Physician Assisted End of Life Bill Reintroduced to California Legislature

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assisted-suicide-2Senator Lois Wolk, on Tuesday, joined a coalition of legislators seeking to reintroduce legislation regarding the End of Life Option Act in the Assembly Extraordinary Session.  Modeled after the original legislation known as Senate Bill (SB) 128, this bill AB X2-15, authored by Assemblywoman Susan Talamantes-Eggman, Assemblyman Luis Alejo and Assemblyman Mark Stone, will continue the effort to pass an aid-in-dying reform this year, citing the urgency of the issue and its overwhelming support among Californians.

“We owe this to all Californians who are suffering from terminal illnesses,” Senator Wolk said. “We owe it to their families. It is our responsibility as a legislative body to act.”

Back in July, a proposal to allow physicians to prescribe lethal doses of drugs to terminally ill patients was sidelined as the bill lacked the support to get out of the Assembly Health Committee.

At the time, Assemblymember Susan Eggman, Senator Wolk and Senator Bill Monning issued a statement, “We have chosen not to present SB 128, the End of Life Option Act, today in the Assembly Health Committee.”

Assemblymember Rob Bonta, who chairs the Health Committee, supported the measure stating, “I believe that suffering patients at the end of their life should be able to choose a painless, dignified, and peaceful death.”

However, other Democrats were opposed to the bill. Assemblymember Freddie Rodriguez said of his experience working as an emergency medical technician on an ambulance, “I was there to help protect and preserve life and give folks a second chance. It’s just something I couldn’t come to grips with in this bill.”

Assemblymember Jimmy Gomez grew up without health insurance and watched as his father died of pancreatic cancer. He said that he believed his father may have lived longer with earlier detection. “I’m not comfortable voting for the bill as currently drafted,” Mr. Gomez said

Assemblywoman Lorena Gonzalez noted that, while her mother died from a terminal illness, she lived longer than her doctors said she would. She added, “I’m uncomfortable with the way suicide could be viewed across society, not just [for] the terminally ill.”

However, there were also some important victories for the ultimately doomed SB 128. In May, the California Medical Association dropped its opposition to the bill, reversing a long-standing policy opposing doctors’ assisting in the death of a patient.

In doing so, they become the first state medical association in the nation to change its position on the long-debated issue of physician aid in dying.

“As physicians, we want to provide the best care possible for our patients. However, despite the remarkable medical breakthroughs we’ve made and the world-class hospice or palliative care we can provide, it isn’t always enough,” said Luther F. Cobb, M.D., CMA president.

He added, “The decision to participate in the End of Life Option Act is a very personal one between a doctor and their patient, which is why CMA has removed policy that outright objects to physicians aiding terminally ill patients in end of life options. We believe it is up to the individual physician and their patient to decide voluntarily whether the End of Life Option Act is something in which they want to engage. Protecting that physician-patient relationship is essential.”

Now the authors have formulated a new bill.

The bill’s introduction follows two recent Superior Court rulings that have underlined that it is the role of the State Legislature to take action on this issue. In his dismissal in late July of a challenge to the state’s ban on aid-in-dying filed by three terminally-ill Californians, including Christy O’Donnell, who has been an advocate of the End of Life Option Act, a Superior Court judge said that it is the responsibility of the legislature, not the courts, to change the law.

“Californians cannot wait any longer,” Sen. Monning said. “Almost seven out of 10 state residents agree that people should have the option to reduce suffering by taking aid-in-dying medication, and it is a disservice to these individuals and their families not to take action now.”

The new legislation, Assembly Bill (AB) X2-15 is authored by Assemblymember Talamantes-Eggman and coauthored by the authors of SB 128, Senator Wolk and Senator Monning.  AB X2-15 is based on the careful and thoughtful language that was being worked on by all three Senators on this issue. If passed, it will allow mentally-competent, terminally-ill adults the option to request a doctor’s prescription for aid-in-dying drugs to painlessly and peacefully shorten their dying process.

The nonprofit organization, Compassion and Choices, has already declared that they will fund a statewide initiative campaign to enact the provisions through a public vote.

“We will not wait for a ballot measure,” Assemblymember Eggman said. “There are people right now who are facing a terminal diagnosis, watching this fight, praying for our success and hoping to be able to take control of their lives through these reforms. They don’t have another year to wait; they are counting on this bill, this year.”

“Every day, terminally ill Californians are suffering needlessly,” said Senator Wolk. Californians are asking for this option and have waited long enough. They must be allowed to die with dignity and compassion. ”

—David M. Greenwald reporting

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About The Author

David Greenwald is the founder, editor, and executive director of the Davis Vanguard. He founded the Vanguard in 2006. David Greenwald moved to Davis in 1996 to attend Graduate School at UC Davis in Political Science. He lives in South Davis with his wife Cecilia Escamilla Greenwald and three children.

