(7) Question 2 does not require a patient to consult with a psychiatrist or palliative care expert before receiving the lethal prescription. Many terminally ill patients suffer from depression and there is no requirement that a psychiatrist determine that the person is of sound mind before the request is granted. Additionally, there is no requirement that the doctors who are consulted have expertise in palliative care to ensure that a fear or experience of pain, which can be managed, is leading to the request. Many attendees of our educational workshops have been surprised that these reasonable safeguards aren't included.

(8) Question 2 does not require family notification. There is no requirement that the patient notify family members. For example, a husband could receive a lethal prescription without his wife being required to be notified. A mother could feel a "duty" to not be a burden and to leave a large estate to her children without her children having a chance to state that they care more about her than her money. Out-of-state family members might not know that their loved one is contemplating suicide and have an opportunity to intervene. Compassionate care at the end of life should involve the loving support and involvement of family members.

(9) Assisted suicide would weaken efforts to expand and improve palliative care. Palliative and hospice care, and the loving support of family members, are better alternatives than suicide for the terminally ill. Palliative care is a person-centered approach that treats all of the different aspects of pain and suffering. Palliative care experts consider assisted suicide as a "lazy way out." Rather than ending a life that is filled with pain and suffering, we should offer compassion, respect and dignity by providing the best in palliative care. That is where our efforts should be directed. However, the incentive to do so will be removed if assisted suicide becomes legal, because suicide will become a substitute for quality health care in some situations. It is also likely, palliative care leaders say, that investment in training for palliative care, effective pain management, and end-of-life communication will be undermined.

(10) Complex issues like assisted suicide should be decided in a legislative process rather than a ballot initiative. Some voters in Massachusetts oppose Question 2 because they believe that a ballot initiative process (dominated by 30-second commercials and sound bites) is not a good way to deal with a complex, ethical issue involving life and death. The legislature exists to review proposals, hold public hearings and build consensus on complicated issues.

When we grow old or sick and we are tempted to lose heart, we should be surrounded by people who ask "How can I help you?" We deserve to grow old in a society that views our cares and needs with a compassion grounded in respect, offering genuine support in our final days. The choices we make together now will decide whether this is the kind of caring society we will leave to future generations. Please join me on Election Day to stop assisted suicide by voting "No on Question 2."

The Archdiocese of Boston has developed an educational website on the Church's teachings on end of life issues, www.SuicideIsAlwaysATragedy.org. The archdiocese is also part of a large coalition of groups from other faiths, from the medical community, and from disabilities rights groups that are advocating a no vote on Question 2. The coalition's website is www.StopAssistedSuicide.org.