View Full Version : California: Assisted suicide debate renewed

01-02-2005, 05:51 AM
Assisted suicide debate renewed

2 lawmakers start campaign to bring Oregon's law here
John M. Hubbell, Chronicle Sacramento Bureau

Sunday, January 2, 2005

Sacramento -- California is about to confront the thorny, complex issue of physician-assisted suicide as two Democratic legislators renew efforts to allow the gravely ill to pre-empt their natural deaths with a final, fatal swallow of medication.

Six years after legislators spurned a similar attempt, the campaign to follow Oregon in devising a legal path for the terminally sick to speed their deaths will unfold as California starts the year with an already packed political agenda.

Soon, Gov. Arnold Schwarzenegger will announce his plan to resolve an $8 billion state budget deficit. Democratic leaders plan to focus on everyday issues they see as eroding the state's quality of life -- from affordable housing to education to transportation.

But those pushing for California to address the subject of physician- assisted suicide say ending needless suffering is also a quality-of-life matter -- one that deserves a new public airing.

"You can't stop these issues from being discussed," said former Assemblywoman Dion Aroner, D-Berkeley, who was unable to garner legislative support for her own assisted-suicide bill in 1999. "You have to make some decisions about what's right and wrong. When is there a better time? There's never a better time."

Legal language will take shape after two public hearings, one to be held in San Francisco on Feb. 4. The bill is likely to be modeled after the landmark Death with Dignity Act given final approval by Oregon voters in 1997.

The law allows the terminally ill with less than six months to live to obtain a lethal prescription after following a process that begins with a patient-doctor consultation and advocates say typically takes a minimum of two weeks.

A doctor must attest to patients' prognosis and mental competence and refer them to a second physician, who must concur.

Following a written statement and second verbal request, a patient may receive the prescription -- up to 10 grams of secobarbital capsules or liquid pentabarbital -- about two days later.

Only patients physically able to administer the dosage themselves are covered under the law.

Since Oregonians legalized the process, 171 terminally ill residents have used it to end their lives, according to state statistics.

In November, U.S. Attorney General John Ashcroft appealed to the Supreme Court to overturn the Oregon law, arguing that it is not medically legitimate. The high court ruled in 1997 that, while the right to assisted suicide is not constitutionally protected, the issue is for states to decide.

"We have seven years of experience in Oregon, and many, many academic studies, and it's all good news," said Barbara Coombs Lee, co-president of Compassion in Choices, a Portland patient advocacy group that helped to craft the state's law.

In 1992, California voters rejected an initiative that would have allowed doctors to aid in the deaths of terminally ill patients.

Aroner's bill narrowly cleared two committees before being tabled in the Assembly in 1999.

But Coombs Lee said even the space of just a few years may had favorably changed its chances in the Legislature.

"More and more, it's something that people are thinking about, particularly as the Baby Boom bulge moves into their late 50s," she said. "They are ... giving care to their parents as they are dying, and it's probably dawning on many of us that we are mortal."

The Catholic Church has long opposed physician-assisted suicide on moral grounds, and medical groups and disabled rights advocates are also against the practice.

"Doctors are supposed to help people live, not kill them," said Peter Warren, a spokesman for the California Medical Association, which represents the majority of the state's physicians.

Laura Remson Mitchell, legislative coordinator for the California Disability Alliance, said her group of disabled adults believes "there is no way you can safeguard people from being pressured into taking advantage of the option of assisted suicide."

"The way the health care system works," she said, "why wouldn't my HMO prefer to pay the $35 or whatever it costs for the (fatal) medication, instead of the $13,000 a year" in medical costs?

Which arguments will resonate with new state Legislature that arrives in Sacramento on Monday are unknown. And the bill's principal backers -- Assembly members Patty Berg, D-Eureka, and Lloyd Levine, D-San Fernando Valley -- say Schwarzenegger's personal feelings are also hard to approximate.

The governor, a social moderate, has not taken a position on the bill, according to a spokesman, and has not previously stated his views on assisted suicide.

Schwarzenegger is Catholic, yet has shown a willingness to break with church orthodoxy on issues such as gay rights and stem cell research.

That emboldens Berg. "I'm a Roman Catholic; he's a Roman Catholic, as is Maria (Shriver)," she said.

Berg, 62, notes that the 36-year-old Levine is "younger than my youngest" child, yet both advocate legalizing assisted dying due to their separate experiences with terminally ill relatives. Berg's husband, Patrick, died of a stroke while hospitalized in 1987.

"Had he survived the stroke, he would have not been able to swallow on his own," Berg said. "I know he would have begged me to hasten his death. And, of course, I would have done it."

Levine's 88-year-old grandmother, Norma Levine, died of lung cancer in 2001 after what the assemblyman describes as a period in which his grandmother became "a very empty shell of a person waiting around to die."

"This was not my grandmother," Levine said. "She didn't want to suffer. She was very clear about that."

Berg's and Levine's personal experiences will be crucial if they hope to gain the support of their colleagues and advance their bill, said Aroner, who spoke often to lawmakers of her ailing mother during her push for assisted- suicide legislation.

But on an issue that's "all personal," Aroner said, empathy will have to translate into votes.

Aroner recalled a fellow Assembly Democrat whose voting record was nearly identical to hers but, ultimately, differed with her on physician-assisted suicide.

"He understood intellectually where this was at," she said. "But when it came time to vote, he said, 'I can't do this.' "

Link (http://www.sfgate.com/cgi-bin/article.cgi?file=/c/a/2005/01/02/MNGFRAK4611.DTL)

Oregon's - Death with Dignity Act:

On October 27, 1997 physician-assisted suicide became a legal medical option for terminally ill Oregonians. The Oregon Death with Dignity Act requires that the Oregon Health Services (OHS) monitor compliance with the law, collect information about the patients and physicians who participate in legal physician-assisted suicide, and publish an annual statistical report.

The Oregon Death with Dignity Act, a citizens' initiative, was first passed by Oregon voters in November 1994 by a margin of 51% in favor and 49% opposed. Immediate implementation of the Act was delayed by a legal injunction. After multiple legal proceedings, including a petition that was denied by the United States Supreme Court, the Ninth Circuit Court of Appeals lifted the injunction on October 27, 1997 and physician-assisted suicide then became a legal option for terminally ill patients in Oregon. In November 1997, Measure 51 (authorized by Oregon House Bill 2954) was placed on the general election ballot and asked Oregon voters to repeal the Death with Dignity Act. Voters chose to retain the Act by a margin of 60% to 40%.

The Death with Dignity Act allows terminally ill Oregon residents to obtain from their physicians and use prescriptions for self-administered, lethal medications. The Act states that ending one's life in accordance with the law does not constitute suicide. However, we have used the term "physician-assisted suicide" rather than "Death with Dignity" to describe the provisions of this law because physician-assisted suicide is the term used by the public, and by the medical literature, to describe ending life through the voluntary self-administration of lethal medications, expressly prescribed by a physician for that purpose. The Death with Dignity Act legalizes physician-assisted suicide, but specifically prohibits euthanasia, where a physician or other person directly administers a medication to end another's life.

Link (http://www.ohd.hr.state.or.us/chs/pas/pas.cfm)