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17 thoughts on “Physician Assisted End of Life Bill Reintroduced to California Legislature”

  1. Tia Will

    “I was there to help protect and preserve life and give folks a second chance. It’s just something I couldn’t come to grips with in this bill.”

    He said that he believed his father may have lived longer with earlier detection. “I’m not comfortable voting for the bill as currently drafted,” Mr. Gomez said”

    “I’m uncomfortable with the way suicide could be viewed across society, not just [for] the terminally ill.”

    It is interesting to me that all three of the objections raised in this article are based on either a limited perspective, a wish for an outcome that does not apply, or a speculation about how something might be viewed.

    I understand thoroughly the wish to help those who may have “a second chance”. However, this ignores how to humanely help those for whom there are no more “second chances”. Death is a normal part of life. We will all reach the point where we are beyond “another chance”. My feeling is that we should be allowed to make our inevitable exist from this stage of existence in as comfortable a manner of our own choosing as possible.

    Early detection is in no way prevented or affected by this measure which is only for those for whom there is no further possibility of treatment.

    People will view any law in many different ways. This bill does not change anything for those who are not terminally ill. To speculate that some may see it as promoting or condoning suicide is a fear driven concern about what “might happen”, not a reflection of current need.

    Just as I do not believe that a person who needs a blood transfusion should be blocked from receiving it by a Jehovah’s Witness who is “uncomfortable” with the idea of transfusion, I do not believe that those with a terminal illness should be blocked from having prescribed by their known and trusted physician a combination of medications with which to end their own life. I would be one such individual and do not think that I should be impeded by someone else’s belief in “second chances” or someone’s desire for better early disease detection, or someone’s fear of suicide promotion. None of these wishes, fantasies or fears should dictate the medical care of an individual who does not share them.

  2. hpierce

    Before I go off on some of the issues involved, I’m going to read this:  http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520162AB15

    I suggest others do the same.

  3. Davis Progressive

    i just think this opens a lot of cans of worms.  it requires that doctors accurately know that an illness is terminal.  i know a lot of people given six months to live, who are still alive years later.  and that precludes new treatments and advancments.  bottom line, i don’t like the idea of trying to play god.

  4. Eskimo Pie

    Every time I hear an objection to this bill, I add the phrase “and therefore no one should have this option.” Because that’s the point. You are giving an option to people they don’t have to take. But at least they’ll have the option.

    Maybe someone thinks they’ll beat their terminal diagnosis. Fine, don’t take this option. Maybe someone’s religious beliefs don’t allow for such things. Fine, don’t take this option. Maybe you think it’s “playing God.” Fine, don’t take this option. But to deny it to others because you think something might happen, or it doesn’t fit with your personal belief system is cruel.

      1. Tia Will

        DP

        So no exception for those of us who at our most vulnerable would consider the worst case scenario to be not be allowed to die in peace and comfort at the time of our own choosing.

        And as for “playing god”, how about those of us who do not believe in a “traditional Judeo -Christian god” ?  Should we not have our religious beliefs respected ?

  5. Tia Will

    DP and Eskimo Pie

     But to deny it to others because you think something might happen, or it doesn’t fit with yourpersonal belief system is cruel.” 

    Completely agreed and is also “playing god” in another way.

    bottom line, i don’t like the idea of trying to play god.”

    And I agree with you. With one very important distinction. There are some who believe that to not “do everything” up to and including maintaining someone alive on machines when they would die if these life maintaining devices are not used is “playing god”. They believe that no one should be allowed to die whether or not they themselves would choose the treatment. So should we allow these individuals to control your health care or mine? Should they be allowed to say that you cannot opt out of or decline a treatment because they consider it immoral to do so, or should each individual be allowed to choose for themselves ?

    Please note that this bill does not force anyone to do anything at all. It allows the individual to choose for themselves. I see this bill as a natural extension of the principle of individual autonomy which is one of the mainstays of medical practice.

    1. hpierce

      “There are some who believe that to not “do everything” up to and including maintaining someone alive on machines when they would die if these life maintaining devices are not used is “playing god”. They believe that no one should be allowed to die whether or not they themselves would choose the treatment.”  There are already laws on the books for this contingency.  Not relevant to the current discussion, but gets to the heart of my potential concern.  I don’t need to finish reading the proposed law to know THAT.  Dad had medical directives, and a ‘do not rescusitate’ directive.  He gave me power of attorney in that matter, after we discussed it, and I knew I was responsible to make sure his directives were honored.  People fitting the cognitive requirements of the current bill can certainly do what Dad did.  For the quoted situation, no new legislation is needed.  Suspect you know this Tia, but don’t understand your apparent support of the bill, based on your quoted assertion.  

      I was never to even consider ‘trumping’ Dad’s wishes.  Didn’t.  No one was playing ‘god’, except, perhaps God.

