The worrisome account of 95-year-old Karen Okada adds new emphasis to Hawaii’s long debated, but never acted on, issue of death with dignity.

Okada in 1998 had prepared directions that her life not be artificially prolonged and now is living a semi-comatose state at Queen’s Medical Center with a feeding tube.

Star-Advertiser reporter Dan Nakaso wrote that the Queen’s Ethics Committee found that "continuing to provide antibiotic treatment and nutritional supplementation is in violation of Ms. Okada’s instructions … and such treatment should be discontinued."

Family members disagreed, the entire matter is in court, and the worry and fear continue.

There is a certain democracy in knowing that death comes to all and makes everyone equal, although those living with those at the end of life know that no matter how dedicated the care, there is always the feeling that something more should be done. If the loved one is not going to get better, then what to do?

Hawaii has agonized over this issue since former Ho-nolulu Star-Bulletin editor A.A. "Bud" Smyser in 1996 was named to a commission to study the issue. Smyser had campaigned for legislation that would allow patients to be involved in the decisions of whether to prolong their lives.

Former Gov. Ben Cayetano helped guide the legislation from committee to recommendation and highlighted the bill in one of his State of the State addresses.

No candidate for political office makes "I will bring you a ‘death with dignity’ law," as a campaign promise, but Cayetano neither ducked the issue nor lacked in the compassion and willpower to lobby for the bill.

As the measure came up for a vote in 2002, it gained support from then-state Senate Judiciary Chairwoman Colleen Hanabusa, who usually wasn’t but on this issue was aligned with Cayetano.

A remarkable series of public discussions on the issue left the measure three votes short of passage, and Cayetano says today he is still a strong supporter.

Another supporter was former Sen. Joe Kuroda, a popular Democrat who recalls while lobbying for the measure that although he retired from political life after four Senate victories and does not miss the stress of political life, said, "if my vote was the one that will decide the fate of a ‘death with dignity’ bill, I’ll run."

Kuroda, now 85 and something of a whiz with email, fished up the memo he sent back in 2002, including the pitch for passage of a death-with-dignity bill.

"If I ever get to heaven, I’ll smile with Bud Smyser, a fair Republican, who in the past had written, ‘The Democratic-controlled legislatures of the 1960s, ’70s and ’80s moved together to create and enact society-benefitting laws.’" Kuroda’s lobbying did no good.

The debate from 1996 to 2002 was interesting enough to provoke an in-depth study by Bill Kirtley, a Central Texas College political scientist, who found two of the players then are opponents today.

U.S. Rep. Mazie Hirono, now Democratic candidate for the U.S. Senate and then-candidate for governor, was "unequivocally for death with dignity," Kirtley said.

He quoted her as saying "We’re not talking about euthanasia here. We’re talking about an individual person’s decision while they are very lucid, and I believe that is one of the most fundamental decisions one can make about their lives."

Kirtley found that Hirono’s opponent then and now, former Gov. Linda Lingle, squared off in opposition.

"Lingle took a strong personal stand against death with dignity," he wrote, quoting Lingle as saying, "I don’t think people should be in the position of killing family members."

Asked this week about the possibility of another try at a death-with-dignity bill next year, Gov. Neil Abercrombie did not indicate this was the right time.

"Everybody should be able to die with dignity," he said.

When asked if he would support such legislation, he said: "It doesn’t serve any useful purpose to try to create drama on something so serious. The whole question of whether one is extending life or prolonging death is something that has been discussed in terms of ethics and philosophy for a long, long time."

It is an issue that will not go away until it is resolved.

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Richard Borreca writes on politics on Sundays, Tuesdays and Fridays. Reach him at rborreca@staradvertiser.com.