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Death with Dignity in Hawaii: A History

Efforts to pass physician-assisted dying legislation in the Aloha state date back to the late 1990s.


A physician-assisted dying bill was considered in the 1998, 1999, and 2001 (HB 2491 / SB2749, SB 709) legislative sessions.


Governor Benjamin J. Cayetano, a long-time supporter of the issue, sponsored House Bill 2487, the Hawaii Death with Dignity Act, which was closely modeled after the Oregon law (the companion bill in the Senate was SB 2745). The bill was authored by our founding board member, Eli Stutsman, JD, and supported by numerous local and national organizations including Hawaii Advocates for Consumer Rights, American Civil Liberties Union of Hawaii, and the First Unitarian Church of Honolulu. At the time, 72 percent of Hawaii residents supported the legislation.

The bill passed the House Judiciary Committee 10 to 1, with 3 abstentions, and on the House floor 30 to 20. Following some legislative wrangling and eventual success in the Senate Judiciary Committee, the bill moved to the full Senate. Due in large part to a strong organizing and lobbying effort by the religious opposition, the bill fell short of passage in the Senate by mere two votes, 14 to 11.

Until this time, no death-with-dignity proposal had come within striking distance of success in a state legislature.

Death with Dignity’s predecessor organization provided substantial financial, strategic, legal, and political resources to conduct the near-winning campaign, while maintaining a supporting role to the local Hawaii organization.


A new physician-assisted dying bill, HB 862/SB 391, failed to advance out of Committee despite a new poll showing that 71 percent of state residents supported it.


Following the 2002 and 2003 defeats, support for the issue around the states eroded. However, half a dozen veteran Hawaii advocates sensed the need for a hands-on local organizing and coordinating effort. The result of their considerations was the founding of Hawaii Death with Dignity Society in December.


A pair of companion bills, HB 1454/SB 1308, was again considered but failed to advance.


The all volunteer group Hawaii Death with Dignity Society attempted to get an aid-in-dying bill passed (HB 675/SB 800, SB 1995) with no success.


House Bill 806, sponsored by Representatives Oshiro (D), Belatti (D), Karamatsu (D), Marumoto (R), Say (D), Thielen (R), and Bertram (D), was referred to the House Judiciary Committee and carried over to the 2010 session with no action.

Additional bills this session were HB 587 and SB 1159.


Proposed Death with Dignity bills (HB 1383/HB 1165/SB 803) did not move out of Committee.

Compassion & Choices, the other mainland right-to-die organization, forcefully declared that death with dignity was already legal in the state, basing their argument upon a little-known 1909 Hawaii territorial law. Shortly thereafter, the Hawaii Attorney General stepped-in, issuing an opinion that writing prescriptions to hasten a competent adult’s impending death was still unlawful in Hawaii, meaning that that such activity was still a crime and would be prosecuted as such. The organization was forced to withdraw from the state.


The Hawaii Death with Dignity Society again tried to get a bill passed; HB 606 did not move out of Committee.


In 2015, another bill was introduced in the Hawaii House, by Representative Ito (D). HB 1255 did not move forward but was carried over to 2016 and failed to meet a Committee deadline for a hearing.

The companion Senate Bill 2373, Hawaii Death with Dignity Act, introduced by Senators Lorraine Inouye (D-District 4), Donovan Dela Cruz (D-District 22), Russell Ruderman (D-District 2), Brickwood Galuteria (D-District 12), and Glenn Wakai (D-District 15) on January 22, 2016, was referred to the Committee on Commerce, Consumer Protection, and Health and the Committee on Judiciary and Labor, where it did not meet a deadline for a hearing to be scheduled.

An October 2015 Stanford University poll found that 76.5 percent of Hawaii residents favor assisted dying as an end-of-life option (80 percent in a 2016 Anthology Research poll).


No fewer than five bills related to assisted dying (three in the House and two in the Senate, all introduced on January 19, 2017) were introduced in the Hawaii state legislature in 2017.

Senate Bill 1129

SB 1129, Hawaii Death with Dignity Act (renamed by amendment to Medical Aid in Dying Act), sponsored by Hawaii State Senators Karl Rhoads (D-Oahu), Lorraine Inouye (D-Hilo), Michelle Kidani (D-District 18), and Russell Ruderman (D-Puna) was the bill that went through the Senate and was deferred in a House committee. The bill resembles the Oregon Death with Dignity Act most closely.

The bill received its first hearing, in the Hawaii State Senate Committee on Commerce, Consumer Protection, and Health, on February 15, where it passed with amendments on a 6 to 0 vote. On February 28 the bill passed in the Senate Committee on Judiciary and Labor, again with amendments, on a 4 to 0 vote.

