More than 48,000 signatures calling for a citizen-initiated referendum on the Maine Death with Dignity Act have been certified by the secretary of state’s office; the last opportunity for opponents to challenge the petitions and prevent a November 2000 vote came and went this week. Although the measure will pass one more time through the Legislature, it is highly appropriate that the ultimate decision about the ultimate choice be made by the people of Maine.

The act is identical to the bill presented to the Legislature in 1998 by Rep. Joseph Brooks of Winterport, the bill that was summarily dismissed by lawmakers, the bill that, according to polls, had the support of 71 percent of the public. It is very similar to bills the Legislature shelved three other times since 1990.

Some lawmakers no doubt have religious and ethical concerns about that prevent them from sanctioning suicide in any form. The fact that none of these bills have received any substantive debate or was countered with legislation to improve end-of-life care suggests that for most it is simply an issue too sensitive to touch. Now, proponents of this referendum are justifiably concerned that some legislators may be come under political pressure to muddle the issue with competing legislation.

Outside of the State House, however, it’s not about politics; it’s about real life. There is hardly a family in Maine that has not gone through the wrenching experience of watching a terminally ill loved one waste away in debilitating, lingering agony, a loved one who knows death is inevitable and whose only desire is that it be quick and painless. Modern medicine can perform many miracles in prolonging life; society has not done well with the issue of what to do when the miracles run out.

This referendum question is not about state-sanctioned euthanasia, it does not allow a family to rid itself of a burden. It allows people in pain and with no hope of recovery to make a choice, an informed, thoughtful and highly personal choice. The patient must voluntarily seek and obtain the opinions of two physicians that he or she is terminally ill and likely to die within six months. The patient must agree to be tested and certified as mentally competent. It is only after two waiting periods and thorough counseling on the options, such as hospice and pain-management medication, that the patient can obtain and self-administer a lethal dose of pharmaceutical drugs.

The coming debate, certain to be vigorous and emotional, will have the benefit of experience. Oregon’s citizen-initiated Death with Dignity law has been in effect for nearly two years and the results bespeak humaneness and caring, not abuse.

In 1998, the first year with complete statistics, 23 terminally ill Oregonians requested and obtained life-ending prescriptions under the law. Fifteen used the drugs to hasten death. Six did not and died from their illnesses and two were still living as of the first of this year.

Of the 15, 12 of whom died peacefully at home, the overwhelming concerns that led them to end their own lives were loss of autonomy, the inability to participate in activities and the loss of bodily functions. The burden on family and the cost of prolonging life were hardly cited. Clearly, for those who make this decision, it is a decision made for spiritual, not financial, reasons.

It is significant that the Oregon’s experience has led to dramatic improvements in care for the terminally ill; the state is now considered a leader in end-of-life care. Hospice admissions are up by 20 percent, to the third highest rate in the nation. Oregon now has the lowest in-hospital death rate in the country. The use of medical morphine to alleviate pain is up sharply and complaints about underprescribing pain medication have plummeted. By all accounts, these improvements are a direct result of the willingness of the people of Oregon to confront this difficult issue.

Maine lawmakers have an obligation now to stand aside and let the people of Maine do the same.