Maui County lawmakers and residents still felt conflicted Thursday after Gov. David Ige signed a measure into law allowing terminally ill people the option to take their lives through prescription medication.

House Bill 2739, known as the “Our Choice, Our Care Act,” gives mentally capable people with six months or less to live the choice to use medication that lets them die in their sleep. The act becomes law on Jan. 1.

“We’re not God,” Rabbi David Glickman of Jewish Congregation of Maui said. “We do not decide our life and death — who shall live and who shall die.”

The bill modeled after Oregon’s Death with Dignity Act includes “strict eligibility criteria and safeguards” that ensure a “safe, compassionate and patient-centered, end-of-life practice,” according to an announcement from the Governor’s Office. The measure also makes it a criminal offense to tamper with a patient’s request for a prescription or to coerce a patient to request one.

“It’s a very personal and very emotional issue to deal with, and I think what the Legislature did and with the governor’s signature is to allow individuals to make that choice for themselves,” said Sen. Roz Baker, who represents West and South Maui. She stood behind Ige as he signed the bill at the State Capitol. “It was a very emotional morning. I think it’s something a lot of people want for themselves and all the legislation does is set up the framework so there’s safeguards so they’re not forced into doing it if it’s not their choosing.”

Ige said the law was written to ensure the patient is in full control, and it provides just one option available for end-of-life care, knowing assisted suicide is not for everyone.

“It is time for terminally ill, mentally competent Hawaii residents who are suffering to make their own end-of-life choices with dignity, grace and peace,” he said.

Hawaii’s heavily Democratic lawmakers approved the legislation late last month. The state joins California, Colorado, Oregon, Vermont, Washington state and the District of Columbia in allowing the practice.

“The time was right for Hawaii to adopt this law,” said Peg Sandeen, executive director of the Death with Dignity National Center, a nonprofit advocacy group. “The safeguards Hawaii state legislators have enacted into this law will ensure that patients are in control of this process and make their own decisions at every step of the way — as is their right.”

Allowing medically assisted death in Hawaii, however, has been divisive. Last year, a similar measure passed the state Senate but was later tabled in the House.

Baker said the House wanted to start with a “clean bill” this session and found more support from representatives. She noted that some of the people at the bill signing were cancer survivors and patients who may use the act in the future.

“This is really about how you want to live your life,” she said. “If it gets to the point where you’re in pain and feel like it’s a burden to you and your family, or you just feel like you want to set parameters and go out on your terms rather than have an illness consume you and it’s all you think about. It’s a deeply personal decision.”

Central Maui Rep. Justin Woodson was the only Maui County lawmaker to vote against the bill, along with nine other state representatives. The only senators to vote no were Mike Gabbard and Breene Harimoto.

Woodson said his concern was over the lethal medication patients would take, which was the equivalent of “100 pills mashed up together.” He added that patients also would need to take a concoction to keep the meds down in their stomach, which would be the equivalent of 30 pills. A final third medication is taken for taste.

“It simply didn’t sit right with me,” he said. “My sense was also that the majority of the community that I represent is not in favor of it.”

Hospice Maui Executive Director Dr. Greg LaGoy said he began discussing new policies with other hospices in the state after Ige’s bill signing Thursday. He was not prepared to make a statement on the issue.

“This is a big conversation, and we need to be clear as to what it is we’re going to say before we say anything,” LaGoy said. “What I can say is that in the states where this has passed, the actual impact was very, very small.”

Critics say they are concerned that the option will lead to hasty decisions, misdiagnoses and waning support for palliative care, in which dying people can be sedated to relieve suffering. Churches and religious leaders also have denounced the choice based on their faith.

Paulette Perkins, secretary to Senior Pastor James Marocco of King’s Cathedral, said the church does not agree with the act.

“It’s not for someone else to decide on the end of their life because as believers in God, we believe that God will take a person at a time appointed,” Perkins said.

Glickman wondered how many times doctors have misdiagnosed patients or been wrong over how long a person has to live. He added that the best a doctor can do is give an educated guess and worried about the precedent the bill sets for future generations.

“I think it’s a slippery slope,” he said. “We’re opening a legal door to let people decide who should live and who should die. I think it’s a dangerous place to go, and I think it’s already an unspoken practice. But to make a law out of it, that scares me.”

* Chris Sugidono can be reached at csugidono@mauinews.com.

List of safeguards in ‘Our Choice, Our Care Act’

• Patients are required to take medication on their own.

• Two doctors must confirm the terminal illness and six-month prognosis.

• Patients are not eligible for medical aid in dying based on age or disability.

• The attending physician must inform the requesting patient about all end-of-life care options, including pain and symptom management, hospice and palliative care.

• The patient’s mental capacity must be confirmed by a mental health professional.

• Two separate requests for medication must be made, with a 20-day waiting period between the first and second request.

• A written request overseen by two witnesses also is required, with one witness prohibited from being a beneficiary of the patient’s estate.