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As reported yesterday on Publicola, Susan Hutchison has substantially trailed Dow Constantine in the all important money race since the August primary. But Constantine supporters should not grow complacent, nor Hutchison fans too discouraged, because as I reported several weeks back, GOP stalwart John Stanton had been quietly promising to wage a million dollar “independent” expenditure campaign on Hutchison’s behalf.

Hutchison’s inability to keep up with her earlier fundraising pace stems mostly from the fact that the bulk of her money came in the form of double-max donations; she simply can’t legally tap much of her ultra-wealthy base a second time. But there’s no limit to how much one can give to “independent” expenditure campaigns, and that’s the beauty of Stanton’s alleged efforts.

We’ll have no idea how much Stanton and his Republican cohorts really raise until the money is spent, but considering what’s at stake in this race, especially for powerful developers seeking to crawl out from underneath our growth management statutes, a million dollars seems like a small price to pay.

At Crosscut, Bob Simmons eloquently points out a simple historical truth with a contemporary meaning: private enterprise failed to provide electrical service to much of rural America, and it took the REA under Franklin D. Roosevelt (and Truman) to get it done. And the right wingers of the day called FDR a communist and everything else under the sun.

Here in the Pacific Northwest, where we’re even more indebted to government action for the creation of cheap, reliable electrical power, you kind of wonder if the morons proclaiming that they “don’t need the government for anything except defense and law enforcement” are going to stop using their computers, microwaves and flat screens, or if many of them are even aware of the BPA. I suppose the magic market fairy just fires up the PS3 for them.

The ridiculous hysteria of August should cause sensible people to reflect on what the proper role of government is in a democracy that adheres to a well-regulated capitalist system. This is a legitimate area for debate.

The essential position of progressives, as I understand it, is that if you don’t have a referee in key sectors the cheaters will prosper. This has been proven countless times in our history, from the railroads and oil companies of yore to Enron and the housing bubble in our own time. From time to time government action has been required to preserve capitalism, not destroy it. Notice nobody wants to centrally plan production of toilet paper or iPods, we’re only talking about essential services, health care being rather essential at times to not being dead.

One can argue for or against regulation in a given sector, and how little or what type of regulation will work best, but the far right has simply decided to hurl whatever insults it can muster instead, and is being egged on by corporate America acting in lockstep with the GOP. These are the folks who supposedly hate class warfare, but ruthlessly wage it against the most vulnerable Americans in order to harvest vast profits from the sick, the working poor and anyone else that gets sucked into the monstrosity known as health insurance.

We’re still waiting on that GOP plan to fix health insurance, and my bet is they’ll never produce one. The GOP and the insurance industry are essentially one and the same thing, and just because there are also a lot of Democrats who display similar whorishness does not excuse any of it.

The health insurance companies have become the new Enrons, and they must be refereed. Obama must indeed welcome their hatred, just as FDR did, or nothing much will be accomplished.

We’ve been experiencing technical difficulties this morning, which may result in scattered down periods throughout the day.  Please be patient.

In the comments from Sunday morning’s post, commenter Roger Rabbit posted a link to another tragic drug war story that I haven’t covered here. It comes out of Kansas, where in late 2007 a pain doctor named Stephen Schneider and his wife Linda (a nurse) were rung up on a 34-count indictment related to prescribing more pain medication than the DEA allows. As Harvey Silverglate explains, this is an all-too-common occurrence:

When pain doctors administer too much of a controlled substance, or do so knowing that they will be diverted to narcotic addicts, they are deemed no longer engaged in the legitimate practice of medicine. But the dividing line is far from clear and not subject to universal agreement even within the profession. Any patient in need of relief can, over time, develop a chemical dependence on a lawful drug–much like a diabetic becomes dependent on insulin. And, once a treatment regimen begins, many patients’ tolerance to the drug increases. Thus, to produce the same analgesic effect, doctors sometimes need to increase the prescribed amount, and that amount varies from person to person.

It is notoriously difficult even for trained physicians to distinguish an addict’s abuse from a patient’s dependence. Nonetheless, federal narcotics officers have increasingly terrorized physicians, wielding the criminal law and harsh prison terms to punish perceived violators. Since 2003, over 400 doctors have been criminally prosecuted by the federal government, according to the DEA. One result is that chronic pain patients in this country are routinely under-medicated.

