Prodded by a terminally ill California woman’s public decision to end her life in Oregon, lawmakers are again mulling legislation that would allow Californians to usher in their own deaths.
Brittany Maynard, who intentionally and legally ingested lethal drugs on Saturday, was in her early 20s when the California Legislature last debated an aid-in-dying bill. At 29, her losing bout with lethal cancer led her to cross state lines and made her the latest public face of an issue that raises vexing policy questions and stirs deep ethical quandaries.
California lawmakers might soon have to grapple with those questions. Maynard has recorded a message for legislators in which, from beyond the grave, she will urge them to act. Multiple lawmakers have discussed potential legislation, staff members said.
Advocates believe their time has come. They point to polls suggesting that more people view expanding end-of-life options as an act of mercy. They argue that Oregon’s aid-in-dying law has set a precedent for making the policy work, with 803 people availing themselves of the option between 1998 and the end of June.
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“The visibility of the issue is so much more,” said Toni Broaddus, the California campaign director for the organization Compassion and Choices. “We’re seeing a lot more media coverage around end-of-life issues in general in part because of baby boomers dealing with their parents’ deaths and starting to think about their own.”
Policies addressing death carry an emotional heft like few others. Debate last year over a bill allowing doctors to inform severely ill patients about their existing right to end-of-life counseling options spurred a raw, soul-baring conversation on the Assembly floor.
Lawmakers reflected on the suffering of loved ones and questioned what constitutes a terminal diagnosis – two talked about their mothers outliving six-month death sentences by years – and 20 voted against the measure.
“This is too complex of an issue to be dealt with in this way,” said Assemblyman Rocky Chavez, R-Oceanside.
If even talking to loved ones about impending death seemed a step too far to some, offering to give people the tools to purposefully end their lives promises to provoke a profound backlash.
Past bills that would have permitted Californians to take their own lives fomented furious opposition, particularly from the Catholic Church, and failed. The most recent attempt was shelved in the waning moments of the 2007 session. The year before, a similar measure withered in committee.
During the last legislative attempt, then-Assembly Speaker Fabian Núñez offered the measure a significant boost by lending his support. It was not enough to surmount the opposition, including denunciations from pulpits that were encouraged by Cardinal Roger Mahony of the Archdiocese of Los Angeles and that Núñez said prompted a concerned phone call from his churchgoing mother.
Núñez is among the advocates saying the landscape has changed and pushing another look at aid in dying. His mother has come around, he said, joining other devout Californians who accept the concept. He likened the issue to wrenching debates over same-sex marriage, both for how rapidly opinions on same-sex marriage have shifted and because the issue entailed not just questions of prudent policy but deeper moral convictions.
“The decision people made to vote or not vote on same-sex marriage was a very personal decision, as this will be,” Núñez said. “People made the decision on same-sex marriage not based on what was going to happen in the election – these issues transcend politics.”
Opposition to the idea goes beyond religious or ethical objections. Death’s finality presents too great a risk of people ending their lives prematurely, with recovery on the horizon, or being prodded toward the decision by caregivers and family members, critics say.
“The number of people who are at risk of significant harm (is) so much larger than the people who would be helped,” said Marilyn Golden, a policy analyst for the Disability Rights Education & Defense Fund. “If assisted suicide is legal, some people’s lives will be ended without their consent through mistakes and abuse.”
Offering death as an option would influence not just patients, Golden said, but also doctors and insurance companies who help guide end-of-life decisions.
“There is a deadly mix between our broken profit-driven health system and the option of assisted suicide, which will become the cheapest so-called treatment,” Golden said. “Will insurers do the right thing or the cheap thing?”
Another likely adversary would be the California Medical Association, a formidable lobbying group that has repeatedly affirmed its opposition to physician-assisted suicide over the last two decades. The group declined to comment on a potential legislative push in 2015.
But a document laying out the organization’s point of view details several reasons for opposing assisted suicide: the potential for abuse, the risk of initiating broader acceptance of suicide, the uncertainty of a diagnosis given how swiftly someone’s condition can change, and the violation of the physician’s fundamental precept of “do no harm.”
“Proponents seek the moral authority of the medical profession to legitimize an attempt to overturn ancient prohibitions against taking the life of another,” the document states. “Placing physicians in the dual role of healer/killer would undermine trust in the physician-patient relationship, since patients may fear that physicians will steer them toward a lethal injection.”
Acknowledging the prospect of a heavy lift in the Legislature, activists have not ruled out pursuing aid-in-dying via a ballot initiative. Broaddus said Compassion and Choices has been ginning up interest with local organizing, including reaching out to receptive district attorneys and city governments.
“The ground strategy for us is still going strong, and we expect it will escalate over the next few months while we look at our statewide options,” Broaddus said. “We are convinced we can move this forward in California.”
Opponents reject that prediction. Golden said the idea appeals to people in the abstract, but “you need to learn about the issue, you need to read the fine print” – the uncomfortable details of hastened death.
Brittany Maynard will not live to see either outcome. In a video recorded before her death, separate from the one that will be played for legislators, she talks about her declining health before saying that “the worst thing that can happen to me is I wait too long.”
“If all my dreams came true, I would somehow survive this,” Maynard says. “But I most likely won’t.”
Call Jeremy B. White, Bee Capitol Bureau, (916) 326-5543.