California’s end of life law goes into effect

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Updated June 9, 2016

After years of debate and activism around the issue, California has become the fifth state in the country to allow terminally ill people to take their own lives with the assistance of a physician prescribing a lethal dose of medication.

Supporters say the new law, called the End of Life Option Act, will bring relief to people suffering from agonizing pain and allow them to end their lives in a dignified way and on their own terms. But critics worry that the law might make it easier to coax people into ending their lives, not because of pain or discomfort, but because they feel like they’ve become a burden to others.

To learn about the details of the law, KCRW talked to both a supporter and critic. They’re Matt Whitaker of Compassion & Choices and Marilyn Golden of the Disability Rights Education & Defense Fund. Have a listen to the interviews below.

You can find more information about the law at the following websites:

Compassion & Choices

University of California, San Francisco

California Medical Association

Medical Board of California

Back in March, we reported on what organizations were doing to prepare for this new law:

On June 9th, California will become the fifth state in the country to have a legal aid in dying law in effect. This will allow the terminally ill to legally take their own lives with the help of a physician. In preparation, Compassion & Choices, a national nonprofit group that advocated for the law, has been holding community forums across the state.

Barnes says interest across the state is enormous. “There is an increase in phone calls, emails, and requests from residents all around the state to learn more about the End of Life Option Act,” he says.

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Dr Mitsuo Tomita (left) and Joe Barnes of Compassion & Choices talk about California’s new aid in dying law at a community forum in San Diego. Efforts are underway to explain the law to both the general public and California’s medical community. Photo: Saul Gonzalez

The aid in dying law covers Californians who are at least 18, who have been diagnosed with a terminal illness and who have six months or less to live. They must also be mentally capable of making their own decisions.

To safeguard against a coerced death, those seeking to end their lives must make two oral requests for the end of life medication 15 days apart. They must also make a signed request that’s witnessed by two adults.

Connie Blair, who attended the Compassion & Choices meeting in San Diego isn’t sick, but she says she wants to have it as an option in case she ever does get a terminal illness.

“I want to be sure that my family knows what my final wishes are,” says Blair. “That everything is written correctly and that I communicate with my family.”

As Compassion & Choices educates the general public about the aid in dying law, it’s also reaching out to California’s physicians. They, after all, will be on the front lines of the law, with the authority to write prescriptions for medication to end their patients’ lives.

That prospect makes many physicians profoundly uncomfortable, says Dr Mitsuo Tomita. Tomita is a recently retired general practitioner in San Diego who volunteers for Compassion & Choices, explaining the details of the law to both the general public and the health care community.

“During the years I was in practice and in my years as a resident, I found that dying certainly isn’t addressed very well,” says Tomita, referring to training doctors receive about how to talk to their patients frankly about death. “And with the advances in medical technology, we are often times prolonging dying rather than allowing for a good death.”

Tomita also says that many doctors in the state are concerned about possible legal liability due to the law, fearing they could be sued for prescribing or not prescribing medication to end people’s lives. Tomita says the law shields doctors from such lawsuits. “You are protected as a physician if you don’t want to be involved in this,” says Tomita. “If you choose to be involved in this, and you do this in good faith, then your liability is not there.”

Last year, the California Medical Association switched its official position on doctor-assisted death from opposed to neutral. And in January, the CMA issued a legal guide for physicians to help them stay in compliance with the law.

Aid in dying literature that walks people through the requirements of the law.
Aid in dying literature that walks people through what they must do before receiving medication to end their lives. There’s been a lot of debate over whether there are enough safeguards in place to protect people from being coerced into taking their own lives. Photo: Saul Gonzalez

But even as aid in dying advocates and some in the medical community make preparations for the enactment of the law, others are still squarely opposed to it.

“We’re hoping there will be efforts to monitor potential abuses, efforts to educate people that this is not their only option,” says Marilyn Golden, senior policy analyst with the Disability Rights Education and Defense Fund. It’s a civil rights group for the disabled community that’s been opposed to the aid in dying law dating back to when it was introduced and debated in the state legislature.

“We had a huge host of concerns,” says Golden. “In general, we were concerned that where assisted suicide is legal some people’s lives will be lost without their consent through mistakes and abuse.”

To counter the message of aid in dying proponents, such as Compassion & Choices, other groups are developing their own education and outreach campaigns. That includes the California Catholic Conference, the public policy voice of the Catholic Church in California.

“I think it has to be a dominant response of us in the Catholic community which is to create the circumstances and conditions where someone would not want to ever take advantage of using this act,” says Ned Dolesji, executive director of the California Catholic Conference, the public policy voice of the Catholic Church in California.

It’s opposed to aid in dying or doctor assisted suicide, because of Catholic religious teachings and traditions.

Dolesji says once the law is enacted Catholic hospitals will exercise their right not to take part in the law. Instead, he says, they’ll emphasize alternatives, such as doing more to comfort the terminally ill with both medication and spiritual guidance.

How are we being more compassionate, more responsible as we walk the journey with people who are dying,” says Dolesji.

But as supporters and critics of California’s aid in dying law make preparations for its enactment, other might already be thinking about how to profit from it.

Valeant Pharamceutials, the company that makes Seconal, the drug most commonly used in physician assisted death doubled the price of the drug since California passed its aid in dying law last year. Seconal now retails for more than $3,000.

Read part one of this report, here.