Inspired by a Bay Area woman’s highly publicized quest to end her grueling battle with cancer, lawmakers are renewing efforts to allow California’s terminally ill greater choice over how and when they die.
On Wednesday, two Democratic state senators and the family of the late Brittany Maynard will unveil the End of Life Option Act, which allows doctors in California to prescribe a lethal dose of medications to terminally ill patients.
“Our hope is to see the end-of-life option as part of a continuum of established rights available to patients,” said co-author Sen. Bill Monning, D-Carmel, who is married to a physician and who has watched close friends suffer through their final days.
California’s current law blocked the 29-year-old Maynard, a UC Berkeley graduate and newlywed diagnosed with aggressive terminal brain cancer, from receiving physician-prescribed medications to end her life at her East Bay home. So she and her husband moved to Portland, Oregon, to take advantage of that state’s Death with Dignity law.
After worsening pain and seizures, she spent her last day walking in the woods with family and friends. Then she took a fatal dose of prescription medicine, drifted into unconsciousness and died peacefully about 30 minutes later, surrounded by the people closest to her.
The goal of a more compassionate and cost-effective way to end our lives — a subject this newspaper explored in its series “Cost of Dying” — has taken on growing resonance with the graying of tens of millions of baby boomers.
But California has spurned several attempts to pass a similar physician-assisted dying law, either at the ballot box or through the Legislature. Opponents say that actively ending a life is a moral violation and that very sick or disabled patients might feel family or economic pressure to die.
Oregon, Vermont and Washington have passed physician-assisted death laws, and court rulings in New Mexico and Montana allow the practice. Lawmakers have pledged to introduce aid-in-dying legislation in Washington, D.C., and at least 12 other states besides California, according to the group Compassion and Choices, which is working to reform state law.
The wrenching case of Maynard, however, may finally trigger a shift in this debate, said Monning and co-author Sen. Lois Wolk, D-Davis.
In a Wednesday news conference, Maynard’s widower, Dan Diaz, and mother, Debbie Ziegler, will appeal to voters to reform the law. So will San Mateo’s Jennifer Glass, a 51-year-old advocate for end-of-life options who is living with advanced lung cancer.
“I believe I should have the legal choice to end my life calmly, peacefully and with dignity,” Glass told this newspaper. “I want that for myself, and I want that for the people I love. Everyone should have that choice.”
Also speaking will be Dr. Robert Olvera, an East Los Angeles physician who lost his 25-year-old daughter, Emily Rose, to cancer after 17 years of illness, capped by what he calls “the four-month agony.”
Maynard’s video — explaining why she was making use of Oregon’s law — has been watched by more than 15 million people on YouTube.
“We were galvanized by Brittany Maynard,” said Wolk. “How courageous she was to share such an intimate, difficult life situation with the public. And then she had to leave everything familiar — her home, for heaven’s sake — and establish residency where no one was. The whole thing was appalling.”
Wolk’s other influence was the traumatic cancer death of her mother, a Philadelphia social worker, when Wolk was only 17.
“I lived with the illness and her death,” said Wolk. “It was pretty brutal … a transformational experience for me.”
The new measure is modeled after Oregon’s Death with Dignity law, with two differences. It requires a translator for non-English speakers. And pharmacists, not just physicians, are given legal immunity for participating in deaths.
Oregon’s 17 years of experience with the law shows it is rarely used and has not triggered any legal disputes. Since the Oregon law went into effect in 1997, 1,173 people have requested prescriptions and 752 have ingested the drugs to end their lives — one out of every 500 deaths in the state. A majority had cancer; the average age of death was 71.
California’s Senate measure will be accompanied by a similar bill in the Assembly.
And an initiative, organized by the group Compassion and Choices, may land on the 2016 ballot.
The measures are likely to prompt a debate of conscience in the Capitol, with votes determined more by religious convictions and family experiences than partisan politics.
Even before the bill’s formal introduction, a coalition called Californians Against Assisted Suicide has expressed its opposition.
“We will advocate quite aggressively against this legislation. … Once suicide becomes an option, it is just another form of treatment and the cheapest option,” said Tim Rosales, spokesman for the group, a diverse coalition that includes disability rights organizations, the California ProLife Council and some Latino organizations.
Doctors are likely to be split. Such legislation has been opposed by the California Medical Association, which says it conflicts with a doctor’s ethical duties. But distinguished physicians such as the late Dr. Arnold S. Relman, chairman of the department of medicine at the University of Pennsylvania and editor-in-chief of the New England Journal of Medicine, have supported it. A survey last month found that, for the first time, most doctors favor aid in dying, shifting from 46 percent in 2010 to 54 percent in 2014.
“It represents a remarkable shift,” said Arthur Caplan, a bioethicist at NYU Langone Medical Center. “If physician opposition continues to weaken, it is likely that … more states will follow Oregon, Washington and Vermont and legalize.”
If the measures pass in the Senate and Assembly, it is hard to guess whether Gov. Jerry Brown will sign it. A former Jesuit seminarian, Brown has not spoken publicly about the issue but has broken ranks with the church on other issues, such as gay marriage. In 1976, he signed the nation’s first law giving terminally ill people the right to authorize withdrawal of life-sustaining medical treatment when death is imminent. Eight other states passed similar laws within a year.
California law makes it felony manslaughter to help someone end his or her life.
The practice happens — covertly, underground, without the help of a doctor — but boosts the risk of complications. And it creates stress and anxiety for the patient and family because legally no physician can be involved to counsel the family or provide medication, said Monning.
“This may be an uphill fight,” he said. “But we think we can be successful.”
Contact Lisa M. Krieger at 650-492-4098.
End of life option act
Modeled after the 1997 Oregon law, the legislation by Sen. Lois Wolk, D-Davis, and Sen. William Monning, D-Carmel, would give any terminally ill, mentally competent California adult resident the right to ask and receive from his or her physician a prescription to hasten death. The patient at any time could rescind the request or choose not to use the medication. Physicians, pharmacists and health care providers could opt out. It would be a felony to coerce someone to request the medication, or forge a request. The legislation exempts Catholic hospitals.
The legislation requires that:
— The medication is self-administered.
— The patient is mentally competent to make health care decisions, which excludes dementia patients.
— Two physicians confirm a prognosis of six months or less to live.
— The attending physician discusses alternatives or additional treatment, such as pain control and palliative and hospice care.
— A written and two oral requests must be made at least 15 days apart.
— Two witnesses attest to the request.