One notorious case along these lines was the prosecution of Richard Paey, a wheelchair-bound attorney in Florida who was originally given a 25-year prison sentence for forging prescriptions (he was pardoned by Governor Crist in 2007). Prosecutors tried to paint him as a drug dealer, but could never prove that he sold any of the drugs he obtained. Ironically, in prison, he was finally given the amount of pain medication he’d been trying to obtain for himself all that time.

Another person affected by this crusade against pain doctors is Siobhan Reynolds, whose husband died after spending years trying to find a doctor willing to treat his pain. Reynolds founded the Pain Relief Network in 2003. She’s been heavily involved in trying to raise awareness of the prosecution of Dr. Schneider, and because of that she found herself a target of the Kansas prosecutors as well. Silverglate writes:

When Reynolds wrote op-eds in local newspapers and granted interviews to other media outlets, Assistant U.S. Attorney Tanya Treadway attempted to impose a gag order on her public advocacy. The district judge correctly denied this extraordinary request.

Undeterred, Treadway filed on March 27 a subpoena demanding a broad range of documents and records, obviously hoping to deter the peripatetic pain relief advocate, or even target her for a criminal trial of her own. Just what was Reynolds’ suspected criminal activity?

“Obstruction of justice” is the subpoena’s listed offense being investigated, but some of the requested records could, in no possible way, prove such a crime. The prosecutor has demanded copies of an ominous-sounding “movie,” which, in reality, is a PRN-produced documentary showing the plight of pain physicians. Also requested were records relating to a billboard Reynolds paid to have erected over a busy Wichita highway. It read: “Dr. Schneider never killed anyone.” Suddenly, a rather ordinary exercise in free speech and political activism became evidence of an obstruction of justice.

Last Friday, after Silverglate’s editorial was printed, the judge in the case fined Reynolds for refusing to turn over the documents. She plans to appeal the ruling.

A few weeks back, I posted about my skepticism of what’s been happening with the investigation of Michael Jackson’s death and the attempts to charge his doctor with manslaughter. Cases like the one in Kansas are what formed my initial reaction to that news. The circumstances of the Michael Jackson case are quite different and bizarrely unique, but they also boil down to a prosecutor deciding that a doctor has done something so improper that it’s not only bad medical practice, but is actually a criminal act. And as this case out of Kansas has shown, it’s often the prosecutors who are a greater threat to the general public.

Please join us tonight for some politics under the influence at the Seattle chapter of Drinking Liberally. The festivities take place at the Montlake Ale House, 2307 24th Avenue E. beginning at 8:00 pm.

And if you can’t make it tonight, please stay in school, work hard for your goals, and listen to your parents. (I hope nobody’s offended.)

[youtube]http://www.youtube.com/watch?v=SSNQpEbtlP4[/youtube]

Not in Seattle? The Drinking Liberally web site has dates and times for 336 other chapters of Drinking Liberally for you to shoot for.

In scolding Kent teachers to get back to work, the always anti-union Seattle Times argues that “Defying court order teaches the wrong lesson.” Uh-huh. Really?

Putting aside the issues of this particular strike (I haven’t paid them much attention, and don’t plan to), teachers, like nearly all workers, have a moral right to strike, even if in Washington state they may not have that legal right, and standing up for one’s rights, even in defiance of the courts, is never the wrong lesson to teach our children, especially in a nation like ours with such a strong authoritarian streak to its national character… a character quickly revealed in the first couple comments in the Times’ comment thread:

davidfelder
anderson island, WA
Why should any Kent student EVER believe another thing his/her teacher tells them?  A teacher willing to disobey a lawful order is a teacher who has no right to expect his/her students to follow the teacher’s rules. A national disgrace.

onein81
moses lake, WA
great first message. mine it to fire every single one of them. take the union leadership and lock them away in jail. am i being to hard. no. back in 1981 Patco members and union leadership were hauled off to jail in handcuffs and chains. fire each and every single one of them.

Whatever the Times editors thought they were saying, surely they must have understood that this is the kind of sentiment their headline would inspire. And while no doubt Times publisher Frank Blethen would be cheered at the thought of union members being hauled away in handcuffs, America in fact has a proud history of civil disobedience… a history lesson conveniently ignored by those who would use the power of the state to trample the rights of others.

The headline in the Seattle Times sounds awfully hopeful, “Wash. lawmakers take next step toward ed reform.” So what exactly is that next step?

They haven’t found a single new dollar to pay for their ideas, but state lawmakers and education officials are pushing ahead with plans to start implementing education reform.

