Honolulu Star-Bulletin from Honolulu, Hawaii • 10

Star-Bulletin A-10 Tuesday. July 29. 1997 Honolulu Star-Bulletin Hospice care could help more in Hawaii Published hv Lihertv Neuisonnent Limited Partnershio Published by Liberty Newspaper Limited Partnership AAA Rupert E. Phillips, CEO John M. Flanagan, Editor and Publisher 11 Diane Yukihiro Chang Senior Editor and Editorial Page Editor David Shapiro Managing Editor Frank Bridgewater and Michael Rovner Assistant Managing Editors A.A.

Smyser, Contributing Editor HAW A I I WORLD By A A. Smyser AAA ATIENT care directors for Oahu's two hospices scanned the list of causes of Ruling on stress could stress the economy lies in Hawaii that have dealt with hospices is overwhelmingly favorable. Such families often can also be a good source of contributions to help others. Kalua and Shirland would like to see hospice insurance benefits extended to a year instead of six months. They would like Medicare payments boosted from $107 a day to cover the actual $147 average at-home cost, which includes medications.

The difference now Is made up by contributions. They would like to see payments for 'resident care" in facilities managed by the hospices boosted to $250 a day. ST. Francis has 12 beds in an old Nuuanu Valley mansion. It will add 24 in September at St.

Francis Hospital-West. Hospice Hawaii has five beds in a Kailua residence, plus the right to use six beds each in the Castle, Queens, Kuakini and Wahiawa hospitals. -Hospice Hawaii has state authorization for two more five-bed homes. One will be at Ewa Beach, the other at a still unchosen Honolulu site. Both hospices still handle most deaths at home, which is where most patients prefer to be.

The state hospice association estimates 1,600 people died last year under care from the two Oahu hospices and six neighbor island hospices. If Kalua and Shirland are right hospices could have brought better deaths to 3,500 more. A A Smyser is the Star-Bulletin's contributing editor. His column runs Tuesday and Thursday. tions, is insured under Medicare-Medicaid standards and most private plans.

Hospice care, much of it at home, is far superior to ordinary home health-care programs when death draws near. The latter have no volunteers or counseling. They are not governed by federal hospice standards. To qualify for hospice, however, patients must accept that their life expectancy may be less than six months. Their lives then shift to regimens aimed at caring rather than curing.

They gain dignity and physical comfort by ending or at least cutting down on chemotherapy, surgery, radiation and feeding tubes. This usually costs less than acute care aimed at curing but no one tries to sell it on that basis. For most dying patients it is simply a better choice. Patricia Kalua of St. Francis Hospice, Hawaii's first hospice, and Barbara Shirland of Hospice Hawaii said diseases where hospice can usually be of great help in the terminal period include heart, cancer, brain, pulmonary, liver, HIV and atherosclerosis.

Unfortunately most hospice referrals still are for cancer. Even more unfortunate, the average patient spends less time in the program than desirable. Thirty percent may spend less than a week before death. Several months can better help patients make peace with their worlds, tidy up their personal affairs and mend broken relationships. More doctors are making hospice referrals than ever before but some do it terribly late.

Patient requests based on word of mouth still may exceed doctor referrals. Word from fami- JL 7,803 deaths in Hawaii last year. They said hospice care, which I'll define UST as it did on privatization of government services, the state Supreme Court has issued a decision correctly applying a bad law and nudged the Legislature to change it The high court ruled that employees may collect workers compensa more fully shortly, could have helped more than 5,100 of the dying people die better but actually helped only about 1,600. Good, compassionate terminal care is a boon for both the patients and their survivors, whose memories will last a long time. The elements hospice can add include very high-level pain control, relaxants to help deal with shortness of breath, relief from nausea and better management of incontinence.

To that add counseling to help both patients and survivors make peace with the world around them. Hospices offer a 24-hour help line and on-call service. They handle the details when death occurs. Hospice care, including medica Honolulu star-bulletim tion for stress caused by disciplinary actions, whether or not the discipline was justified. Lawmakers stubbornly refused to act on privatization but cannot afford to retain the workers comp aberration.

The justices ruled that a Big Island 6th-grade teacher could collect workers compensation for her trauma stemming from her principal's ordering a five-day suspension without pay for allegedly striking a student The court held that the trauma was work-related, even if the teacher improperly inflicted corporal punishment The teacher denied that she had engaged in corporal punishment, maintaining that she accidently bumped the student, but the high court said she qualified for workers compensation regardless of whether she had engaged in misconduct. In its opinion, the Supreme Court said it was "compelled" to uphold employees' right to workers compensation in such cases "unless and until the Hawaii Legislature chooses to amend" the workers comp law. Deputy Attorney General Dorothy Sellers has correctly interpreted that language as an invitation for the Legislature to change the law. That will not be easy. The problem is that Brian Kanno is co-chairman of the Senate Human Resources Committee and has been an impediment to any measure opposed by labor unions.

