Physician Assisted Suicide (PAS) activity in California
Part 2 of two parts
2015-JAN to 2018: Bill AB-15 "California
Choices Act" becomes law
and is later suspended:
Governor Brown's letter to the Legislature, continued:
Governor Brown discussed a rarely discussed aspect of Physician Assisted Suicide laws. The mere existence of the Oregon law appears to give comfort to many terminally ill people in that state who know that they have an option if their quality of life degenerates beyond their ability to cope. Many times in Oregon, patients will obtain lethal quantities of pills from their physicians, and not use them. The presence of the pills, and the knowledge that they can take them at any time, gives them comfort. They know that they have two options: to suffer in pain and have a longer life, or to end their life early and avoid the suffering -- both options under their total control.
Tim Rosales is a spokesperson for the advocacy group: "Californians Against Assisted Suicide." The group is primarily composed of physicians, disability advocates, and clergy from various faith groups, including the California Catholic Conference of Roman Catholic bishops. Rosales said:
"This is a dark day for California and for the Brown legacy. As someone of wealth and access to the world’s best medical care and doctors, the governor's background is very different than that of millions of Californians living in healthcare poverty without that same access -- these are the people and families potentially hurt by giving doctors the power to prescribe lethal overdoses to patients."1
I find this belief also difficult to interpret, because a Physician Assisited Suicide (PAS) law would make help in dying available to everyone. If a person who is dying of a terminal illness does not have access to continuing medical care to control their pain and is further unable to afford visits to doctors to request a prescription for drugs that would end their life, then the presence of the Physian Assisted Suicide (PAS) law still might help them end their life. They might be able to scrape up enough money to see two doctors, obtain a prescription, purchase the drugs, and then end their lives as rich people will be able to. In practice, a person who is seeking PAS might shop around among doctors and find two who would help them without charge on compassionate grounds. If that proves impossible, then a dying person in agony could always try crowd funding.
2015: Objections to the Physician Assisted Suicide (PAS) law:
Many conservative religious groups remain opposed to the bill.
The Roman Catholic Church normally considers suicide to be a moral sin. This is the most serious level of sin. However, Father William Saunders, president of Notre Dame Institute and pastor of the Queen of Apostles Parish, commented that the Church recognizes that:
"Grave psychological disturbances, anguish, or grave fear of hardship, suffering, or torture can diminish the responsibility of the one committing suicide" (#2282). This qualification does not make suicide a right action in any circumstance; however, it does make us realize that the person may not be totally culpable for the action because of various circumstances or personal conditions."2
The number "2282" refers to the section dealing with suicide in the Catechism of the Catholic Church. It says:
- 2280 Everyone is responsible for his life before God who has given it to him. It is God who remains the sovereign Master of life. We are obliged to accept life gratefully and preserve it for his honor and the salvation of our souls. We are stewards, not owners, of the life God has entrusted to us. It is not ours to dispose of.
2281: Suicide contradicts the natural inclination of the human being to preserve and perpetuate his life. It is gravely contrary to the just love of self. It likewise offends love of neighbor because it unjustly breaks the ties of solidarity with family, nation, and other human societies to which we continue to have obligations. Suicide is contrary to love for the living God.
2282: If suicide is committed with the intention of setting an example, especially to the young, it also takes on the gravity of scandal. Voluntary co-operation in suicide is contrary to the moral law. Grave psychological disturbances, anguish, or grave fear of hardship, suffering, or torture can diminish the responsibility of the one committing suicide. (Emphasis is not in the original)
2283: We should not despair of the eternal salvation of persons who have taken their own lives. By ways known to him alone, God can provide the opportunity for salutary repentance. The Church prays for persons who have taken their own lives.3
In addition to the opposition to PAS by conservative religious denominations, many groups that support the needs of the disabled are also opposed. A major concern is that if assisted suicide is made generally available, then the public might begin to expect disabled people to commit suicide. However, as the bill is written, PAS is only permitted to persons with a terminal illness and a life expectancy of less than six months. Thus, very few disabled people would be eligible for help in dying.
