Suicide” Is Inaccurate, Biased Term to Describe Terminally-Ill Patients’ End-Of-Life Choices Public Opinion & Medical Experts Urge Media to Adopt Neutral Terms

“Suicide” is Inaccurate, Biased Term to Describe Terminally-Ill Patients’ End-of-Life Choices Public Opinion & Medical Experts Urge Media to Adopt Neutral Terms

PRESS KIT Why it’s Wrong To Refer to “Aid-In-Dying” as “Suicide”

• Terminally ill people who want the choice of aid in dying do not want to die but, by definition, they are dying. They are facing an imminent, inevitable death and they simply want the option to avoid unbearable suffering.

• “Suicide” is hurtful and derogatory term to both a dying patient and the patient’s loved ones. It conjures images of irrational, depressed teenagers, adults with mental illness, and terrorist bombers. It suggests guns and violence. It suggests the patient is choosing death over life.

• Cancer patient Char Andrews told the National Press Club, it is “an insult” to her fight against her illness to call the choice she wants “suicide.”

• Cancer patient Jack Newbold told reporters that he resented media reports announcing that he was going to kill himself. “I am not committing suicide, and I don’t want to die. I’m not killing myself; cancer is taking care of that.”

• Recently the Oregon Department of Human Services removed all reference to “assisted suicide” from its reporting on the Oregon Death with Dignity Act. A spokesperson admitted the agency probably never should have used the term in the first place.

• The Oregon Death With Dignity Act specifically states that a the ending of one’s own life under the controls and safeguards of the law is legally not a suicide.

• The American Public Health Association, one of the nation’s most esteemed health care organizations, recognizing the profound difference between a typical “suicide” and the choice of a terminally ill, mentally competent adult to take life- ending medication to end suffering, has urged health educators, policy makers, journalists, and health care providers to refer to this choice in “accurate, value- neutral terms such as ‘aid in dying’ or ‘patient directed dying’.”

• Increasingly, mental health professionals are describing the fundamental differences between the psychological state of a person who irrationally rejects life and the psychological state of a person who loves life and would choose it if they could, but who faces suffering and prolonged deterioration leading to inevitable death.

• Finally: “suicide” is the term preferred by opponents because it is inflammatory and provokes negative reactions. Hence, it is not a neutral term. Opponents of aid- in-dying are aware that the majority of the public supports an individual’s right to end their life if suffering becomes intolerable, and so tries to reframe the debate by using inaccurate and pejorative language.

FOR IMMEDIATE RELEASE: Wednesday, September 28, 2005 CONTACT: Steve Hopcraft, 916/457-5546; [email protected]

“SUICIDE” IS INACCURATE, BIASED TERM TO DESCRIBE TERMINALLY-ILL PATIENTS’ END-OF-LIFE CHOICES

Public Opinion & Medical Experts Urge Media to Adopt Neutral Terms

SACRAMENTO, CA – Public opinion research released today shows that use of the term “suicide” to describe the end-of-life choices of terminally-ill patients is inaccurate and biases audiences against patients and their families. “’Suicide,’ or ‘assisted-suicide,’ or ‘physician-assisted suicide’ are loaded, pejorative terms that paint terminally-ill patients in the same negative light as terrorist bombers,” Barbara Coombs-Lee, co- president of Compassion and Choices told a national news media teleconference. “’Suicide’ is inaccurate because it indicates a self-destructive act that kills a person. Fatal diseases are killing terminally ill patients, and patients are choosing to avoid a prolonged dying process. Using the term ‘suicide’ can adversely-affect patient’s life insurance and other survivors’ benefits. Suicide is a sin in many religions, and physician-assisted suicide is a crime in all states. Using the term has negative impacts on terminally ill patients, their families and survivors. It’s not accurate and it’s not fair.”

Terminally ill patient Jack Newbold is facing the final days of his life. An Astoria, Oregon, sea captain, Newbold, 59, has bone marrow cancer. Newbold has obtained a lethal dose of medication under the Oregon Death with Dignity law. He told the news conference that he resented media reports that he is about to “kill” himself. “I’ve got just a few days left to live, and I don’t want to put my wife and family through a prolonged death. I’m not committing suicide, and I don’t want to die. But I am dying, and I don’t want someone dictating to me that I’ve got to lie down in some hospital bed and die in pain.” Newbold joined the teleconference from his final road trip, during which he expects to die with dignity within a few days. “I was upset by media reports that I intend to ‘kill’ myself. I’m not killing myself; cancer is taking care of that. I may take the option of shortening the agony of my final hours.”

