A new assembly bill being pushed through the California Legislature would allow terminally ill patients to request that their doctors assist them in dying by prescribing lethal doses of prescription medication.
The bill, AB 654, is supported in the Legislature by Assemblymembers Lloyd Levine (D-Van Nuys) and Patty Berg (D-Eureka). If passed, it would make California the second U.S. state to allow patients to choose death by legal prescription.
The bill’s movement through the Legislature comes after a national debate over euthanasia was sparked by the March 31 death of Terri Schiavo, a Florida woman whose husband fought to have a life-sustaining feeding tube removed from Schiavo’s stomach, causing a court battle with Schiavo’s parents that received national coverage.
Oregon is the only U.S. state to have so-called “right to die” legislation in its “Death With Dignity Act,” which AB 654 is modeled after.
California legislators have previously tried to pass assisted suicide bills, once in 1992 and again in 1999, but both attempts were unsuccessful.
“The 1992 ballot initiative was essentially a euthanasia bill,” said Will Shuck, press secretary for Berg. “The 1999 bill wasn’t as strong and carefully crafted as what we have today.”
Shuck said it has taken a long time to get members of the California Legislature and the medical profession to agree.
“It was a long, hard fight for the government and the medical profession to agree that people have the right to halt treatment if (they) want,” Shuck said. “(If) the doctor informs you that if you don’t have this (treatment), you’ll die sooner, you have that choice. In a lot of ways, this is a similar choice.”
Doctors have expressed mixed opinions and some degree of concern over the bill, with some doctors calling it unethical, and contradictory to the basic assumptions and function of the medical profession.
“I’ve been practicing (medicine) for 38 years, and (assisted suicide) is the opposite of what doctors do,” said Dr. Kenneth Stevens, an oncologist and radiology specialist at Oregon Health and Sciences University, as well as a member of Physicians for Compassionate Care Educational Foundation. “Doctors treat symptoms. (Those pushing for legal assisted suicide) are saying that life is a disease.”
The American Medical Association opposes legislation such as California’s AB 654 and Oregon’s Death with Dignity Act.
Shuck points out that the bill makes the practice of assisted suicide completely voluntary for doctors.
“What the bill does is (specify) that if a doctor has a personal objection to it, he or she would never be required to,” Shuck said. “A lot of doctors say that they would be willing to help people in this way, and it would be left to them.”
Stevens shares the concerns of the AMA regarding societal risks, and said he believes there is an inherent, potentially horrific risk involved with legalizing the practice. According to Stevens, there are economic pressures that could influence the decision-making process.
“If you have cancer and have a less than 5 percent chance of living (longer than) five years, and you’re insured under Oregon’s Medicaid program, the state Medicaid will not cover curative cancer treatment,” Stevens said. “But they will pay for assisted suicide. There’s a real danger there.”
But Shuck contends the law would not be administered in the same manner as it is in Oregon.
“This is not Oregon,” said Shuck. “Californians would not be affected by how Oregon provides its medical care.”
Shuck challenges concerns brought up about the economic pressures that may discredit AB 654, and does not feel that insurance problems are an issue once the patient steps foot into the doctor’s examination room.
“As long as there’s a treatment that could save someone’s life, the doctor is obligated to do it,” Shuck said. “But by the time we get to the point of talking about assisted dying, there is no more money to be saved. It’s already been spent on the expensive tests and treatments.”
According to Shuck, AB 654 will have numerous safeguards in place to prevent emotionally or mentally incompetent patients from receiving prescribed lethal doses, citing a dozen criteria that a patient must meet in order to qualify to participate.
For instance, the individual must be terminally ill with less that six months to live, must be a resident of California, and must have been examined by at least two physicians who agree on the diagnosis, prognosis and the patient’s capability of making fully-informed, voluntary decisions, Shuck said.
Additional criteria will include the patient having to self-administer the medication, make multiple oral requests and one legally witnessed written request for the medication. The patient must also undergo two required waiting periods, and must be fully informed of alternatives, such as hospice care and pain treatment.