A general concern of those opposed to PAS was that friends and relatives of vulnerable individuals might pressure then to end their lives for various reasons. Also, insurance companies could conceivably urge their clients in the direction of committing suicide by refusing to pay for the cost of continuing medical treatments, while offering to pay for drugs to end terminally ill clients' lives.
Marilyn Golden, a senior policy analyst at the Disability Rights Education & Defense Fund in Berkeley, CA, said:
"There is a deadly mix when you combine our broken healthcare system with assisted suicide, which immediately becomes the cheapest treatment. The so-called protections written into the bill really amount to very little." 4
The Calfornia Legislature passed Assembly Bill # 15 -- the PAS law -- in the fall of 2015.
Opponents of physician assisted suicide attempted to gather signatures to place a referendum on the 2016-NOV ballot. If passed, it would have repealed the PAS law. On 2016-JAN-04, they announced that they had failed to obtain a sufficient number of signatures to implement the referendum. 5
Governor Jerry Brown signed it into law during 2015-OCT. However, the law was written so that it did not come into effect until 90 days after the "extraordinary session" of the Legislature adjourned. That happened during 2016-MAR. The End of Life Option Act went into effect on 2016-JUN-09
The law is set up to automatically expire ten years after it becomes effective. In early 2026, if the law turns out to have no significant negative unintended consequences, it can be simply be revisited by the Legislation and passed once more into law.
Provisions of the law:
In order to qualify for Physician Assisted Suicide (PAS) now alternately called Medical Aid in Dying (MAID), an adult "... with the capacity to make medical decisions " must meet the following requirements:
- Be diagnosed as having a terminal disease.
- Voluntarily express the wish to receive a prescription for an aid-in-dying drug.
- Be a resident of California and able to establish residency through any of 4 specified means.
- Documents his or her request pursuant to the requirements set forth in Section 443.3 of the law
- Have the physical and mental ability to self-administer the aid-in-dying drug.
- Shall not be considered a “qualified individual” under the provisions of this part solely because of age or disability.
A request for a prescription for an aid-in-dying drug shall be made solely and directly by the individual diagnosed with the terminal disease and shall not be made on behalf of the patient, including, but not limited to, through a power of attorney, an advance health care directive, a conservator, health care agent, surrogate, or any other legally recognized health care decisionmaker. 7
2015-DEC-10: Compassion & Choices launches California education campaign:
Compassion & Choices is a non-profit group that promotes people's access to physician assisted suicide. They also disseminate information on advance healthcare planning and end-of-life matters, distribute Death with Dignity handouts, provides a consultation resource for physicians, etc. Five days after the California PAS law was signed into law. they launched a bilingual campaign in the state to educate terminally ill individuals and "families and medical providers about the benefits and requirements of the state’s new aid-in-dying law."
Kat West, National Director of Policy & Programs for Compassion & Choices, said:
"It is important for every Californian to clearly understand the benefits and requirements of the law so every state resident knows all their end-of-life care options, especially if they are suffering. Our California Access Campaign will educate and empower both doctors and terminally ill adults about all the end-of-life care options to relieve intolerable suffering, including hospice, palliative care and medical aid in dying." 6
The California Primary Care Association (CPCA) in Sacramento, CA has joined with community health centers, hospitals, medical and other hospice facilities and Compassion & Choices:
"... to ensure that all Californians know medical aid in dying is a legitimate and trusted end-of-life care option." 6
Carmela Castellano-Garcia, President and CEO of CPCA, said:
"The California Primary Care Association is proud to continue our partnership with Compassion & Choices by educating patients and our healthcare partners about the end-of-life options now available to them. Everyone deserves compassion and the option to make informed decisions at the end of their lives." 6
This appears to be another error in interpreting the law. PAS was not available to terminally ill individuals in intractable pain during late 2015 when the above was written. I cannot understand how so many spokespersons can interpret incorrectly such an important matter.
