The anti-euthanasia movement found new life last week after voters in Massachusetts defied the conventional wisdom by rejecting a physician-assisted suicide initiative.
In a setback for the "aid in dying" movement, Question 2, known as the Death With Dignity initiative, lost by a margin of 51 percent to 49 percent after leading by 68-to-20 in a poll released in early September by the Boston Globe.
The turnaround came after the "No on 2" camp fractured the liberal coalition that approved similar measures in Oregon and Washington by building a diverse campaign of religious leaders, medical professionals and advocates for the disabled along with a few prominent Democrats and a member of the Kennedy clan.
"This is a welcome roadblock in what many supporters of assisted suicide thought would be a Shermanesque march to the sea," said Wesley J. Smith, a senior fellow at the Discovery Institute's Center on Human Exceptionalism. "It shows that opposition to assisted suicide is not strictly a Catholic thing, nor a religious one — although that certainly plays a part."
Joe Baerlein, whose Boston political-consulting firm, Rasky Baerlein, helped run the anti-Question 2 campaign, said the win came despite initial research showing that Massachusetts voters agreed by a margin of 2-1 that individuals should make their own end-of-life decisions.
"Truthfully, my colleagues and I looked at this and thought we had an insurmountable task ahead of us," said Mr. Baerlein, a former Democratic campaign operative. "We mounted a campaign where even if you have these beliefs, you don't like the way it would be handled under Question 2."
The key was convincing voters to think about the details. Question 2 would have allowed terminally ill patients to commit suicide at home using doctor-prescribed drugs after first having two doctors sign off on the prescription.
The No on 2 camp argued that the initiative had too many flaws. No psychiatrist was required to screen patients for depression. There was no family-notification provision, and patients would fill their prescriptions at local pharmacies, leading to worries about unused pills falling into the wrong hands.
"The doctor wasn't required to be present at the death. Voters didn't like that," Mr. Baerlein said. "And people were shocked that the prescription would be filled at local pharmacies. One guy in our focus group said, 'You've got to be kidding me — I'm there in line to get Sudafed, and there's someone ahead of me getting poison pills?'"
While Boston Archbishop Cardinal Sean O'Malley was an active opponent, the campaign broadened its coalition by bringing in Jewish, Muslim and evangelical leaders.
"On Election Day, we had a rabbi, a black minister and a doctor holding 'No on 2' signs, which is rare," Mr. Baerlein said.
Then there was the money. The No on 2 campaign raised nearly $5 million, thanks in large part to Catholic institutions and leaders, giving it a 3-to-1 advantage over the pro-Question 2 campaign.
"If you look at the tremendous amount of commercials waged against us, to have come within 50,000 votes is truly amazing," said Mickey MacIntyre, chief program officer of Compassion and Choices, a pro-euthanasia group that backed the Question 2 campaign.
He said defeat of Question 2 doesn't change the surveys showing that most Americans support "aid in dying."
"We know the vast majority of people believe in having aid in dying, but it's difficult in an initiative situation when you're that badly outspent, especially when the opposition is telling voters, 'You can believe in death with dignity but not the specifics of this measure,'" Mr. MacIntyre said.
John Kelly, director of Second Thoughts in Boston, a disability advocacy group, said the No on 2 campaign avoided being pegged as a partisan fight. Several prominent Democrats spoke out against it, including columnist E.J. Dionne; Dr. Ezekiel Emanuel, brother of Chicago Mayor Rahm Emanuel; and Victoria Reggie Kennedy, wife of the late Sen. Edward M. Kennedy.
Second Thoughts also endorsed Question 3, the successful medical-marijuana initiative, and linked the two issues under the banner of patients' rights.
"We were able to get enough of a disabled rights perspective so that the archetypal culture war — religious conservatives versus secular Democrats — was not set up," Mr. Kelly said. "And I think that's what the other side thought would happen."
After ballot victories in Oregon and Washington, the physician-assisted suicide movement has stalled in New England. A 2000 ballot measure in Maine was narrowly defeated, and bills introduced in the New Hampshire and Vermont legislatures have gone nowhere.
"Part of it is the culture," said Tom Whalen, a political-history professor at Boston University. "In many ways, people are still conservative here and resistant to change. I think this [measure] crossed some political fissures."