently, Van der Voort (who was formerly president of the Hawaii Hemlock Society and now serves on the board of the Final Exit Network) believes that giving doctors the power to prescribe poison is the only way to prevent husbands from killing their wives.
“Assisted-suicide bill in death throes: Stiff opposition seems likely to keep the legislation from surviving the session.” (Hawaii Star-Bulletin 2/8/07)
“Hearing passionate on death with dignity.” (Honolulu Advertiser 2/8/07)
Doctor-assisted suicide bill fades at Legislature (Hawaii Star-Bulletin) 2/6/05
Proposal seeks the right to death” (Honolulu Star Bulletin, 3/8/04)
“Suicide bill goes to full house” (Honolulu Star Bulletin, 3/5/04)
“Teach options to assisted suicide instead” by Herbert Hendin and Kathleen Foley (Honolulu Advertiser, 2/9/03)
Hawaii: Assisted suicide bill dies in Senate (Update, Vol. 16, No. 1, 2002).
Hawaiian Senate resurrects then narrowly defeats assisted suicide bill (Update, Vol. 16, No. 2, 2002).