Elizabeth Wallner is a single mom from Sacramento who was suffering from stage IV colon cancer that has spread to her liver and lungs. She said:
"Death doesn’t scare me. What scares me more is to have my only son and my family watch me die slowly and painfully. I don’t want this agonizingly traumatic image to be their last memory of me. ... " 8
She noted that:
"... current law allows incurable, terminally ill adults to tell their doctors to stop life-sustaining treatments or to sedate them into a coma, and withhold nutrition and fluids until they die days or even weeks later. ... We believe that there is no rational reason to differentiate between these legally authorized medical practices and prescribing medication to terminally ill adults who request it." " 8
She died on 2017-JUL-18, with the help of a PAS subscription for life-ending medication.
2018-MAY-12: PAS law was tentatively overturned by court:
During the law’s first six months during the second half of 2016, the state reported that 173 terminally ill residents were prescribed lethal medications by their doctors. 111 of them (64%) took the drugs and died.
During 2017, 577 were prescribed drugs and 374 (65%) took them. "About 90 percent were more than 60 years old, about 95 percent were insured, and about 83 percent were receiving hospice or similar care. The median age of the patients was 74. 11
The Life Legal Defense Foundation, which is opposed to PAS, filed a case before the Riverside County Superior Court. Judge Daniel Ottolia tentatively overturned the PAS law, and gave the Attorney General five days to appeal. His ruling was based on the fact that the law was passed during a special session that had been convened to address healthcare legislation. The judge interpreted the PAS law as not being related to healthcare, and therefore could not have been legally passed by the legislature. The law was suspended for at least a month.
Sean Crowley, spokesperson for Compassion & Choices -- a pro-choice group -- said that:
"The people we represent are shocked and are absolutely heartbroken this option has been taken away from them." 9
Peolple who have already obtained pills to be used in dying are also affected by the court ruling. If they take the pills, then they would legally be interpreted as committing suicide. This might void their life insurance. Joan Nelson, 82, of Marin County, has been diagnosed with leiomyosarcoma, a terminal cancer. She said:
"I am very troubled to learn that this court has made a ruling that could interfere with my ability to use my aid-in-dying medication when my suffering becomes unbearable."
Attorney General Xavier Becerra also asked Judge Ottolia to cancel his ruling. He argued that the judge improperly issued a statewide order for a local lawsuit. Also, under state law, he should have given his office 10 days to file objections before putting the ruling into effect. Judge Ottolia has scheduled a hearing on these issues for 2018-JUN- 29.
The following information sources were used to prepare and update the above essay. The hyperlinks are not necessarily still active today.
"California Governor Signs Physician-Assisted-Suicide Bill Into Law," National Public Radio, 2015-OCT-05, at: http://www.npr.org/
Fr. William Saunders, "Suicide: Gravity and Responsibility," Eternal Word Television Network, ~1995, at: http://www.ewtn.com/
"Catechism of the Catholic Church: Part 3, Section 2, Chapter 2, Article 5: The Fifth Commandment," The Vatican, undated, at: http://www.vatican.va/
Sharon Bernstein, "California governor signs bill legalizing physician-assisted suicide," Reuters, 2015-OCT-07, at: http://www.reuters.com/
"California: Current status," Death with Dignity, undated, at: https://www.deathwithdignity.org/states/
"Compassion & Choices Launches Bilingual Access Campaign for California Aid-in-Dying Law," Compassion & Choices, 2015-DEC-10, at: https://www.compassionandchoices.org/
"Assembly Bill No. 15," California Legislative Information, 2015-OCT-05, at: http://leginfo.legislature.ca.gov/
Elizabeth Wallner, "Another View: Dying patients deserve to decide their last days," Sacramento Bee, 2015-MAY-27, at: http://www.sacbee.com/
Dan Witcomb, California judge tosses state's physician-assisted suicide law," Reuters, 2018-MAY-15, at: https://www.reuters.com/
Beth Ruyak, "Remembering End Of Life Option Act Advocate Elizabeth Wallner," 2017-JUL-24, at: http://www.capradio.org/
Teri Webster, "California Public Health department reports 374 doctor-assisted deaths in 2017," 2018-JUN-23, at: https://www.theblaze.com/
Copyright © 2007 to 2018 by Ontario Consultants on
First posted: 2007-JUN-02
Last updated 2018-JUN-24
Author: Bruce A Robinson