Public opinion researcher David Binder presented findings from his California research indicating that respondents found terms such as “assisted suicide” both inaccurate and biased. “Respondents have a negative impression of the term ‘assisted-suicide,’ as it carries loaded connotations that it is a crime. Patients are also insulted by this term and want a term that is more neutral, without the inherent bias,” said Binder. When asked to provide a letter grade to various terms to describe end-of-life language choices, “assisted suicide’ received a “D,” scoring only slightly ahead of ‘hastened death,” the least effective phrase tested to describe the process.

Binder found that respondents scored “death with dignity,” “Right to Die,” “End of life choices,” as much more accurate descriptors.

Binder’s findings correspond with a May 2005 Gallup Poll indicating that 75% of Americans support euthanasia for certain patients, but only 58% support “doctor- assisted suicide” for the same patients. Use of the term “suicide” was the only difference in the question asked. The Gallup Poll concluded, “The apparent conflict in values appears to be a consequence of mentioning, or not mentioning, the word ‘suicide’.”

Dr. Peter Goodwin, an Oregon physician who is an expert on that state’s Death with Dignity, which is being challenged by the Bush Administration before the U.S. Supreme Court, presented his own views. “I have treated scores of terminally-ill patients, and not one of them wanted to die. Not one of them wanted to ‘kill’ themselves,” said Dr. Goodwin. “These patients wanted to live as long as they could experience life. They did not, however, want to prolong their deaths. As a physician, I resent the term ‘physician- assisted suicide. I have never felt I was assisting a suicidal patient, but rather aiding a patient with his or her end of life choice.”

The experts asked that news media consider alternative language to the term “suicide,” and offered many other phrasings, including: Death With Dignity, Aid in Dying, Choice in Dying, End of Life Choices, Choice at the End of Life, terminally Ill Patients’ Rights, Compassionate Choices, and Choice and Control at the End of Life.

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Excerpt from David Binder Research:

“Participants agree that assisted suicide is an inaccurate phrase for the issue being discussed, with some participants arguing that the word suicide refers to a more physical and active choice like jumping off a bridge.”

“I don’t believe that suicide and what we’re talking about are the same thing.”

“Suicide is jumping off of a bridge.”

“Suicide is something that doesn’t encompass just a choice at the end of life when one is suffering or when one is a vegetable or in excruciating pain. It can be for a number of different reasons which do not fall into this category at all.” Why it’s not “Suicide” or “Assisted-Suicide”

As society considers social questions, language makes all the difference. Reporters and editors often use the term “assisted suicide” to describe a terminally ill patient receiving help to shorten a prolonged and sometimes agonizing dying process.

Several research tools reveal this term is both biased and pejorative. A neutral term that more accurately reflects the conscious decision of a competent and terminally ill patient’s voluntary choice should replace it.

No Life to Live

“Suicide” is hurtful and derogatory term to both a dying patient and the patient’s loved ones. It conjures images of irrational, depressed teenagers, adults with mental illness, and terrorist bombers. It suggests guns and violence. It suggests the patient is choosing death over life.

But the fact is the patient can’t choose life. Most patients asking for assistance in dying have exhausted all possible curative therapies and are thus left with only the manner of how death comes to them. They may choose what some call “the least worst death” but they cannot choose life. Terminally-ill patients are by definition already dying, having a probable life expectancy of six months or less.

History of the Term

Strict clinical distinction - Physicians originally embraced the term "physician assisted suicide" to distinguish it from euthanasia, the latter being a process in which a third party, usually a healthcare professional, brings about the patient’s death by administering a lethal dose of medication, most commonly via injection.

Physicians like Drs. Timothy Quill and Marcia Angell adopted the term “physician- assisted suicide” to signify the voluntary self-administration of medication by the patient. They did not consider the effect the term might have on patients, its negative connotation among the general public, or even in churches that withhold sacraments from “suicides.” Instead, they were after a strictly clinical distinction between the patient’s own control versus the involvement of a third party.

Using “Suicide” is Inappropriate

Lawmakers and physicians are increasingly recognizing that there is a distinction between the act of suicide and the informed decision of a competent adult to hasten the dying process.

