Updated: 12/09/2012 07:15:07 AM EST
In late September, polls showed a ballot initiative that would make physician-assisted suicide legal for terminally ill patients had support from 68 percent of Massachusetts voters.
Over the next month, that support steadily eroded, and on Election Day the measure failed by a razor-thin 51-49 percent margin.
How did a proposal that seemed sure to pass just five weeks before the election come up short?
Joseph Baerlein, president of Rasky Baerlein Strategic Communications, who handled public relations for the Committee Against Physician Assisted Suicide, said the measure's opponents had to convince voters who supported the idea of assisted suicide that the bill before them was flawed.
"We focused our campaign strategy on looking at those weaknesses," said Baerlein. "For us to have a chance to win, we would have to have some amount of voters who felt it was their right take another look, so they would see that this wasn't the right way to do it."
The Death with Dignity Act, or Question 2, mirrored legislation passed in Oregon and Washington state.
It would have allowed terminally ill individuals given less than six months to live to self-administer a lethal dose of medication if they have clearance from two doctors.
Through an aggressive advertising campaign, opponents of the measure sought to convince voters that predicting a person's end of life within six months, as the ballot question stated as a requirement, is difficult.
Opponents also focused on the fact that while the bill required two physicians to confirm a patient had six months or less to live, it did not require that the patient be evaluated by a psychiatrist.
"When someone tells you have six months to live, you're going to get depressed," said Richard Aghababian, president of the Massachusetts Medical Society, which opposed the initiative. "Will someone be taking the drug because of depression or excruciating pain?"
Opponents also drew attention to the fact that a doctor did not have to be present when a patient took the high dosage of lethal pills. A patient was also not required to notify his or her family members of the decision to take life-ending drugs under the law's language.
"Voters could never get their heads around the fact that if they had an ill grandmother, they would want to be at least notified if grandma was going to take her life," said Baerlein. "They wouldn't want to come home one day and find a note that grandma decided to take her life. They saw that as borderline cruel."
Money also played a part in the measure's defeat. Groups opposing Question 2 spent $4.8 million, compared to the $1.1 million that was spent by its proponents.
The Committee Against Physician Assisted Suicide reported the highest amount of expenditures for any ballot-question committee this year, at $4 million. The largest donors to the committee were the Boston Catholic Television Center, $1 million; St. John's Seminary Corp., $1 million; Knights of Columbus, $450,000; and The Catholic Association, $420,000.
Independent from the ballot-question committees, six organizations made expenditures to oppose question 2. The Massachusetts Family Institute, The Trustees of Emmanuel College, Stonehill College, Anna Maria College, College of the Holy Cross and the Trustees of Boston College spent $48,264 opposing the measure. An individual also reported spending $2,373 opposing the same question.
The amount of money spent on Question 2 was far below the record for a ballot initiative in Massachusetts. In 1998, a committee spent $8.2 million in support of a ballot measure to deregulate the electric utility industry, according to the state Office of Campaign and Political Finance.
"I think when you're down 68-20, if you don't have money you're dead on arrival," said Baerlein.
The ballot question cannot be put before voters again until 2018, according to state law.
Proponents of assisted suicide could try to address the issue in the Legislature in the meantime.
Several advocates for Question 2 did not respond to a request for comment on this story.
Aghababian said he hopes the attention the issue has received in recent months will help increase the quality of palliative or "end-of-life" care in Massachusetts.
"I would hope we would all become more intelligent about this issue and not get dragged into a dilemma in which some people would unnecessarily give up the hope of living," he said.