There are still a few months before the state’s newly enacted assisted-death statute takes effect, and that’s fortunate. That leaves time for state health officials to ensure that, when the law is implemented, it is strengthened by all the safeguards legislators intended it to have.

The passage of House Bill 2739, later dubbed the “Our Care, Our Choice Act,” followed years of heated debate over the state’s role in end-of-life issues.

Hawaii was long preceded in taking this policy step by Oregon, the first jurisdiction to enact a Death With Dignity Act, through a ballot initiative in 1994. Others now with similar provisions on the books are California, Colorado, the District of Columbia and Montana. Some two dozen other states continue to debate the proposal.

Getting the votes required is unarguably a difficult leap, running up against deeply held beliefs about life and, in the case of the assisting physicians, about the part the health-care profession should play as well. The Legislature took pains to include provisions that assuage some of these concerns.

One assertion made during session this spring was that an assisted-death provision could lead to abuse. For example: Family members or other caregivers whose interests could be served by the death of the patient might unduly influence the decision he or she makes.

To guard against this and other potential problems, a robust protocol is laid out:

>> Three voluntary requests must be made by a patient, including one written and two verbally communicated to his or her doctor. The two spoken requests must be made at least 20 days apart, bringing enough thought and consideration to bear on the difficult choice.

>> Two Hawaii physicians must confirm the patient as eligible; he or she must be an adult resident of Hawaii and be terminally ill with a prognosis of six months or less to live.

>> The patient also must be shown to be acting voluntarily and mentally capable of making their own health-care decisions, and physically capable of administering the lethal drugs. Mental capacity must be confirmed by a psychiatrist, psychologist or licensed clinical social worker.

>> Patients must give consent after the doctor informs them of all other end-of-life options.

All this is important, because there are ways of relieving suffering short of ending one’s life. Palliative care, the critics of the law argued, has greatly improved and is a viable option to provide comfort to a dying patient.

The state Department of Health must continue its efforts to devise the application and review process with the aim of enabling an enlightened, empowered decision.

This careful approach was what persuaded holdouts at the state Capitol to let the program move ahead. There is reason to be alert to developments that could later weaken the protections.

Other states have been pressed for changes after living with the program for a while. For example, advocates of amending the Oregon law have pressed to extend eligibility to people suffering from a disease such as Alzheimer’s, not only ailments that are themselves terminal. Or they have pushed for an extending the survival prognosis window from six months to a year.

So far, such initiatives have failed. It’s interesting, and encouraging, to see that some of the resistance has come from right-to-die groups such as Compassion &Choices. They worry, with good reason, that letting the constraints slip could convince opponents in other states that their concerns are well-founded.

Clearly, Hawaii must proceed with caution.

When the assisted-death option becomes active in January, residents want to see it presented as a choice that is truly compassionate. And state leaders must not allow such “compassion” to evolve into a force directed more by expedience than by loving care.