Ninth Circuit Court - In 1996, the 9th Circuit Court, in deciding the case of Compassion in Dying v. State of Washington noted: “We are doubtful that deaths resulting from terminally ill patients taking medication prescribed by their doctors should be classified as ‘suicide.’ ... We believe that there is a strong argument that a decision by a terminally ill patient to hasten by medical means a death that is already in process should not be classified as suicide. Thus, notwithstanding the generally accepted use of the term ‘physician-assisted suicide,’ we have serious doubts that the state’s interest in preventing suicide is even implicated in this case.” The court continued, “We believe that the broader terms – ‘the right to die,’ ‘controlling the time and manner of one’s death,’ and ‘hastening one’s death’ - more accurately describe the liberty interest at issue here.”

What Experts Say

"End of life decisions by terminally ill patients are not akin to what is commonly termed 'suicide', which is considered to be a self destructive act often related to feelings of depression. These decisions to hasten death are more accurately paralleled to a patient's thoughtful decision to decline life sustaining measures: a product of judgment and reason, based on the desire to maintain one's dignity in a period where death is pending. A working group of the American Psychological Association stated that: ‘It is important to remember that the reasoning on which a terminally ill person (whose judgments are not impaired by mental disorders) bases a decision to end his or her life is fundamentally different from the reasoning a clinically depressed person uses to justify suicide.’"

Gonzales v. Oregon No. 04-623 Excerpt from Amicus Curiae briefs filed in Support of Respondents Brief of Amicus Curiae Coalition of Mental Health Professionals in Support of Respondents, p. 17.

Dr. Charles F. McKhann - In his 2004 testimony submitted to the House of Lords, Dr. McKhann, M.D., a U.S. cancer specialist and former professor of surgery at Yale University noted, “Terms such as murder, self-murder (suicide), killing and doctor- executioner are used deliberately to inflate passions and stifle reason. There is so obviously a difference between murder and helping a person die at his own request that gross attempts to blur the distinctions are offensive. They also discourage debate and polarize the community at a time when the public would be better served by thoughtful consideration of all the facets of such a complex issue.

American College of Legal Medicine - The ACLM recognizes “the term "physician- assisted suicide" is arguably a misnomer that unfairly colors the issue, and for some, evokes feelings of repugnance and immorality. The appropriateness of the term is doubtful in several respects….ACLM rejects the term "physician-assisted suicide” (Brief Amicus Curiae of the American College of Legal Medicine, Vacco v. Quill, 1996 WL 668827)

American Psychological Association - In the recent case of Gonzales v. Oregon before the United States Supreme Court, an amicus curiae brief submitted by mental health professionals pointed out that a working group of the American Psychological Association has recognized: “It is important to remember that the reasoning on which a terminally ill person (whose judgments are not impaired by mental disorders) bases a decision to end his or her life is fundamentally different from the reasoning a clinically depressed person uses to justify suicide. (Brief of Amicus Curiae Coalition of Mental Health Professionals, WL 1749170 at 17, Gonzales v. Oregon, 126 S. Ct. 904 (2006) (No. 04-623); (see also, Smith and Pollack, A Psychiatric Defense of Aid in Dying, 34 Community Mental Health Journal 547 (1998).

American Academy of Hospice and Palliative Medicine - In its Position Statement on Physician Assisted Death the AAHPM notes: “The term PAD (Physician Assisted Death) is utilized in this document with the belief that it captures the essence of the process in a more accurately descriptive fashion than the more emotionally charged designation Physician-assisted Suicide. Subject to safeguards, PAD has been legal and carefully studied in Oregon since 1997. In all other states, PAD remains prohibited by law, although there is an underground practice that remains largely unstudied.”

Dr. Timothy Quill & Margaret Battin, Ph.D. - In explaining why they prefer to use the term “Physician-Assisted Dying,” in their book of the same title, Dr. Timothy E. Quill and Margaret P. Battin, Ph.D., note that “[a]lthough suicide can be considered heroic or rational depending on setting and philosophical orientation, in much American writing it is conflated with mental illness, and the term suggests the tragic self-destruction of a person who is not thinking clearly or rationally. Although distortion from depression and other forms of mental illness must always be considered when a patient requests a physician-assisted death, patients who choose this option are not necessarily depressed but rather may be acting out of a need for self preservation, to avoid being destroyed physically and deprived of meaning existentially by their illness and impending death.” (Physician-Assisted Dying: The Case for Palliative Care and Patient Choice. The John Hopkins University Press. 2004.)