      Still have to ‘drill down’ into the proposed bill, but my concern is coercion (sp?) of those who are meeting the ‘litmus test’ of the protocals, by those who would financially (or otherwise) gain financially (or be spared costs).  If the legislation provided for anyone who was convicted of having coerced someone to ‘end their life’, had to take the same drug upon conviction, my concerns would be greatly relieved.

  6. Tia Will

    hpierce

    I am not clear on how you are differentiating someone being given “power of attorney” and therefore being able to decide for the ill or disabled individual and your concern that these individuals would use coercion. You seem comfortable with the power of attorney doubtless knowing that while you would not go against your father’s wishes, some others might not and might act in their own perceived best interests once they had that power. And yet you are concerned about potential coercion ?

    1. hpierce

      “And yet you are concerned about potential coercion ?”  Hell yes!  Relatives, others, can be coercive PARTICULARY if they don’t have POMA.  The latter implies true trust and a commitment to the relative’s welfare. 

      You may (or may not) be familiar with end-stage pancreatic cancer.  Normally, excrutiating pain.  No cure.  Had my Dad suffered that (he was ‘spared’ the pain) and had he chosen to use the morphine drip to over-dose (he actually never used one drop, and had two aspirin once) and end his life, I would have respected that choice.  If I had a sibling who had the discretion, and wanted to get ahold of Dad’s estate by coercing him to ‘take the pill’ I’d probably be serving a long sentence for sibling-cide. [Which, actually meant I crossed my own moral/religious inclinations].

      To put it plainly, Dad could trust me.  Not all folk can trust their relatives/caregivers, etc.  Should the “state” be arbiter?  Hell yes.

  7. Tia Will

    DP

    Actually I was not being presumptuous at all. I had no idea until I read your post about what your personal religious beliefs might be. This does not alter the fact that many people do think that their own religious or moral beliefs should be the standard for others. I do not share this belief and this law is only one area in which I believe that we should stop dictating the moral actions of others.

    1. hpierce

      Which others?  The one who suffers?  The moral actions of someone who buys a gun, loads it, places it in their mouth and pulls the trigger, I do not judge [unless they destroy their family in the process].  If somone obtains a bunch of sleeping pills, overdoses, same.  This bill (will read tomorrow) might well open the door to serious abuse by ‘third parties’.  Under current law, if you load the gun, put it in your loved one’s mouth (and they were suffering) and pulled the trigger for them, you would be subject to criminal prosecution.  Not sure, if after this law is passed, whether anyone would be chargeable for doing the gun thing.  Results would be the same.

  8. Tia Will

    Every person who has commented against this law as cited in the article or from their own perspective has done so on the basis of a single anecdote about a family member of theirs, and who that family member could or could not trust. No one has addressed the issue that I am asking.

    I completely trust my family members. I do not believe that there is a god whose dictatesBut wh I will be breaching by taking my own life. My moral system includes a firm belief that my life is mine to live in its current form, or end and move on when this form reaches a point that is unbearable to me.

    hpierce brings up the point of pancreatic cancer with its excruciating pain and the option of a morphine drip used to the point of cessation of breathing. This example is frequently brought up by those who believe that all pain at end of life can be controlled without the intent to end the life. But what if excruciating pain is not the issue. What if the issue is uncontrollable seizure activity such as can be found with some brain tumors ? Or what if my condition has left me with the inability to go out and purchase a gun ( or what if I find it morally repugnant to leave behind the mess of a gun for my family or others to deal with) ?

    What I am finding is that those who are opposed to this change in the law are comfortable with what the law provides for them within their moral framework and are afraid that this change will somehow adversely affect them. What I have not yet once heard commented on is how current law adversely affects me and those who share my moral sensibility. How it criminalizes either me, or my doctor, or my family for doing nothing more than following my own moral compass in a way that affects no one except me and my own family members.  So what I am asking everyone to consider is what the current law imposes upon those of us who do not share your worst fear. Realize that at a crisis point in my life, the current law would force me to either die the death of your choosing or  to move away from my home and all I love, would force some family member to accompany me thus disrupting their support networks, jobs, children in order to move to an area that has accepted that my rights to medical care should equal yours.  All so that I can exercise what I perceive as my right to live the last of my life in the  manner I choose, not the manner that you are forcing upon me by current law.

  9. hpierce

    Tia… for the record… I have not said I oppose the proposed legislation. I have said I have concerns, which may be relieved after I have fully reviewed the legislation.  Those concerns may not be relieved.  I hope you are not saying that your moral compass trumps mine in expressing concerns or doubts.

    I am not trying to tell you what to do, or what to believe.  Please accord me the same rights.

     

  10. Tia Will

    hpierce

    I hope you are not saying that your moral compass trumps mine in expressing concerns or doubts.”

    I would not dream of doing so. However, those who would continue to prohibit the prescription of life ending drugs to those who qualify and do desire them, are certainly telling others what they can do and cannot do. I have no idea whether that does or does not apply to you, so can we not make this personal ?

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