When you or someone you love is diagnosed with a serious, potentially life-limiting illness, it rocks your world.

You can feel numb, confused, lost and at the mercy of something over which you have no control.

Your life involves multiple visits to the doctor, tests and procedures that are foreign, scary and sometimes uncomfortable.

But regaining control, autonomy, individuality and dignity are possible with the right care.

Hospice and palliative care specialists have achieved a high level of expertise in caring for those with chronic, serious or terminal conditions. They help restore quality of life through active medical, emotional, social, psychological and spiritual care, while honoring an individual’s values and wishes.

They care for people before the very end of life, even while that person is receiving curative treatments. They support those who are healthy by discussing preferences for care at the end of life before a crisis occurs.

Many of these special ists, including us, are members of Kokua Mau, the Hawaii organization that has led the effort to improve care for seriously and terminally ill people for over 15 years.

We work to educate the public, shepherd progressive legislation and expand the availability of palliative and hospice care across our state. One measure we supported was Hawaii’s Provider Orders for Life Sustaining Treatment (POLST) program, which allows people with serious illness to control exactly the type of care they receive.

Recently, “aid in dying,” or “physician-assisted suicide,” has been proposed as an option for those living with a terminal illness in Hawaii.

Those in favor of aid in dying cite the value of an additional choice near the end of life. Those opposed view it as possibly limiting choices for people who are seriously ill.

Since its inception in 1999 following the Governor’s Blue Ribbon Panel on Death and Dying, Kokua Mau has maintained a neutral stance on physician aid in dying. People of compassion and integrity hold diverse views on this sensitive topic, including our own members.

However, our membership does agree on one thing: that it is critical for our community to fully understand modern hospice and palliative care so that we can provide the very best care possible for those living with serious or terminal illness.

That is more important than the singular issue of aid in dying.

Aid in dying is legal in several states and we must learn from their experiences. But we also must recognize the unique cultures of Hawaii.

We cannot know whether introducing physician-assisted suicide to Hawaii would improve or diminish quality of life for the majority of those living with serious illness, but the proposal does raise questions:

>> Would aid in dying in Hawaii expand available options to the terminally ill, or lead to loss of the progress that has been made?

>> Could we fully protect the most vulnerable among us from potential abuse?

>> Could we be assured that those suffering from depression or living in poverty would receive the very best care possible?

>> Would some feel liberated by the “right to die” while others feel the burden of an obligation to die?

These considerations require thoughtful community dialogue, but the conversation must focus on patients and quality of life from an overall perspective and not strictly from a legal or civil-rights viewpoint.

For the sake of those living with serious illness, and the people who love and care for them, we must continue our progress and commitment to assure awareness of and access to the best of modern hospice and palliative care.