He refused to move three workers compensation reform bills last year, and refused again in this year's session to hold hearings on changes sought by the business community. The Hawaii Employers Council warned that the court decision will hamper employers' ability to apply necessary workplace discipline. At a time when Hawaii increasingly is portrayed as hostile to business, this additional burden could add to the state's economic woes. The Legislature should not hesitate in changing the law to allow discipline in the workplace without companies or government agencies risking being hit with claims of compensation for stress. Allowing a union puppet to block such legislation would lead to real stress for the state's economy.

Shredding documents Vy-y HTW- i -mYt QUOTABLE AAA "We have a people problem out there. We don't know who it is, but there's someone driving around out there setting Honolulu Fire Chief Anthony Lopez on brush fires in Leeward Oahu. "Stylish dress and decoration of women in hospitals aFe forbidden. Women are duty-bound to behave with dignity, to walk calmly and refrain from hitting their shoes on the ground, which makes Rules issued by Afghanistan's Ministry for the Propagation of Virtiie and the Prevention of Vice. "The biggest problem right now is Governor Weld shot his foot off.

He held a news conference and bashed the chairman of the committee that held his fate on this nomination." Senate Majority Leader Trent Lott on Massachusetts Gov. William F. Weld's nomination to be ambassador to Mexico and his criticism -of Senate Foreign Relations Committee Chairman Jesse Helms. HE scandal over Switzerland's handling of stolen Nazi gold and bank accounts of Jewish Holocaust victims has deepened again with confirmation by Switzerland's Don't fall for 'Everybody does it' largest bank that documents discovered in its shredder room by a night watchman may have been related to property sold by German Jews under Nazi rule. The Union Bank of Switzerland had previously maintained that the documents salvaged by the guard, Christoph Meili, were unrelated to dormant accounts of Holocaust victims.

Meili, who lost his job after turning the documents over to a Jewish organization in January, is under investigation for breaking Switzerland's banking secrecy rules. He has fled to the United States with his wife and two children because he said he felt their lives were in danger. Congress has moved to give them permanent residence status. Now a bank statement acknowledges the documents may have some relation to the victims. The CRITICAL LIGHT By William Safire AAA 'ASHINGTON It was mid-Octo ber, the final month of the 1996 presidential campaign.

A column Dole and Barbour? I put it down to the Republican inability to react swiftly to news. Now it comes clear. Haley must have been worried that the Asian connection would boomerang. The Republican think tank he headed an adjunct to the RNC had in 1994 borrowed $2 million on the collateral of Ambrous Tung Young, a citizen of Taiwan. Haley made the deal aboard a yacht in Hong Kong and was reluctant at first to blast Clinton for foreign fund-raising.

At the Thompson hearings, that GOP fund-raising chicken has come home to roost As usual, most media coverage of the Barbour appearance centered on his performance "spirited," "well-prepared," "combative" and less on the evidence of wrongdoing developed. We cover the show but ignore the case. The case is that a top Republican official solicited a huge loan from a foreign national. The millions traveled through an affiliated think tank to the National Committee and because money is fungible materially helped GOP political campaigns. Barbour insists this shell game was legal; if so, the law needs tightening.

He borrowed from a foreigner on the anticipation of a favorable IRS ruling on a think tank's status; that was foolish and most damaging to his reputation politically debilitating. His Republicans stiffed Young for half his loan and now the RNC must make him whole. The Asian lender used a colorful expression to explain his loan: not just to gain influence and access, but "to put powder on my face." That usually derisive Chinese phrase tu zhi mo fen, "rouge and powder" means "to hide blemishes with makeup," its extended mean-: ing "to improve one's image with superiors." That's behind some foreign giving. But to equate the one-time ethical lapse of a GOp campaign chief with the sustained, widespread, and probably espionage-ridden mar-: riage of Asian money to the Clinton-Gore White House is to fall for the "everybody does it" excuse. "Everybody doesn't do it," said Barbour (meaning, "Not everybody does He's rjght; the scale of the Clinton-Gore Great Asian Access Sale is unprecedented, its pattern i(ov-er-up unique.

THE White House-Commerce cover-up has-spread to the Justice Department. Lest credible evidence be developed by the Senate' implicating a "covered person" (Vice Presi-: dent Gore), Janet Reno resisted allowing vie-; timized nuns to testify publicly. Not even Democratic senators could swallow that insult In the same way, when the House's Burton committee subpoenaed Justice Department records of $700,000 in wire transfers from Vietnam to an account in the Banque Indo-Suez supposedly controlled by Ron Brownj Justice responded three days later with a sub-: poena for all Chairman Burton's election records. Republicans who make mistakes and try to- brazen their way out will get roughed up in the investigations; that's healthy. But let us." keep our eye on the main arena: the Clinton-; Gore sale of influence to agents of Beijing.

