To be or not to be

October 28, 1991

"To be, or not to be: that is the question . . ." Hamlet's tortured musings have become so familiar that few of us stop to remember that the question he was pondering was suicide. Suicide -- the willful ending of one's own life -- has rightfully been condemned through the ages. It is not a victimless crime; human beings are social creatures and suicide can play havoc with the lives of survivors.

Even so, in a society that fears death and worships life no matter its cost, death is not always the worst thing that can happen. Many people say that they are more afraid of being kept alive on machines than of dying. Because so many people now fear they will have no control over choices about their medical care at the end of life -- and because they do not want to give up all medical care -- suicide has become a political issue. Next week voters in Washington state may well legalize a measure that will allow doctors to administer lethal injections or otherwise aid terminally ill patients who have requested such assistance. Meanwhile, Dr. Jack "Suicide Machine" Kevorkian is bedeviling Michigan authorities who are searching state law for ways to prosecute him for his assistance to two more women whose grave medical infirmities made them want to end their lives.

Kevorkian is the maverick zealot. With his rantings of store-front "obitoria" where people can drop in to commit suicide, he represents probably the worst fears of those who warn against the ethical slippery slope of physician-assisted suicide. But the 223,000 citizens who signed Washington state's initiative cannot dismissed so easily. They are, in fact, sending an urgent message to the medical community and to a health care system that seems more concerned with avoiding legal liability than with meeting moral responsibilities to patients.

Initiative 119 may well be the health care equivalent of Proposition 13 -- the California proposal that stirred taxpayer revolts throughout the country. People are frustrated with a medical system that seems arbitrary and downright cruel, especially at the time of death. No wonder so many people regard physician-assisted suicide -- with safeguards against abuse -- as a logical way of regaining some control.

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