Pubdate: Wed, 18 Mar 2015
Source: Baltimore Sun (MD)
Copyright: 2015 The Baltimore Sun Company
Contact:  http://www.baltimoresun.com/
Details: http://www.mapinc.org/media/37
Author: Thomas F. Schaller
Note: Thomas F. Schaller teaches political science at UMBC; his most 
recent book is "The Stronghold: How Republicans Captured Congress but 
Surrendered the White House." His column appears every other Wednesday.

DRUG AND DEATH EFFORTS KEY FOR STATE

 From gay marriage to marijuana decriminalization, Maryland has been 
a national leader on social issues in the new century. This year, 
state legislators and new governor Larry Hogan can further burnish 
the state's reputation by setting a national example on heroin 
intervention and death-with-dignity legislation.

Let's start with Governor Hogan's noble call to mitigate heroin 
addiction and overdose deaths in Maryland. The governor brings 
personal experience to the issue: He lost a cousin to a heroin overdose.

Maybe the issue would not have figured so prominently on Mr. Hogan's 
mind if not for his family's tragedy, but so what? Governors lead 
best when they move low-salience or dormant issues to the forefront 
of the state agenda, and Mr. Hogan should be commended for doing so, 
whatever his reasons.

Heroin overdose deaths have been rising in the state each year since 
2010 and have doubled in that period. A big part of the problem - one 
hardly limited to Maryland - has been the introduction of fentanyl 
into the heroin supply. Even for careful users with strong 
tolerances, fentanyl can be lethal the very first use.

Because fentanyl is both cheaper and more potent than heroin itself, 
profit-minded drug dealers find it particularly attractive to cut 
their heroin supplies with it. They may lose a few customers along 
the way, but drug dealers who don't bear the personal or social costs 
of their menacing trade care little about the collateral damage.

The first wave of fentanyl-related heroin overdoses came in 2006, but 
then a second wave began two years ago. The Northeast and Midwest 
regions have been hardest hit.

Mr. Hogan tasked Lt. Gov. Boyd Rutherford to oversee the state's 
heroin response efforts. Mr. Hogan also created two state panels to 
investigate and remediate the problem of heroin addiction, and 
applied $500,000 in federal funds to increase drug treatment programs 
in Maryland's jails and prisons.

Let's hope Governor Hogan's prioritization of this issue reduces the 
state's number of tragic, untimely deaths from heroin overdose.

Timely deaths are another matter, and Maryland should cement its 
reputation as an early policy adopter by passing physician-assisted 
suicide legislation.

The right to control one's life is indelibly linked to the right to 
manage one's death, especially when pain and suffering for those 
dying and their loved ones can be relieved by suicide.

Before touting the benefits of "death with dignity" laws, I encourage 
people to read Atul Gawande on the subject of end-of-life medical 
decision-making: either his 2014 book "Being Mortal: Medicine and 
What Matters in the End," or his shorter but still powerful 2010 New 
Yorker article with the headline Letting Go. (Dr. Gawande has not 
staked out a clear position on physician-assisted suicide.)

People should not be forced to live in pain to satisfy other people's 
religious beliefs. And they darn sure shouldn't be kept alive to run 
up medical bills and bankrupt their survivors. As Dr. Gawande 
explains, people who accept their fates and embrace palliative care 
on average live as long if not longer than those who try vainly to defy death.

In the Maryland General Assembly, Howard County Del. Shane 
Pendergrass and Montgomery County Sen. Jamie Raskin are two of the 
leading advocates for "death with dignity" legislation. They have 
modeled their proposed bill on the first-in-the-nation law adopted in 
1994 by Oregon. (Legal challenges prevented the law from being 
implemented until 1997.)

That's where 29-year-old Brittany Maynard moved so she could die with 
dignity last November from a brain tumor that had made her life 
miserable. Because hers was such an unusual case - a young woman 
willing to sacrifice her privacy so she could empower others with 
painful, terminal illnesses to have the same choice she made - Ms. 
Maynard became a global figure.

With a bit of luck and a lot of mercy, perhaps in the future a series 
of eponymous "Brittany's laws" will spread across the country much in 
the same way that so-called "Megan's laws" and "Amber alerts" have 
taken hold nationally.

Until then, Maryland should join the handful of states that permit 
assisted suicide.
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MAP posted-by: Jay Bergstrom