A coalition of forces beat back Question 2

On Tuesday the Roman Catholic Archdiocese of Boston did something it had not done for a while: It won a major political battle.

The archdiocese and other Catholic donors supplied a significant share of the $5 million spent to defeat Ballot Question 2, which would have let terminally ill people obtain a prescription drug to end their lives.

But the church did not win the fight alone. By Election Day a large, diverse coalition of opponents had united against the measure, including many Jewish, Christian, and Muslim clergy; palliative care doctors; hospice workers; and pharmacists.

Polls in early October suggested two-thirds of voters supported the ballot question. But on Election Day it failed by 2 points. Opponents outspent proponents by a factor of six.

“I’m proud of how we did, given how outgunned we were,” said Steve Crawford, strategist for the Death With Dignity campaign supporting Question 2.

Masterminding the opposition’s campaign was Joseph Baerlein of Rasky, Baerlein Strategic Communications, who claims an undefeated record as a ballot question strategist. In 2006 he helped liquor sellers beat back a proposal to allow more supermarkets to sell wine; two years ago, he was the strategist behind the successful Vote Yes on One Committee that advocated repeal of the sales tax on alcohol.

This year’s fight over Question 2 “had to be the toughest one we’ve ever done,” he said in an interview on Wednesday.

Baerlein said opponents of the measure had two built-in disadvantages: The language of the measure made it sound appealing, describing a voluntary process by which a terminally ill person could “end his or her life in a humane and dignified manner.” In addition, Baerlein said, initial research showed that Massachusetts voters held a strong core belief that they should have a right to control their end-of-life decisions, and that others should, too.

But in focus groups, Baerlein said, support took a nosedive when participants were told the measure did not require mental health specialists to sign off and did not mandate that family members be notified. When told that one of the common lethal prescriptions required patients to break up 80 to 100 capsules and stir their contents into a drink, support waned.

“People didn’t find that very dignified,” Baerlein said.

They also recoiled at the idea that the prescription would be obtained from a local pharmacy and ingested without supervision.

“As one guy said, ‘So, I’m waiting in line for my Sudafed and some guy waiting in front of me is trying to kill himself?’ ” Baerlein said.

The research informed a series of powerful ads, including one featuring a pharmacist warning of the dangers and pouring out a bottle of red pills that skittered into a glass dish.

“No doctors, no hospitals, just a hundred of these,” the pharmacist in the ad says. “And they call that death with dignity?”

Dr. Marcia Angell, a leading proponent of the ballot question and former editor of the New England Journal of Medicine, said the ads frightened people.

“What they did was to make people worry that their first instincts were somehow wrong, that something bad they couldn’t quite put their finger on was going to happen,” Angell said. “It was a war between reality and scare tactics.”

The ads were misleading, she said. Viewers of the pharmacist ads, for example, might think people had to swallow all those pills, not knowing that a liquid form is available.

Catholic institutions and individual donors supplied much of the money needed to wage an intense air war in the final two weeks of the campaign, when the ads had to be heard above the noise of other campaigns. Boston Catholic TV and St. John’s Seminary, the main training ground for Boston priests, each contributed $1 million. The archdiocese gave $250,000 cash, plus about $80,000 in in-kind donations.

“People expect us on issues like this to step out and be part of the effort,” archdiocese spokesman Terrence C. Donilon said. “We didn’t bring this fight to Massachusetts, but we sure weren’t going to allow it to pass here, because it was wrong.”

Catholic religious orders, out-of-state dioceses, political action groups, and individual donors also contributed. Sean Fieler, a Catholic hedge fund manager from New Jersey involved in conservative political causes and sanctity-of-life issues, gave $500,000. The Washington-based Catholic Association, which describes itself on its website as “a faithful Catholic voice in the public square,” contributed $420,000.

A group of prominent ­rabbis wrote an open letter opposing the idea on religious grounds. The Rev. Liz Walker, a minister in the African Methodist Episcopal church and former television news anchor, wrote an essay arguing against the measure in the Globe.

“It was the United Nations of religions,” Baerlein said.

Peg Sandeen, executive director of the national Death With Dignity National Center, said she hoped Massachusetts would have a chance to reconsider the issue.

“I really think we just opened up the conversation,’’ she said. “This was Step 1 in Massachusetts. For many voters, this is the first time they have even thought about death with dignity or end-of-life options.”

Lisa Wangsness can be reached at [e-mail].