A new education reform committee recently held its first meeting. It is chaired by the superintendent of public instruction and counts among its members the speaker of the House and the chair of the Senate Education Committee, so the political will to move on is there.

No money to pay for their ideas, or any idea how to raise the money, but at least they started a new committee.  Can’t get much bolder than that.

But some of the faces around the table have sat at similar meetings, battling similar issues for years.

Oh. That’s not an encouraging sign.

First came the governor’s Washington Learns task force that published an ambitious plan to improve education in 2006. That report led to the state’s new Early Learning Department, but the Legislature could not find the money to implement most of the other ideas.

There’s that pesky money problem again.

Then came the reinvented State Board of Education, which moved ahead on some related ideas, including new high school math requirements and a proposal to require high school students to earn 24 credits instead of 19 to graduate.

Next, the Basic Education Finance Task Force, wrote a road map last summer for completely changing the way the state distributes its education dollars. The task force’s ambitious plans would cost an estimated $3 billion to $4 billion a year, on top of the $7 billion a year the state already spends on education.

And the money…?

The 2009 Legislature adopted some of the task force’s ideas and put a new group, the Quality Education Council, in charge of implementing the plan, but with a new twist. This time, the task force is also in charge of finding the money to pay for the changes.

Rep. Skip Priest, R-Federal Way, has sat around many education reform tables, including Washington Learns and the Basic Education Finance Task Force.

“I think it’s time we have a sense of urgency about this issue,” Priest said after the Quality Education Council held its first meeting at the end of August.

No shit, Sherlock.

Honestly, there is no substantive education reform without the money to pay for it, and all the committees and commissions in the world won’t change that. So in a state facing its deepest fiscal crisis perhaps ever, and a long term  structural revenue deficit as far as the eye can see, the real “next step” to education reform in Washington state is an honest debate about tax restructuring, and unless Republicans like Skip Priest are willing to push for that debate, they really aren’t approaching education reform with any sense of urgency at all.

I’m just sayin’.

In the spirit of this post at EffU, I’d like to see who can come up with the funniest set of hypocritical statements from a wingnut blogger when it comes to the “George Bush is our President and we should respect him and everyone should shut up” and “Barack Obama should not be telling our schoolchildren to work hard” brain malfunction.

[youtube]http://www.youtube.com/watch?v=ofxVMlU97yA[/youtube]

[youtube]http://www.youtube.com/watch?v=-yUMQR_Bo7s[/youtube]

In Part II of my “Talkin’ with Teabaggers” adventure, I chat with an elderly gentleman protesting last Thursday’s pro-healthcare reform rally (you know, the one that never happened).  No snarky subtitles or silly inserts this time, just a few minutes of unedited conversation about healthcare, and why us whippersnappers don’t need or deserve it.

In what has become an ironic cliche that typifies the inanity of the current healthcare reform debate, this eighty-ish-year-old man may be opposed to government run health insurance, but he sure does love him some Medicare. When asked if he’s happy with Medicare he says “yes.” When asked if he’d want it taken away, he says “no.” When asked if the government has done an “okay job” running Medicare, he says “As far as I’m concerned, it’s been okay with us.”

In fact, his high degree of satisfaction with his government-run Medicare seems to form the basis for his opposition to any plan that might include a government-run public option for the rest of us. “Why mess it up for old people?” he asked me.

Good question. Perhaps we should give up on this “public option” thing and just allow everybody to buy into Medicare, regardless of age? I know he thinks young folks don’t need it (hell, he didn’t have health insurance until he was 40, so why should anybody else?) but if that’s true then they’d sure be cheap to insure. Meanwhile, they’d still be subsidizing his Medicare coverage through their payroll taxes, just like they’re doing now, so how could that possibly mess anything up for him?

Yeah, sure… under that scenario, Medicare would be the public option. But shhhh, don’t call it that, and we might get his support.

I mostly have a reputation as a foul-mouthed, partisan muckraker and agitator, and with a brand name like HorsesAss.org, why shouldn’t I? But I think it of interest to note that in the wake of Friday’s WTO ruling that EU nations illegally subsidized Boeing rival Airbus, I actually took the time to interview a US congressman, and write a thoughtful, objective analysis of the decision, whereas the Seattle Times—our region’s paper of record—relied solely on reporting and analysis from the Associated Press and Bloomberg News.

A ruling in a controversial international trade dispute that directly impacts one of our region’s most important employers, and the Times couldn’t even be bothered to assign a reporter to cover the story and attempt to get a richer local angle. Kinda pathetic.

