HPACC members believe we can virtually eliminate all requests for PAS and PAD by effectively addressing the underlying reasons people request PAS and PAD in the first place. We know from a significant body of research that a strong correlation exists between clinical depression or unmanaged pain and requests for PAS or PAD. We also know that when properly treated, many of the same patients no longer wish to commit suicide.

A few key, basic alternatives include:

· More effective pain management;
· Better diagnosis and treatment of depression; and,
· Increased use of hospice care.

Last year, the Hawaii Medical Association, along with the American Medical Association initiated an ambitious, two-year project known as the Education for Physicians on End-of-Life Care (EPEC) program. The goal is to help improve the care given by physicians to dying patiens by developing a standardized, core curriculum that will train physicians in the basic knowledge and skills they need in order to appropriately care for patients at the end of life.

The Hawaii Nurses Association supports legislation that promotes a clearer understanding and respect for patients' advance directives and other policies designed to improve end-of-life care.

The Disability Rights organization, Not Dead Yet, urges improvements in home attendant care services. Under current rules, seriously disabled people are often forced into institutions in order to get the care they need for everyday living.

It is these alternatives to PAS and PAD that demand our utmost attention and commitment.

Conclusion

For those who equate legalized PAS and PAD to death with dignity - they would do well to heed the words of former Surgeon General C. Everett Koop, M.D.

"Let those who seek death with dignity beware, lest they lose life with dignity in the process."

Instead of PAS and PAD, the members of HPACC support physician-assisted living!