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Massachusetts ballot to include marijuana, end-of-life questions

When Massachusetts voters go to the polls this fall to vote in local, state, and national races, they will also be asked to decide whether to allow terminally ill patients to end their lives and whether to legalize marijuana for medicinal purposes.

A third question on the ballot seeks to give independent auto mechanics greater access to repair data and diagnostic codes. If passed, Massachusetts would become the first state to approve the so-called Right to Repair provision.

Supporters of all three initiatives have cleared the final hurdle needed to get their measures on the ballot by submitting the required 11,485 signatures, Secretary of State William F. Galvin announced Wednesday.

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The state will mail booklets to voters in September explaining the three measures and offer­ing arguments for and against each.

The end-of-life proposal would allow physicians to prescribe a lethal drug to patients who have a terminal illness with a prognosis of six months or less.

Physicians would be mandated to present patients with other options, including pain control and palliative care, and to refer them for psychiatric counseling if there was reason to think their judgment is ­impaired. Hospitals or physician groups could choose not to participate and could prohibit the practice at their facilities.

A similar proposal has been submitted on Beacon Hill in ­recent years but has stalled in the Legislature. Lawmakers’ ­efforts in several states, including Maine and Vermont, have also failed.

The issue lends itself more to a ballot question, said ­Stephen Crawford, spokesman for the campaign. Washington, one of three states that passed has such law, served as the model for the Massachusetts proposal. Oregon was the first state to approve such a law, in 1997.

In 2011, 114 people in ­Oregon received a prescription for life-ending drugs, and 71 people died as a result of people taking the drugs, according to a state report. Eighty-three percent of the deaths were people who had cancer.

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The Catholic Archdiocese of Boston has created a website opposing the effort, titled ­“Suicide is Always a Tragedy.”

“Our society will be judged by how we treat those who are ill and the infirm,” Cardinal Seán O’Malley said in a statement announcing the campaign in February. “They need our care and protection, not ­lethal drugs.”

The Massachusetts Medical Society has not voted on the ballot question specifically. But the group voted in December to affirm a longstanding position against physician-assisted suicide.

Dr. Richard Aghababian, the society’s president, said in an interview Wednesday that physicians, who are “trained to preserve life,” should not play such an active role in ending a person’s life. “I think we need to have ethical norms for our profession,” he said.

Proponents of the law take issue with calling the practice suicide. If the proposal were to pass, death certificates for people who take the life-ending drugs would list the underlying illness as the cause of death.

Offering dying patients in Massachusetts a choice would be humane, said Dr. Marcia ­Angell, a former editor of the New England Journal of Medicine and the first signer of the petition that put the issue on the ballot.

“This is not a matter of choosing death over life,” Angell said. “This is a matter of choosing the manner of death. These patients are going to die imminently, and the only question is whether they will have an easier death, somewhat sooner.”

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Massachusetts voters will ­also be asked to weigh in on ­another controversial medical question: whether to legalize the use of marijuana for medicinal purposes by people with documented chronic illnesses and create a system of marijuana dispensaries. Qualifying conditions outlined in the proposal include cancer and glaucoma, as well as severe pain and nausea.

The ballot measure would make Massachusetts the 18th state, along with the District of Columbia, to permit the use of medical marijuana.

In 2008, voters here ­approved a ballot question ­decriminalizing possession of limited amounts of the marijuana. Possession of up to an ounce of the drug is now classified as a civil infraction that carries a $100 fine.

This year’s proposal calls for the Massachusetts Department of Public Health to issue identification cards to residents who provide a doctor’s certification of their illness. The state would allow up to 35 treatment centers around the state to distribute the drug, with no more than five operating in a single county.

Jennifer Manley, a spokeswoman for the Committee for Compassionate Medicine, said in an e-mail that qualified ­patients should have the option of using marijuana, a drug that has been proven to alleviate pain, stimulate appetite, and provide other forms of relief.

“In providing compassionate care, it should be up to the doctor and his or her patient to decide the best course of treatment,” she wrote.

With a decriminalization law in place, however, some ­opponents say chronically ill patients already have little trouble getting the drug.

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“Our concern is that really this isn’t about compassionate care of our sick and dying,” said Heidi Heilman, president of the Massachusetts Prevention Society. “This is about widespread use and abuse of marijuana in our state.”

Heilman said the current ballot referendum does not provide strong enough controls to prevent the acquisition of marijuana by those who do not have serious medical conditions.

The final ballot question proposes requiring car makers that sell vehicles in Massachusetts to install universal tracking systems, allowing independent auto repair shops to more easily diagnose maintenance problems.

Supporters say independent mechanics now lack access to some of the repair information larger dealerships can tap into, which puts them at a competitive disadvantage.

“We’re just looking for fairness, a level playing field between the dealers and the independent shops,” said Art ­Kinsman, a spokesman for the Massachusetts Right to Repair Coalition.

But car manufacturers are strongly opposed to the bill, which they argue would force vehicle redesigns that could yield higher costs for consumers.

Dan Gage, a spokesman for the Alliance of Automobile Manufacturers, said independent auto body shops already have the option of buying the same tools that dealerships use to identify problems. The measure would mean a step backward for manufacturers, he said.

“It’s turning back the clock on all sorts of innovations that we are able to put in a vehicle,” he said.

Ballots questions in Massachusetts offer voters a chance to address political issues separately from the Legislature.

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In 2010, voters approved ending the state’s alcohol tax, while rejecting proposals to cut the state’s sales tax and repeal the state’s affordable housing law.


Adam Sege can be reached at adam.sege@globe.com. Follow him on Twitter @AdamSege. Chelsea Conaboy can be reached at cconaboy@globe.com.