The Catholic Church was one of the groups that derailed an effort in 2002 to legalize assisted death in Hawaii. The bill, which had been introduced by Democratic then-Gov. Benjamin Cayetano and passed the state House of Representatives, was defeated 14-11 vote in the state Senate.
"What strikes me as so ironic about the movement for physician-assisted suicide -- is that it is portrayed as a movement to affirm individual freedom and autonomy," said the Bishop of Honolulu Clarence (Larry) Silva in an email to ABCNews.com. "However, the fact of the matter is that people have been committing suicide quite autonomously for millennia, without the help of physicians.
"The fact that the proposed laws require informed consent before a lethal dose can be prescribed indicates to me that in the depths of their hearts people know that suicide is wrong," he said. "They seem to want a way to convince themselves that it is acceptable by having a 'higher authority' authorize it."
He said suicide is "always a tragedy" and hurts family and friends who are "left behind," leaving them with grief and "lasting guilt."
But advocates for aid in dying say that end-of-life care is sometimes inadequate.
Orfali, who described his devotion to his wife as "love on steroids," said her last days were agonizing when morphine and two other standard medications were unable to alleviate her pain.
She had been a champion surfer in her age class throughout chemotherapy, but in the end, "nothing worked," even with the palliative care of hospice, he said.
Hospice care varies, according to Nathanson, who was one of the founders of two hospices in Hawaii. "They belong to a national association, but they make their own rules."
Some allow "terminal sedation" -- that is, giving an intravenous cocktail of drugs that depress respiration and hasten death -- but others do not.
But terminal sedation is under a doctor's control, according to Nathanson, and "the patient has no say in it."
Critics of Oregon's law have used the "slippery slope" argument that "people would come from miles around to get medicine and we would be bumping off the elderly and the poor," he said, but that never materialized.
According to a report from the Oregon Department of Human Services, 95 prescriptions for lethal medications were written in 2010, compared to 88 during the previous year. Of those, 59 patients took the medications.
"There is also an incredible paradox here," said Nathanson. "The people you end up writing a prescription for may end up living longer than expected. ... They didn't have the toxic anxiety that eats at you."
As for Orfali, he said that had his wife been able to get a prescription for the Nembutal, the drug used in Oregon, she would have been spared so much suffering.
Jeri Orfali even ordered lethal medication on the Internet, but never used it.
"She really wanted pills as a backup, but she was too afraid to use them," said her husband.
Medication obtained online often isn't strong enough to induce death and a family member needs to be nearby to "finish off the job," according to Orfali.
"She was a nonviolent person," he said. "The last thing she wanted me to do was to put a bag over her head.
"She told me on her way out, 'This doesn't make sense to me in this condition. Can I try like in Oregon? That was the only thing she asked me in the end," Orfali said.
Eventually, Jeri Orfali was given terminal sedation, but she endured 16 hours of tortured breathing before she had a blood clot and her lungs collapsed.
"It was like watching someone water boarded in front of you," said Orfali, who wrote two books on the topic, "Death with Dignity," and, "Grieving a Soulmate."
Meanwhile, he wonders about Steve Jobs' death of respiratory failure just two weeks ago and whether he suffered as Jeri Orfali did.
"Everyone talked about how great things were and how he lived a great life. But did he have a good death?" asked Orfali. "Death is an ugly thing."