Dr. Joseph B. Straton, M.D., M.S.C.E. - In a 2006 symposium article Dr. Straton writes:

“One problem with the phrase ‘physician-assisted suicide’ is the image brought about by the term "suicide." In general when thinking of suicide, one pictures a person who ends his or her life while struggling with depression, hopelessness, or an altered state of mind brought about by alcohol, drugs, or despair. We picture a person with life and opportunity ahead. We see a person who irrationally ends his or her life while suffering from despair that is or should be transient. We envision that if this person just could see beyond the current despair, they will understand that their life can be fulfilling and will want to continue living. For these reasons, we do not provide a legal means permitting someone to end his or her life. In fact, society's role is seen as providing means to prevent the act of suicide and to assist people to get beyond the transient despair. The image and connotations brought to mind by the term ‘suicide’ are not reflective of the situations faced by people who are terminally ill and may consider hastening their deaths.” Dr. Straton argues that: “…the phrase ‘physician-assisted suicide’ poorly represents the decision faced by people who are terminally ill and should be replaced with the phrase ‘physician assistance with dying’.” (End of Life Decision Making: The Right to Die? Physician Assistance with Dying: Reframing the Debate; Restricting Access. (Rev. 475, Spring 2006). Temple Political & Civil Rights Law Review).

Oregon Department of Human Services - In Oregon, where physician aid-in-dying has been a legal option since 1998, Section 127.880 §3.14 of the law states: “…Actions taken in accordance with ORS 127.800 to 127.897 shall not, for any purpose, constitute suicide, assisted suicide, mercy killing or homicide, under the law. [1995 c.3 §3.14]. In October of 2006, the ODHS, which oversees the Oregon Death With Dignity Act, announced it would no longer refer to a death under the law as "assisted suicide" or "physician assisted suicide” recognizing, as one medical epidemiologist put it, “[it] probably has not been correct for us to be using this language all along.”

American Public Health Association - Similarly, at its 2006 annual meeting, the APHA adopted a policy recognizing that “The term “suicide” or “assisted suicide” is inappropriate when discussing the choice of a mentally competent terminally ill patient to seek medications that he or she could consume to bring about a peaceful and dignified death.” The APHA policy emphasizes “the importance to public health of using accurate language” and, accordingly, urges: “That health educators, policy makers, journalists, health care providers recognize that the choice of a mentally competent terminally ill patient to choose to self administer medications to bring about a peaceful death is not ‘suicide’, nor is the prescribing of such medications by a physician ‘assisted suicide’.” Newbold said. "I don't want someone dictating to me The New York Times that I've got to lie down in some hospital bed and die in pain." July 10, 2005 by Nicholas D. Kristof Mr. Newbold has started the process of obtaining the barbiturates; two doctors must confirm that the Jack's Death, patient has less than six months to live, and the patient must make three requests over at least 15 His Choice days. Typically, the drug is secobarbital - the powder Portland, Oregon. is removed from the capsules and mixed into water or applesauce - or pentobarbital, which comes as a Jack Newbold is a 59-year-old retired tugboat liquid. Patients typically slip into a coma five captain who is dying of bone cancer. It's one of the minutes after taking the medication and die within most painful cancers, and he doesn't want to put his two hours. wife and 17-year-old daughter through the trauma of caring for him as he loses control over his body. Like many patients, Mr. Newbold says that his biggest concern isn't pain so much as the loss of So Mr. Newbold faces a wrenching choice in the autonomy and dignity. That's partly why he wants coming weeks: should he fight the cancer until his the medication on hand - if he feels himself losing last breath, or should he take a glass of a barbiturate the self-control he has prized all his life, he can solution prescribed by a doctor and put himself to hasten the process. sleep forever? He's leaning toward the latter. "I may never use the medication," he said, "but the "I've got less than six months to live," he said. "I knowledge that you have the ability to end it gives don't want to linger and put my wife and family you so much relief." through this." That's common - many patients who get the I don't know what I would do if I were Mr. barbiturates do not in fact use them, but derive Newbold, nor if I were his wife or daughter (they're comfort from having the choice. Over all, 208 both supporting him in any decision he makes). But patients over seven years have used the law to hasten I do believe that it should be their decision - not death, according to the Compassion in Dying President Bush's. Federation of Oregon, which helps patients work their way through the legal requirements. Unfortunately, Mr. Bush is fighting to overturn the Oregon Death With Dignity law, which gives Mr. When patients use the law, they typically set a date Newbold the option of hastening his death. Oregon and gather family and friends around them. Those voters twice passed referendums approving the law, who have witnessed such a parting say it's not as which has been used since 1998, and it has wide morbid as it may sound. support in the state. "It's pretty weird knowing what day you're going to The Bush administration issued an order that any die, but we could plan for it," said Julie McMurchie, doctor who issued a prescription under the state law whose mother used the barbiturates about a week would be prosecuted under federal law. Oregon won before she was expected to die naturally of lung an injunction against the order, John Ashcroft lost an cancer. "Two of my siblings lived out of state, and appeal, and now the Supreme Court will hear they were able to come, so we were all present. ... arguments in the fall. We were all there to hug and kiss her and tell her we loved her, and she had some poetry she wanted read "I'm just grateful I live in the state of Oregon, where to her, and it was all loving and peaceful. we have this option," Mr. Newbold said. "I'm just sorry the John Ashcrofts of the world want to dictate "I can't imagine why anybody would begrudge us not only how you live, but also how you die. There's that opportunity to say goodbye, and her that nothing more personal, other than childbirth, than opportunity to have peace." passing on." The same applies to Jack Newbold and everyone in Mr. Newbold, a Vietnam veteran and former his position. Mr. Newbold faces an excruciating merchant seaman, is funny and blunt, with a flair for choice in the coming weeks, and he's got enough on nautical language unsuitable for a family newspaper. his mind without the White House second-guessing He started with head and neck cancer. Now cancer is him. spreading to his bones, disabling him and forcing him to take morphine for pain. Back off, Mr. Bush. "By God, I want to go out on my own terms," Mr. End-of-Life Language Choices News Release, Sept. 28, 2005, page 6

