Proponents of assisted suicide say that competent adults should be free to make their own decisions about life, death and health. The Legislature has a responsibility, however, to protect those who are vulnerable to the will of others. Senate Bill 1129 contains “safeguards” included in Oregon’s “Death With Dignity” law, but they provide inadequate protection for elderly and disabled individuals who are at risk of abuse.

We are told that 80 percent of Hawaii residents favor doctor-assisted suicide, but that is unbelievable. The fact is, doctor-assisted suicide is extremely rare in the states that allow it. On the other hand, throughout history, elderly and disabled individuals have been victimized by relatives, caregivers and others who stand to gain from inheritance or simply by shedding the cost or burden of caregiving. Legalization of doctor-assisted suicide would only make matters worse.

The primary safeguard in SB 1129 is a requirement that two physicians believe that the patient has less than six months to live, is able to make and communicate health-care decisions (a very low standard), and that the request for lethal drugs is voluntary. Unless the patient complains that a loved one is trying to kill them, however, doctors may be hard-pressed to find that the patient’s request was not voluntary.

Assisted suicide would not be available for patients with “impaired judgment,” but that term is undefined, and it is left to the judgment of physicians who may not be able to diagnose mental illness and disabilities. The physician might refer the patient to a psychiatrist or psychologist for consultation, but referrals in certain areas of disability and in rural areas would be difficult if professionals are not available.

SB 1129 requires that the patient make two oral requests for lethal drugs and a third one in writing subscribed by two witnesses. The elderly or disabled may be reluctant, however, to oppose family members who encourage them to “make the request.” Worse, one subscribing witness may be an heir with the other paid to agree. Since the document would usually be signed in private, detection of wrongdoing would be unlikely.

Other provisions defeat safeguards. The patient is not required to inform next of kin of the suicide request, and the whole matter may be shrouded in secrecy. The lethal drug may be administered in private and without witnesses by one who encouraged the suicide and witnessed the written request.

The state Department of Health would issue annual reports of records requesting lethal drugs, but those would not reveal coercion or undue influence or any interest witnesses have as heirs, insurance beneficiaries or caregivers. Studies in other jurisdictions show that similar reports have been inadequate to show how assisted suicide affects vulnerable groups.

The “benefits” of suicide for those who would resort to it do not come close to outweighing the harm it would cause to others. If this bill proceeds, it should prohibit the prescription of lethal medication to individuals over 75 years of age and those with disabilities who are dependent on others for care and support.

The argument that individuals nearing death should be spared “unbearable pain” is answered by pain killers. The argument that they should be spared a “loss of autonomy and dignity” has little meaning for those with disabilities who have benefited from compassionate care with dignity for their entire lives.

John P. Dellera, of Kahala, was executive director of the Hawaii Disability Rights Center from 2009 to 2011 and is a director of the Autism Society of Hawaii. He has been a caregiver for a young man with autism for over 20 years.