William Safire writes for the New York Times. in this space on the Asian connec tion" had just appeared, followed the next day by a front-page article about John Huang's Union Bank said it had copies of documents relating to "the case of three properties, for the purchase of which a German bank in 1937 acted as intermediary and whose previous owners were possibly Jews." Since Jews were under Nazi pressure to sell their property in Germany at prices well below market values, the mortgages for a 1937 sale of property, possibly by Jews, could come under the scope of a commission investigating Switzerland's ties with Nazi Germany. Just last week, Swiss banks broke their tradition of secrecy, publishing a list of 1,872 names of holders of dormant accounts from the World War II-era, in re tuna-raising in the Wall Street Journal. Though TV lagged, the LA Times and New York Times were advancing the story of illegal Asian money flowing into the Democratic campaign. But silence from the Republicans.

Not only were they not the original source of the story, they offered little newsworthy reaction. I ran Alfonse D'Amato into Haley Barbour, then chairman of the Re publican National Committee, campaigning in Birmingham, and put it to him: Did he have a statement? His reply: "This is something for Ross Perot to hit hard." That struck me as curious; why Perot, the third-party candidate why not Capital punishment system is flawed sponse to mounting international pressure, after repeated claims that identifying the depositors was impossible. But there probably were many more names that have not yet been disclosed. Sen. Alfonse D'Amato, R-N.

who has been leading the fight in Congress for a full accounting by the Swiss banks, called the list "just the tip of the iceberg." It is becoming clear that Swiss collaboration with the Nazis went well beyond the normal obligations of a neutral country. A U.S. government investigation concluded last May that Swiss policies supported Germany's capacity to wage war and helped prolong the war. The disclosures have shaken Switzerland, as well they should. Even after more than half a century, it's not too late to get the truth and a measure of justice for the victims.

Mindanao rebellion A MATTER OF OPINION By Tom Teepen AAA ASHINGTON On June 29, 1972, the Supreme Court found the AST September, President Fidel Ramos signed a peace states' death penalty laws unconstitutional. Executions were being agreement with the leader of Muslim rebels in the ern Philippine island of Mindanao. Under the agreement, ordered arbitrarily, the justices said. The practice was rife with racial bias. Legal representation for the poor was atrociously bad.

ton; Columbus, Baltimore County, and Talladega, Ala. We are executing persons who are mentally' ill, retarded or under age all with diminished judgment. Of the minority of nations." still executing, only Iran, Pakistan, Iraq; Yemen and the United States kill for juvenile: crime. A recent study reports 69 persons have been-freed from death rows since 1973, 21 just since 1993, after new evidence developed; fewi close to the process doubt that innocents have', been executed. Fatal errors are sure to grow.

Congress has; truncated the appeals process and has cut off state-court funding for 20 federal defender re source centers, the nation's main sources of competent counsel for indigents. Maybe the justice system is bound to reflect: the nation's racial bias and economic in-: equity, but by what possible justification, Can inherent distortions that are only barely tolerable even where lives are not at stake be allowed to govern life-and-death decisions? Twenty-five years later, we are killing cret. The American Bar Association, though it does not oppose capital punishment, called in February for a moratorium on executions. The ABA called capital cases "a haphazard maze of unfair practices with no internal consistency." Poor defendants, the ABA found, often are assigned "grossly unqualified" lawyers: "Decisions about who will die and who will live turn not on the nature of the rather on the nature of the legal representation." Even when counsel is competent, attorneys are so underfunded they can't afford independent investigations or experts. And, the ABA said, appellate counsel is often shabbier yet The Southern rights center says Alabama limits expenses for indigent counsel to $2,000 a case; Mississippi, $1,000.

Texas courts have found no fault with attorneys who sleep through parts of death penalty trials. The bias against African Americans is so well-documented that scholars aren't bothering to study the issue further. The statistical link is stronger than the one between smoking and heart disease. A defendant's chances of being executed depend less upon the crime than upon its site. Death sentences are especially high in Hous- again, now at a record post-'72 clip, with some states even staging double-headers.

The Supreme Court, which began sanction ing new capital statutes in 1976, at first under close scrutiny, now kisses off the system's manifest racial bias as inevitable. The court is indifferent to the randomness in death sen four provinces of Mindanao were grouped as an autonomous region, with the rebel leader, Nur Misuari, and his Moro National Liberation Front in charge. The accord was depicted as the end of 27 years of insurgency. But a more radical group, the Moro Islamic Liberation Front, didn't accept the agreement and has resumed the rebellion. Thousands of people have fled to escape the fighting in Central Mindanao.

Prospects of economic development have dimmed as investors have been frightened off. Trying to offset alarming reports from the area, Ramos asserted that "there is no full-blown war" in Mindanao, but declared eight towns "calamity areas" after 44,000 residents fled. The non-Christian peoples of the southern Philippines have been resisting the government in Manila for centuries. Ramos thought he had finally brought peace, but the war goes on. A tences.

It indulges legal representation for the poor so inept it amounts to malpractice. Those flaws, and more, were apparent at a conference at the Carter Center in Atlanta last week, co-sponsored by Emory Law School and the Southern Center for Human Rights. Tom Teepen is the national correspondent of Cox" Newsvapers. Not that the problems had been exactly se.