In the most recent, 2017, legislative session, a medical aid in dying bill (SB 1129) passed in the Hawaii State Senate on a 22 to 3 vote. The Hawaii House of Representatives Committee on Health heard the bill on March 23, 2017, and deferred it; the bill may return for consideration in the House in the second year of the biennium.

On March 7, 2017, the Hawaii State Senate passed SB 1129 on a 22 to 3 vote.

The Hawaii House of Representatives Committee on Health heard the bill on March 23, 2017, and deferred it.

Endorsements of SB 1129

Organizations that submitted testimony in support of SB 1129 (now SB 1129 SD2) for the Senate hearings included:

  • Hawaii Death with Dignity Society
  • ACLU of Hawaii
  • Democratic Party of Hawaii (separately also the DP’s LGBT Caucus, Kapuna Caucus, and Women’s Caucus)
  • International Longshore and Warehouse Union
  • Interfaith Alliance Hawaii
  • Life of Land
  • Rainbow Family 808
  • First Unitarian Church of Honolulu
  • Chamber of Commerce for Persons with Disabilities Hawaii
  • Hawaii Psychological Association
  • Nursing Advocates and Mentors
  • Compassion & Choices
  • Hawaii Association for Justice
  • Filipino-American Advocacy Network
  • Hawaii Friends of Civil Rights
  • Americans for Democratic Action Hawaii
  • Hawaii Advocates for Consumer Rights

The Hawaii Medical Association stated it would not oppose any assisted dying legislation this session.

Other Bills in the 2017 Session

The other bills are, in the Senate:

  • SB 357, Hawaii Patient Choice at End of Life Act, sponsored by Hawaii State Senators Lorraine Inouye (D-Hilo), Les Ihara (D-District 10), Karl Rhoads (D-Oahu), Russell Ruderman (D-Puna), Glenn Wakai (D-District 15), Brickwood Galuteria (D-District 12), and Brian Taniguchi (D-District 11).

In the House:


A 2017 Merriman River Group poll commissioned by the Honolulu Civil Beat found that 63 percent of registered voters in the state supported the legislation. A 2018 Mason-Dixon Polling & Strategy poll commissioned by the Honolulu Star Advertiser found 71 percent of state residents in support of an assisted dying bill.


In 2018, the second year of a biennium, four death with dignity bills were introduced on January 24, of which HB 2739, Hawaii Our Care Our Choice Act, sponsored by Hawaii State Representatives Della Au Belatti (D-Makiki), Mark Hashem (D-Hahaione), Nicole Lowen (D-Kailua-Kona), Sylvia Luke (D-Makiki), Dee Morikawa (D-Niihau), Scott Nishimoto (D-Kapahulu), Scott Saiki (D-McCully), Gregg Takayama (D-Pearl City), and Chris Todd (D-Hilo), moved forward and eventually became law.

A joint hearing of the House Health and Human Services and Judiciary Committees on HB2739 HD1 took place on February 27. On February 28, the two committees passed the bill 4-1 and 7-1, respectively. A full House vote took place on March 6, 2018, with 39 Representatives voting in favor and 12 against.

The Senate Committee on Commerce, Consumer Protection, and Health on March 16, 2018 passed the bill unanimously. The Senate Committee on Judiciary passed the bill 4 to 1 on March 23, 2018. The full Senate approved the bill on March 29, 2018 by a vote of 23 to 2.

Hawaii Governor David Ige signed the bill into law on April 5, 2018. The Hawaii Our Care, Our Choice Act went into effect on January 1, 2019.

Other Bills in the 2018 Session

  • SB 2727, Hawaiʻi Medical Aid in Dying Act, sponsored by Hawaiʻi State Senators Russell Ruderman (D-Puna), along with co-sponsors Senators Brickwood Galuteria (D), Clarence Nishihara (D), Donovan Dela Cruz (D), Karl Rhoads (D-Oahu), and Lorraine Inouye (D-Hilo). Senators Ruderman, Rhoads, and Inouye had sponsored SB 1129, which passed in the Hawaiʻi State Senate in 2017 and was later tabled in the House Committee on Health.
  • HB 2218, Hawaiʻi Voluntary Assisted Dying Act, sponsored by 16 Hawaiʻi State Representatives, led by primary sponsor Rep. Cindy Evans (D-North Kona).
  • HB 2736, Hawaiʻi Our Care Our Choice Act, sponsored by Hawaiʻi State Representative John Mizuno (D-Kalihi).
  • SB 1129, which passed in the Senate in 2017 and was deferred in a House committee.

Shareable Victory Graphic

2018 Hawaii Victory Graphic

Note: This page includes edited versions of various texts by Eli D. Stutsman, JD, and Scott Foster.

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