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Public Policy

State Net Capitol Journal: Will California Prompt More States to Endorse Aid-In-Dying Measures?

 by Rich Ehisen

California Gov. Jerry Brown (D) signed legislation last week making the Golden State the fifth to allow doctors to legally prescribe terminally ill patients drugs to help them end their own life. The signing of ABx2 15 ended – at least temporarily – one of the year’s longest and most contentious legislative debates. Aid in dying advocates believe it could also push other states to follow suit.

“California has a huge impact across the country,” says Jessica Grennan, the National Field and Political Director for Compassion and Choices, a non-profit that advocates for aid in dying bills across the country. “My phone has been ringing off the hook from both advocates and elected officials that want to bring forth bills now. What happened in California was such a pivotal moment for the whole nation.”

Compassion and Choices President Barbara Coombs Lee was even more emphatic. 

“This is the biggest victory for the death-with-dignity movement since Oregon passed the nation’s first law two decades ago,” she said in a statement after Brown signed the bill last Tuesday.

To date, only three other states have approved so-called aid-in-dying laws: Vermont, Oregon and Washington. Of that trio, only Vermont’s law was adopted through legislation; laws in Oregon and Washington came via voter-approved ballot measures. Lawmakers were also not the impetus in Montana and New Mexico, where courts ruled that nothing in their state laws bar doctors from helping patients who wish to end their lives. The New Mexico case, however, is still under appeal.

California’s law is based on the Oregon statute. It allows a patient who has been given six months or less to live the opportunity to request drugs from their physician that the patient can then use to end their own life. The patient is required to make their request twice, at least 15 days apart and with witnesses to verify the patient is not being coerced. The doctor may then prescribe the drugs, but the patient must administer them on their own. The idea, proponents say, is to allow patients with no hope of recovery and facing a death filled with extreme pain to take control of their own passing and to alleviate that suffering. 

That possibility drew an unusually personal and somewhat emotional signing message from Brown. The former Jesuit seminarian noted he had conferred at length with his own doctors, a Catholic Bishop and “former classmates and friends who take varied, contradictory and nuanced positions.” He also pondered letters urging his signature from Archbishop Desmond Tutu and the family of Brittany Maynard, who became a national icon of the aid-in-dying movement in 2014 when she moved to Oregon after learning she had a terminal brain tumor. Maynard relocated from her California home specifically to be able to take advantage of Oregon’s aid-in-dying law.

“In the end, I was left to reflect on what I would want in the face of my own death,” Brown wrote. “I do not know what I would do if I were dying in prolonged and excruciating pain. I am certain, however, that it would be a comfort to be able to consider the options afforded by this bill. And I wouldn’t deny that right to others.”

With the nation’s most populous state now on board, attention turns eastward, where similar measures are pending in New Jersey, New York and Massachusetts. The New Jersey bill, AB 2270, cleared the Assembly last year but has not yet received a vote in the Senate. The New York and Massachusetts bills are awaiting initial committee votes.

Whether California actually influences those states to support their legislation remains to be seen. Many states have considered and rejected such bills since Oregon adopted the first aid-in-dying bill in 1994. Several of those rejections came in California and Massachusetts, where voters rejected a ballot measure in 2012, and legislation in the 2013 session died in committee. Similar bills were again introduced in over 20 states this session; California is so far the only one to see one of those measures become law.

But public support for them is growing. A California Field Poll released last Monday shows that 65 percent of Californians support the new law, with only 27 percent opposed. A Gallup survey in 2014 placed support nationwide at 69 percent, the highest ever figure in such polls.

But opponents still cite numerous issues with the laws. Every state, for instance, allows patients to create advance directives that require doctors to stop administering life-saving care as the patient desires. They all also have laws that allow palliative sedation for patients in extreme pain. Many religious groups also oppose such bills as being counter to church doctrine, while advocates for the disabled argue that their population is vulnerable to doctors prescribing death-inducing drugs for long-term disabilities that are not terminal. That has some proponents questioning California’s influence on what other states will do.

“The impact of what happened in California may be a lot more limited than some people think because other states really have paid a lot more attention to the objections and concerns of the disability community,” Marilyn Gold, a senior policy analyst with the Disability Rights Education and Defense Fund, told the Associated Press. “In state after state after state, there have been multiple attempts, and these measures have failed.”

Just a day after Brown signed the bill, a group called Seniors Against Suicide filed paperwork for a referendum to overturn the law. The group will need to obtain 365,880 valid signatures to get the issue before voters on the 2016 ballot.

Even so, Compassion and Choices’ Grennan believes the momentum is definitely swinging in their direction.

“One of the most encouraging things for us is that we are now seeing so much more diversity among our supporters,” she says, noting that recent polls show that 81 percent of New York residents support the legislation pending there. “We’re seeing both Democrats and Republicans, all ethnic backgrounds and ages. We had over 200 bill sponsors and co-sponsors this year, and I think we’re going to just see more of that. Americans want their options at the end of life.”

Death with Dignity Gaining Ground in States

By the end of this year, 25 states will have considered legislation to allow terminally ill patients to end their own lives, according to the Death With Dignity National Center. Although Death with Dignity measures failed in 12 of those states, they were considered for the first time in six states. Since Oregon passed its Death with Dignity law in 1994, three other states have passed such laws, including California this month.

Source: Death With Dignity National Center


States with Death with Dignity law: Washington, Oregon, California, Vermont

States that have considered or will consider Death with Dignity legislation this session: Alaska*, Hawaii, Nevada**, New Mexico, Pennsylvania, Utah**, Wyoming**, Colorado**, Kansas*, Oklahoma*, Minnesota*, Iowa**, Missouri**, Wisconsin, Tennessee**, North Carolina*, Maryland**, Pennsylvania, New Jersey, New York*, Connecticut***, Delaware**, Rhode Island**, Massachusetts, Maine***

* First-time Death with Dignity introduction

** First-time introduction failed to pass

*** Repeat introduction failed to pass


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