Pain Protection

A Tucson legislator will introduce a bill that could give the terminally ill control over their own pain medication.

When Tucson State Rep. Linda Lopez sponsored an "Aid in Dying" bill last year, she knew it didn't have a chance.

"I felt very fortunate just to have it heard," the Democrat says about House Bill 2454, which would have legalized physician-assisted suicide for terminally ill patients.

Even though that bill, which was co-sponsored by 10 other Democrats and one Republican, was predictably killed by right-wing legislators who control the state's House of Representatives, that isn't stopping Lopez from introducing another bill later this month that treads into similar territory.

Her new bill--titled the Patient Comfort and Control Act--doesn't go as far as HB 2454, which was modeled after Oregon's controversial law that allows physician-assisted suicide in some situations. The new proposal would allow individuals to set up an advance directive giving them the right to control their own pain medication in the event of a terminal illness. She'll discuss the bill at a meeting of End-of-Life Choices--Arizona on Saturday, Jan. 10, at 10 a.m.

Lopez knows it's also extremely unlikely that this bill will ever make it to Gov. Janet Napolitano's desk--even though it seems far less controversial than HB 2454.

"This will be a much more attractive piece of legislation, because a lot of folks fear what could happen to them when they become terminally ill, whether they're right-wing or not," says Lopez.

On one hand, the bill has a lot of elements that, one would think, have widespread appeal. People would have to set up the advance directive before becoming terminally ill, when their mind is sound. (This would mean that people who are currently terminally ill would be left out, leading some people to criticize the proposed bill for not going far enough, Lopez says.) The patients would have to be able to take the medication themselves. And the law would make patients and their doctors partners in determining how much medication the suffering and terminally ill can have--but with the patients having the final say. These patients would never have to worry about being undermedicated.

"One of the problems we have in this country is that there's often not enough medication (given to those in) chronic pain," Lopez says. "Because pain medications are so addictive, there's an issue over the control of physicians and their prescribing of pain medication. But what we forget is people who are terminally ill and who are in severe pain should be able to manage it."

But then there's the other hand: The bill would allow people to control their pain medication completely, meaning, in Lopez' words, "the individual could know full well that the pain medication could hasten their death." In other words, the law would give people access to enough medication to kill themselves, if they wanted.

That's the rub that could doom the bill in the minds of the religious, anti-suicide crowd.

"I think it will be a hard fight, just given the makeup of our Legislature," Lopez says.

Lopez can count on the support of End-of-Life Choices--Arizona. The group was known, both on a local and national basis, as the Hemlock Society until last July, when the group changed its name; the local chapter followed suit about one month ago. The name change happened because, as local volunteer Jean Osborne puts it, "There was the feeling that the name Hemlock Society had an adverse connotation. The plant represents death and that sort of thing, and we're trying to get more into end-of-life choices issues."

Earl Wettstein--a Tucson resident who spent years on the national Hemlock board and is currently the president of the local chapter's education arm, the Fifth Freedom Foundation--says Derek Humphry, who founded the group in 1980, erred when he named the group after the nasty poisonous plant that killed Socrates.

"It's been a problem for us ever since," he says.

Wettstein--who got involved in the group after he was a caregiver for a terminally ill aunt who begged for his help in ending her life--says the name change reflects the group's broadened mission, into areas such as the advocacy of living wills, better power-of-attorney laws, organ donation and 911 education. And Lopez's proposed bill fits into that mission.

"This is a pain relief bill," he says. "It's a whole different approach to what we want, which is for people to experience the end of their lives in peace and dignity. You ought to be able to control your own destiny."

Lopez says she's introducing the bill--and giving the public talk at the End-of-Life Choices meeting--in an effort to make people think.

"I believe that each time we introduce a bill, and get media coverage, it helps raise public awareness. It makes people think about the end of life. How many people do you know have an advance directive or a living will? People don't like to think about it. ... Our culture just doesn't like to deal with death."