SAVES is not affiliated with Exit International / Dr Philip Nitschke and opposes the public availability of a 'peaceful pill'.

Some of the states in the USA have provision for Citizens Initiated Referendums in which issues considered to be inadequately addressed by the normal political process can be put directly to the people. That is how Oregon's Physician Assisted Suicide legislation was achieved. A similar approach in Michigan, which became known as Proposal B because it was second on the list of issues under consideration, failed in November last year by a substantial margin.

The approach was sponsored by Merian's Friends, a group named after Merian Frederick, a notable Ann Arbor woman with Lou Gehrig's disease who was helped to die by Dr Jack Kevorkian in 1993.

The group launched its campaign for physician assisted suicide in 1996 with the initial task of obtaining the mandatory number of signatures in support, some 400,000. At the time, several surveys showed that about two-thirds of state residents favoured a law allowing physician assisted suicide with strong safeguards against abuse.

As it happened the costs involved in obtaining the signatures depleted the funds available to Merian's Friends to the extent they were able to mount no more than a token advertising campaign. Support for Proposal B plummeted after opponents launched a virtually uncontested television campaign against Proposal B. Citizens for Compassionate Care spent more than $5 million in a advertising blitz that targeted voters' pocketbooks by denouncing Proposal B as a bureaucratic nightmare.

Merian's Friends countered with a $75,000, three- day advertising campaign featuring former Governor William Milliken, a vocal supporter of patients' rights. But it was nowhere near enough.

Although perhaps the dominant factor, it seems that money was not the only reason for Proposal B's demise. There were criticisms of the way the proposal was presented. And compared with Oregon, Michigan did not have as much backing by state political leaders or the medical community. Michigan also has a larger proportion of Catholic residents.

There was also the Kevorkian factor. Although Kevorkian, a resident of Michigan, did not support Proposal B, his decision in June to harvest the organs of a man he helped die drew considerable negative publicity and may have aroused disquiet in some of the electorate.

While the defeat of Proposal B by close to a three to one factor is a set-back for the voluntary euthanasia movement in Michigan, it is obviously not the end of the story. Lessons have been learnt the hard way and already there is talk of the next attempt. In addition, Michigan Governor, John Engler, announced towards the end of January that he plans to appoint a Commission on End-of-Life Care.

And despite the obvious wealth of religious backed opposition, one can only wonder how long they can continue to spend vast sums of money in opposing needed and inevitable law reform.