Your Life The Right to Die Oregon set off a fierce national debate when it passed a law in 1997 allowing doctors to prescribe lethal drugs to terminal patients who want to end their lives. Now the administration is challenging that law in the Supreme Court—and reigniting the controversy over doctor- assisted dying. By Susan Jacoby November 2005

(The following is an excerpt from Susan Jacoby’s November, 2005 article)

"I think of this as 'doctor-aided dying' or 'compassionate aid in dying,' " says Charlene Andrews, 68, a retired teacher from Salem, Ore., who was diagnosed with advanced breast cancer in 2000. "That may be less catchy in headlines than 'doctor-assisted suicide,' but it's much more truthful. I am still fighting to live with every available medical tool, but I am going to die of this disease anyway.

"The only question is whether I will be able to say goodbye to my family while I'm still myself," says Andrews, whose cancer has spread and who is still undergoing chemotherapy. She summoned the energy to attend the Supreme Court hearing and speak to the National Press Club in Washington on the misuse of the word "suicide." "This has nothing to do with suicide in the traditional sense," she says flatly.

Letters to the Editor Death With Dignity

E. James Lieberman, M.D.

Washington, D.C.

The article in the March 3 issue on Oregon's Death With Dignity Act (DWDA) was relevant and enlightening. Shortly after the 6-3 Supreme Court vote supporting the law came the eighth annual report on the DWDA, a remarkable medical and psychosocial experiment. The report is posted at .

Since 1998, 246 people have used prescribed medication to hasten death (average 31/year; 12 per 10,000 deaths in Oregon). A large study of terminally ill Oregonians (1,384 cases, 2004) found that 17 percent considered physician aid in dying (PAD) seriously enough to discuss it with family members; 2 percent formally requested it, and of those, 1 in 16 used it.

Patient requests for PAD stemmed from multiple concerns, primarily the loss of ability to participate in enjoyable activities, loss of dignity, and loss of autonomy.

During 2005, 36 of 38 PAD patients (95 percent) died at home. All had some form of health insurance. Over 90 percent of the patients were enrolled in hospice care, mostly home based (almost four times the national rate). End-of-life care in Oregon is exemplary for the rest of the country, thanks in part to DWDA.

There is preliminary evidence of a lower overall suicide rate among Oregon's terminally ill residents. Even most of those who enter the program die of natural causes. The PAD option is psychological insurance that brings peace of mind; over the years several dozen who enrolled and died peacefully had reported their intent to resort to violent suicide if they found life unbearable.

