Washington state voters will have a life-or-death decision to make this November, if supporters of a physician assisted suicide initiative are successful with a signature drive.
Former Governor Booth Gardner is an advocate for the initiative effort, coordinated by a group known as the It's My Decision committee.
According to the website, www.itsmydecision.org, the committee calls itself a "broad coalition of physicians, nurses, hospice patients family members, organizations and concerned residents."
It's not the first time the issue of physicians assisting terminally ill patients with suicide has surfaced in the Northwest.
A previous drive was attempted in this state more than 15 years ago, and Oregon just celebrated the 10th anniversary of its physician assisted suicide law. The initiative, billed as "death with dignity", would allow patients with less than six months to live and who are of sound mind to ask for and receive a lethal oral prescription medication so they could commit suicide.
The 2008 initiative is different from the previous effort in this state in that under the current porposal a patient has to be able to administer the suicide drug themselves, according to language in the initiative.
That's not to say there's universal support in Washington for the proposal, as a group calling itself the Coalition Against Assisted Suicide is opposing the initiative.
The coalition is based in Olympia, but you don't have to go that far to find those with opinions on physician assisted suicide.
Rev. Ron Jetter of Our Saviour's Lutheran Church in Sunnyside, while he understands the premise that assisted suicide relieves terminal patients experiencing pain, sees it as a choice that's not for a person to make over their own life.
"From a religious standpoint it's difficult to accept," he says of physician assisted suicide. "I don't see that we're given permission to choose the timing of our own end. Just because we have the technology doesn't mean we have to use it."
As a hospice chaplain, Jetter is well familiar with the issues facing patients and families experiencing a terminal illness.
"Hospice gives people choices of dying with dignity, spending their last days with quality of life, especially where once a certain level of medication is withdrawn because it can't make them better," says Jetter, president of the Sunnyside Ministerial Association. "Chaplains are able to help them work through their spiritual issues."
He said the process allows patients and their families to "clean up" any remaining relationship issues and provide them a "sense of completion and peace." Suicide, he contended, "robs them of the chance to do that."
Hospice can be of such a benefit, Jetter added, noting there are instances where a person's health improves to the point they are no longer terminal and no longer need the hospice service.
Doctors, of course, would have to prescribe the suicide dosage and, from a medical perspective, Dr. Kathryn Norris of Lincoln Family Medicine said physician assisted suicide would run directly counter to her oath as an osteopathic doctor. She said the oath involves not prescribing deadly drugs to anyone, even when asked.
"It's up there on my wall," Norris said of the oath. "I like that it's there. No, sorry, I couldn't do it (prescribe a suicide dosage)."
Dr. Al Fiedler of Grandview has a similar view of the issue.
"I stand by the AMA that physician assisted suicide is fundamentally incompatible with the role of healer," Fielder said.
Retired Sunnyside family physician Dr. Rick Roach agrees that a doctor's ethics don't permit administering suicide. "It's hard for us to say suicide is OK," he said.
At the same, though, Roach is not opposed to the initiative making it on the ballot.
"You're talking about freedom. I don't think you legislate morality," Roach said. "We have respect for free choice and it's a very personal thing."
Roach added, "I think it would be interesting to see how people are thinking about it. I would say it's not reasonable to keep that off the ballot."
Roach said in his 30-plus years in medicine he never encountered a terminally-ill patient who requested an end to their life. He also noted that with medication the patients were able to be kept fairly comfortable.
Mary Arthur is the administrator for Hillcrest Manor in Sunnyside and has experienced caring for the dying.
"I have personally cared for those dying of cancer, including my mother and father, and am pleased to say that modern medicine can keep our loved ones pain free and still not affect their cognitive abilities," said Arthur. "The last days I spent with my parents were powerful days of knowing them and appreciating who they really were and are."
Not only does she oppose assisted suicide based on personal experience, but for moral reasons as well. She feels "it is murder to assist in the taking of the life of an innocent person."
Noting that her "first prerogative is to provide those I care for with quality of life," Arthur said she could not participate in the assisted suicide process if it became law.
"I am almost 70, and I promise that if assisted suicide ever is approved in Washington state or in our nation, I will go to jail before I will allow the murder of an innocent elder at Hillcrest Manor."
Jetter, too, has direct experience in caring for the dying. Thirty years ago, as the youngest child in his family, Jetter was responsible for much of the care for his 96-year-old grandfather in his final months.
"When he was in a nursing home he wanted to end it with a pill," Jetter recalled. "But it wasn't for us to judge that his life was over."
Jetter continued, "When he did die a few months later we knew it was his time. But even now all these years later how would I ever be proud of that decision if I had helped him die. It would have haunted me."
This November, voters may just get a chance to decide whether such a medication would be legal to prescribe. Whether the patient should be able to have and administer that "pill" to end it all.