Now, I don’t mean to pat myself on the back. It was Rep. Jay Inslee’s staff who deserves the credit for reaching out to me and offering a few minutes with the congressman—an opportunity I jumped at—but if Inslee was making himself available to foul-mouthed bloggers like me, you can be sure he was making himself available to the Seattle Times. In fact, I can’t help but wonder if Inslee only had the time to talk with me because most of the rest of our local media simply weren’t interested in putting the effort into such an admittedly wonky story?

Perhaps I was too harsh in implying some sort of bias in our local media’s refusal to cover last week’s pro-healthcare reform rally? Maybe our local media is just lazy?

In defending his efforts to achieve a local monopoly, Times publisher Frank Blethen long promised that freed from the financial drain of the JOA, his newspaper would emerge stronger and more vibrant, but most observers would agree that the Times’ local coverage has continued to shrink since the P-I ceased print publication. Here’s hoping that once this economy turns around, Blethen actually attempts to fulfill his civic promise.

Then.

Capitalizing on his war record, McCarthy narrowly defeated the overconfident Senator Robert La Follette in the 1946 Republican senatorial primary and assailed his Democratic opponent, Howard McMurray, as a man so desperate for election that he would accept communist support. The baseless charge worked. McCarthy trounced McMurray and, in 1947, became the junior U.S. senator from Wisconsin. He quickly alienated his colleagues (especially after he tried to court the German-American vote by criticizing the prosecution of Nazis accused of slaughtering American troops during the Battle of the Bulge) and he soon feared that he could not be re-elected without a major issue to improve his political standing. Consequently, on February 7, 1950, he told a group of Republican women assembled in Wheeling, West Virginia, that there was serious “communist influence” in the Truman administration, declaring, ” I have here in my hand a list of 205 . . . names that were known to the Secretary of State and who nevertheless are still working and shaping the policy of the State Department.” Even though no such list existed, McCarthy’s accusations gripped the media and he soon became a national figure, promoted on the covers of national news magazines.

Now.

The defining accomplishment of Van Jones’s life was his founding of the Ella Baker Freedom Center. While the controversy over his appointment was going on I meant to look into who she was, but didn’t get it done. Ron Radosh, an expert on the hard left of which he was once a member, has the answer:

[T]he name of Jones’ Oakland group, The Ella Baker Freedom Center, is most appropriate. Most people have referred to the late Baker as simply a civil rights activist. I am writing from vacation in Nantucket, without benefit of my files at home. But in my book, Divided They Fell: The Demise of the Democratic Party, 1964-1996, I point out that the late civil rights lawyer Joe Rauh had noted that everything Baker said in the 60’s might as well have been taken verbatim from The Daily Worker, the Communist Party newspaper. Baker was so pro-Communist that she attacked Hubert Humphrey and other liberal anti-Communists as ultra reactionaries. Known as the “grandmother of SNCC,” Baker was aligned with those in the movement who were trying to push the organization to the far left.

I think that sums up the Obama administration pretty well. If you think Hubert Humphrey was an ultra-reactionary, this administration’s for you!

Red-baiting never goes out of style.

This is just the beginning, unless someone with a really big megaphone decides to fight back. No, not the president, he’s too busy making sure bankers, health insurance executives and the rest of Wall Street are mollified.

You know who I mean. [ed. note update-I messed up my original link, the link is now to whom I am talking about. Congratulations to all who guessed “KO.” Sorry about the bad link.] Yeah, this is war. Either the far right puke funnel is brought to heel by utterly destroying its undeserved credibility, something that should have happened long ago, or our democracy plunges into neo-McCarthyite darkness for who-knows-how-long. Which obscure administration or member of Congress will be next? Will it it be a third under-secretary for African affairs, or will it be, um, YOU?

Throw in a still shaky economy and two foreign wars that seemingly have no end, and it’s difficult to predict what might happen.

How’s that post-partisanship civility working out? Yeah, I know, regular people get sick and tired of the clown shows, but the clown shows are not a bug, they’re a design feature. They show that many Democrats won’t fight for their principles, or that many Democrats are unprincipled whores, and in either case weakness and whorishness is exposed.

The clowns clown, the pundits pontificate and the “reasonable” Republicans chortle while they watch the polls and congratulate each other on what a great monkey wrench they possess. Next up will be a set of “promises” from the GOP, probably with some grandiose name only a Colbert could appreciate, that will list the requisite demands for lower taxes, bashing of immigrants, fear-mongering against gays and any clever phraseology Frank Luntz crafts to make a shit sandwich look like Pan-bagnat.