The term "assisted suicide" is inaccurate and misleading with respect to the DWDA. These patients and the typical suicide are opposites: • The suicidal patient has no terminal illness but wants to die; the DWDA patient has a terminal illness and wants to live. • Typical suicides bring shock and tragedy to families and friends; DWDA deaths are peaceful and supported by loved ones. • Typical suicides are secretive and often impulsive and violent. Death in DWDA is planned; it changes only timing in a minor way, but adds control in a major and socially approved way. • Suicide is an expression of despair and futility; DWDA is a form of affirmation and empowerment.

APA has not taken a position on DWDA. If it does, the above points should be taken into account. Religious objections to PAD should not interfere with those who believe DWDA is consistent with humane and ethical medical practice, the integrity of the doctor-patient relationship, the right of individuals to exercise choice in a free, pluralistic society, and the role of state law in regulating medical practice.

Footnotes

Dr. Lieberman is a board member of Compassion and Choices. According to its Web site, it is a nonprofit organization working to improve care and expand choice at the end of life.

How the media helped sink bill Are journalists so afraid to come to terms August 9, 2005 with the horrible choices that face terminally ill McKinleyville, CA (Humboldt Co.) patients and the people who care for them that McKinleyville Press (Cir.W.2, 000) they willingly embrace the dark side? Denying

their pain won’t immunize anyone from the It recently occurred to me that the media played an possibility of the same fate. We’re all going to important role in the failure of the California die, and some of us will suffer horribly first. Compassionate Choices Act, sponsored by The physician’s oath to “first do no harm” Assemblymembers Patty Berg and Lloyd Levine. is often cited as an injunction not to help patients By adopting the label “physician-assisted suicide” shorten their lives. How should “harm” be from opponents of the bill, the press turned itself defined? Some say ordering invasive measures into a massive lobbying effort against it. Similar such as feeding tubes to prolong the suffering of legislation was named the Death With Dignity Act patients who are beyond the possibility of physical in Oregon, where it was passed by voters twice recovery is more harmful than helping them to die before being enacted in 1997. pain-free a few days or weeks sooner. Just to check my memory, I checked it out Doctors are human, and most of them are at Google News. The search “compassionate passionate about helping others. Sometimes their choices” +California only brought up two stories desire to cheat death at all costs death blinds them in the last 30 days. There were 15 for “physician to the price paid by their patients. Making it legal assisted suicide” +California and six for “doctor and accepted for patients to request help in assisted suicide” +California. choosing to remain pain-free at the end of life can When someone commits suicide with a open a critically important dialog. pistol, the headline doesn’t read “Gun shop- Proponents of the War on Some Drugs assisted suicide.” When a police officer is play a role in this mess as well. Decent physicians ambushed and killed, with a legal assault rifle, it’s are always under threat of theatrical prosecution not called “NRA-assisted homicide.” Why does for prescribing enough drugs to adequately treat the gun lobby enjoy a free ride on the severe pain. Ironically, a lot of the same people consequences of its actions, while activists who rally against palliative treatment and fighting for the rights of the terminally ill patients compassionate choice are also active in right to are ridiculed for their efforts? bear arms circles. Drumming on the physician connection Why should patients who have been law- was a brilliant stroke, since doctors are vulnerable abiding all their lives be forced to sneak around, to bad publicity. By implying that physicians asking their doctors to commit a crime, in order to would be roaming the streets, looking for slightly- remain in control of their suffering? Whose sick people to euthanize, opponents and the media business is it besides their own? What kind of were able to stir up enough controversy to defeat person wants to interfere in such a personal the bill for now. decision? The people most in need of help are too Death with dignity is entirely patient- sick to testify at hearings. The roughly five driven. If you think it’s wrong, don’t do it. If it percent of terminally ill patients whose pain violates the teaching of your church, don’t do it. cannot be relieved by the most aggressive In fact, even in Oregon, not many people conventional means have to rely on others to do it. Only a handful of eligible patients ask for advocate for them. The opposition consists of the prescription, and even fewer use it. Most say people who believe God should decide when each having the option gives them peace of mind. person is permitted to die, and expect everyone to I’m sorry to say it, but the California blew have the courage of those convictions. it on this issue. Since Berg and Levine intend to Despite the whining of various critics, introduce the bill again next year, there will be an journalists generally bend over backwards trying opportunity for redemption. I’ll be watching. to be fair. Why is this issue so different? It’s as if (Elizabeth Alves believes end-of-life they had joined anti-abortion groups in calling choices are deeply personal. Comments and opponents baby-killers. suggestions are welcome care of the Press or at [email protected])