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January 1991

Neighborhood Board Elections
President's Message (Arlene Ellis)
League Testifies on Annual Plan Review (Astrid Monson)
Action on Charter Amendments (Astrid Monson)
It Doesn't Take Much
General Membership Meeting
Teamsters Vote Count
United Nations to Focus on Women in the '90s
From the President (Massachusetts Voter) (Risa Nyman)
Scarlet Letters: An Introduction
Letter from LWV to Kent Baker, KHON-TV2 (Anne Lee)
Vacancies on the Governor's Boards & Commissions
Update on City Recycling Efforts (Dorothy Turnbull)
Hawaii's Living Will (Joan Hayes)
Welcome New Members
Honolulu League Contemplating Computer System for Office
New Publication: Gun Control

Hawaii's Living Will

Our Living Will law, passed in 1986, was a step in the right direction. But it has two glaring defects. I've been trying to make it stronger, and clearer, for four years. We're on the verge of success.

Hawaii's law includes a sample "Living Will." It says that if the person who wrote it is determined to be unable to communicate his or her wishes and is in a terminal condition then medical treatment should stop except for food, water and pain medicine. (Emphasis added.)

The first problem is that the word "terminal" can, and does, create dilemmas for doctors. They ask themselves, "Is this patient really terminal?" The patient can survive for years on water (through an intravenous tube) and food (again through a tube either through the nose or directly through an incision in the stomach). Nation-wide about 10,000 patients, with no hope of recovery, are being kept alive this way.

I had tried to substitute "with no hope of recovery" for "terminal." For the second defect I had proposed language which would rule out, in such cases, artificial feeding and hydration. For the first time, the major players in this drama have gotten together and agreed on new language which will become an Administration bill, sponsored by the State Health Department.

But that may not be enough. Last Session I asked colleagues whether they would want to be kept "alive" indefinitely in such a state. None had a moment's hesitation in saying "Absolutely not!" But when I asked, "Would you support a bill that would make such an outcome impossible if you had instructed that you be allowed to die naturally under these circumstances?" "I'd have to be awfully sure the people in my District want this" was the reply.

Changing the Living Will law may be like changing Hawaii's abortion law. When I started working on it in 1969, people laughed at me and said, "Try again in twenty years!" But we got group after group to pass a resolution asking that abortion be made a matter of choice, with the woman ultimately responsible for that decision. As you may recall Hawaii was the first state to make abortion a matter of choice and to eliminate, for our residents, illegal abortion as the leading cause of maternal death. At the decisive Senate hearing about 75 witnesses advocated freedom of choice. Five opposed repealing our 100-year-old law. Over 40 witnesses testified for a group from the ILWU, to the Chamber of Commerce, to the Council of Churches.

If each of you ask each organization of which you're a member to consider changes which would make a Nancy Cruzan case impossible here and then to pass a resolution favoring those changes, I think we can enact them in 1991.

If your group wants to learn more about this, ask Attorney Jeff Crabtree to tell his story. If he can't make it, ask me. Jeff Crabtree recently went through a four-day trial in Family Court at which he asked that his mother be allowed to die. Her massive brain injuries due to a hiking fall over four years earlier meant she would never recover. A former nurse, his mother had no Living Will, but she had told family members she would never want to be kept alive under those circumstances. After the Judge's decision, Shirley Crabtree was transferred to a different nursing home where the tubes were disconnected. She died a few days later.

Just because a sample will appears in the law doesn't mean it is inviolable. You can edit it. You may want to strike out "terminal" and to rule out "artificially supplied food and water". Changes won't make your Living Will invalid. Stating your wishes clearly while you're able to make decisions means your body won't linger while family members finally agree on what should be done.

Joan Hayes

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