Democrats, please feel free to win this fight on policy grounds by carefully arguing your position, giving away the store to your opponents and then attempting to win over the public with excuses, that’ll work well.

I generally don’t write about every single drug war tragedy that I come across, especially ones from outside of the northwest. They happen so routinely – whether it’s a botched drug raid against an innocent suspect, a police officer dying in the line of duty, or innocent people getting caught in the crossfire of competing drug gangs – that it would dominate this blog if I wrote about them all. But one that just happened in northeastern Georgia caught my attention for a couple of reasons and I feel like sharing some thoughts on this.

On September 1, a 28-year-old pastor named Jonathan Ayers was shot and killed by undercover police officers in the town of Toccoa, Georgia. The pastor had been seen driving a car with an alleged drug dealer as a passenger. After Ayers dropped off the suspect (a woman who has not been identified) at a gas station, the officers quickly pulled up in an Escalade and drew their guns (the CNN page has a good video from the convenience store surveillance camera). Ayers sped off as the plain-clothed officers discharged their guns at him. He was wounded from the gunshots and later died at a hospital.

If anyone is convinced that there was some dark side to this pastor, his blog should cast serious doubt on that notion. Reading his recent entries just made my heart sink. Ayers left behind a pregnant wife and was where I was a little less than a year ago, looking forward to ultrasounds and having those “oh shit, I’m going to be a dad” moments. It’s not clear why he had allegedly given this drug suspect a ride, but according to his friends, he considered it his Christian mission to help people, so it wasn’t uncharacteristic for him to be doing favors for strangers.

One post in particular, from only three weeks before the shooting, really struck me as well:

Scared as Crap

I got pulled over today for no insurance. I was like are you kidding? The deputy told me “no I am not kidding you have no insurance”. We both got on the phone and called the insurance company to figure this whole thing out. They told the deputy that I had a policy but no vehicle’s was on the policy. I was like what kind of policy do I have? So we finaly got it fixed.

I left there and I wandered how many people go through life and think they are ok because they are a good person, have done some good deeds, and they aren’t as bad as some other people. Here’s the thing they don’t know Christ! They have never started a relationship with Jesus. One day they will stand before God and He will say “depart from I never knew you”. They are going to be in for the sadest day of their life. Don’t miss Jesus because you think you are good enough!

I’ve seen several comments to the articles I’ve read about this incident saying things like “well, why did he speed off if he was innocent?” The post above should answer that question completely. Only three weeks before he was killed, he was this rattled from a routine traffic stop. It shouldn’t surprise anyone that the sight of several non-uniformed individuals getting out of an Escalade with guns would have scared him enough that he’d choose to drive away as fast as possible.

It’s not likely that an atheist from the Pacific Northwest is going to change the way the drug war is fought in rural Georgia, but every tragedy in this war weighs on me and hardens my determination to start the dominoes falling where they’re most likely to tip over. This one in particular. While religion has never been a part of my life, I couldn’t help but notice that Ayers’ determination as a Christian mirrors my own determination in this battle. And our underlying motivations are largely the same, to build a better society and to promote peace. I hope that Jonathan’s family can find peace in this tragedy and that Americans of all stripes will take a long look at what this war is doing to us.

Last week’s contest was won by ‘waguy’. It was Long Island MacArthur Airport in Ronkonkoma, NY. If you want to keep up with what areas are being added to the Bird’s Eye View image server, you can check out this page, where the Bing team is releasing monthly updates.

Here’s this week’s, good luck!

Earlier this week, the Montana Supreme Court heard oral arguments in the Death With Dignity case that is expected to uphold a District Court ruling from last December that found that patients have a right under the Montana State Constitution to request medication that aids in dying.

Washington’s law has been in effect for six months now, and the main issue in that time has been the question of whether Washingtonians in certain areas can find doctors who will allow them to exercise their rights. In Montana, which is even more vast and rural, this will almost certainly be an issue as well. I touched on that issue very briefly here and had some back and forth in the comments, but Jacob M. Appel covers it far more extensively here at Huffington Post:

Janet Murdock learned this awful lesson the hard way. The sixty-seven year old Missoula woman, who suffered from advanced ovarian cancer, initially believed that Judge McCarter’s ruling would guarantee her the death that she desired. Instead, she spent her final months trying to find a local doctor willing to help her die — eventually giving up food and water when no physician in the entire state proved willing to supply her with a lethal dose of medication. Her desperate efforts certainly were not aided by the Montana Medical Association, which issued a policy documented declaring aid in dying a violation of professional ethics, or that group’s president, Kirk Stoner, who has championed an absolutist, anti-assistance position on the issue. In response, before her death in June, Murdock released a statement that read: “I feel as though my doctors do not feel able to respect my decision to choose aid in dying…Access to physician aid in dying would restore my hope for a peaceful, dignified death in keeping with my values and beliefs.” The challenge for those on both sides of this issue is how to balance the “values and beliefs” of desperate patients like Murdock and Baxter with those of medical professionals who are personally opposed to easing their deaths. Our society will soon be forced to adjudicate these competing claims: Which right trumps? The patient’s right to die or the doctor’s right to follow her conscience?

The ongoing public debate over “conscience” clauses, which permit individual health care providers to opt out of medical practices to which they are morally opposed, has until now been confined primarily to issues of reproductive freedom. Pharmacists who refuse to fill prescriptions for emergency contraceptives have become lighting rods in the debate over religious freedom and women’s health. A critical shortage of abortion providers has led some progressive commentators, including myself, to call for mandatory abortion training in obstetrics residency programs. However, even those policy-makers who support conscience exemptions in these areas should be able to recognize the fundamental difference between pharmacists who refuse to fill birth-control prescriptions and the physicians who would not help Janet Murdock to die. A handful of rogue druggists may certainly impede access to contraception — but all pharmacists do not oppose RU-486. A shortage of abortion providers, while deeply troublesome, is not the same as a complete, state-wide absence of abortion providers. If Montana doctors can act on their consciences, patients wishing to die will not merely have to endure additional burdens to vindicate their rights. Rather, they will have absolutely no means to effectuate them. Much as constitutional guarantees of press freedom do little good for prospective publishers if they do not have access to paper or ink, the right to aid in dying is strikingly useless if nobody is willing to help.

The legal profession long ago recognized that if our judicial system is to function meaningfully, all criminal defendants — even the most distasteful — should be entitled to representation. As a result, states provide attorneys for those who cannot find them on their own, and judges occasionally compel individual members of the bar to represent the interests of unpopular defendants. In contrast, doctors have rather stubbornly clung to historic notions of professional autonomy. These arguments might hold more sway if physicians operated in an open marketplace and if anyone with the appropriate knowledge and skills could practice medicine in the United States. In reality, medical licenses are a limited commodity, reflecting an artificial shortage created by a partnership between Congress and organizations representing physicians — with medical school seats and residency positions effectively allotted by the government, much like radio frequencies. Physicians benefit from this arrangement in that a smaller number of physicians inevitably leads to increased rates of reimbursements. There’s nothing inherently wrong with this arrangement. However, it belies any claim that doctors should have the same right to choose their customers as barbers or babysitters. Much as the government has been willing to impose duties on radio stations (eg. indecency codes, equal time rules) that would be impermissible if applied to newspapers, Montana might reasonably consider requiring physicians, in return for the privilege of a medical license, to prescribe medication to the dying without regard to the patient’s intent.

Mandating that physicians aid in dying should be a last resort. First, Montana should explore other, less-invasive means of ensuring that all citizens are guaranteed their constitutional right to die. One solution might be hiring a handful of publicly-salaried physicians, recruited from out-of-state, whose primary responsibility would be to offer palliative services, including lethal prescriptions, to the terminally ill. Another possibility would be easing licensure requirements for out-of-state physicians, particularly those from Washington or Oregon, who come to Montana on a short-term basis solely for the purpose of helping the terminally ill to die. Finally, the state might simply scrap its general requirement for physician-issued prescriptions in cases of terminal illness, instead providing both drugs and instructions directly to dying individuals or their families. In short, the state should think creatively about ways to ensure that the terminally ill do not suffer without taking the drastic step of forcing doctors to assist in dying.

The right to die is not an abstract principle. This right — or its absence — has a profound effect on the fundamental welfare of nearly every individual and family in the nation during the most vulnerable moments of their lives. If the Montana Supreme Court guarantees citizens the right to aid in dying, and I am both hopeful and confident that the court will do so, then it is also incumbent upon the justices to ensure a mechanism by which patients can exercise their rights. To do otherwise — to offer a theoretical right to die that cannot be meaningfully exercised — will be both a hollow gesture and a cruel taunt to the terminally ill.