On Monday, October 5, California Governor Jerry Brown signed into law the controversial act, ABx2 15, also called the End-of-Life Option Act, legalizing physician assisted suicide. California is now the fifth state to allow this procedure, joining the ranks of Oregon, Vermont, Montana, and Washington. This decision comes after a year of debate within California, following an op-ed written for CNN by terminally ill patient and Right to Die advocate, Britney Maynard.
While Brown had remained silent about his own stance on the law as it saw debate in California’s senate and state Assembly, he wrote a personal rationale for his actions in a letter. "I do not know what I would do if I were dying in prolonged and excruciating pain," he wrote. "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."
Brown said that he consulted with both sides of the argument, the Maynard family, two of his own doctors, a Catholic bishop, and his own friends, before making his decision. The bill had passed state legislators in August but remained on Brown’s desk for nearly two months before being signed during a special legislative session that was meant to address the topic funding issues with Medi-Cal.
Ultimately, Brown considered that, “the crux of the matter is whether the State of California should continue to make it a crime for a dying person to end his life, no matter how great his pain or suffering.”
Many critics call into question Brown’s reasoning, claiming that his personal inclinations as a wealthy man with resources and connections are not representative of a majority of those that the law affects, such as the disadvantaged and the elderly. Californians Against Assisted Suicide, an organization that was deeply involved in the legislative debate this past year, released a statement, saying that they were "reviewing all of [their] options moving forward [...] [Patients living in health care poverty] are the people and families potentially hurt by giving doctors the power to prescribe lethal overdoses to patients."
Many opponents of the law fear that it will push those in poverty to make a decision they do not personally want because of financial limitations. Other fears include the discrimination of the elderly and disabled, and the exploitation of patients by insurance companies.
However, while religious opponents and special interest groups argue the dangers of physician-assisted suicide, others point to the facts present in Oregon, one of the five states permitting physician-assisted suicide. A 2008 study conducted by Oregon’s Department of Human Resources found that, “over the past 10 years, most of the terminally ill Oregonians who legally ended their lives were people with advanced cancer (86 percent), between 55 and 84 years old (80 percent), white (98 percent) and well-educated (69 percent attended college).”
As California’s law is closely modeled after Oregon’s Death with Dignity act, advocates argue that the results from Oregon prove that the law is unlikely to be used by the financially limited or under-educated.
The End-of-Life Option Act requires that patients be over 18 to request the drug, to submit two oral requests, at least fifteen days apart, and one written request. A consulting physician and the attending physician would both need to confirm that the patient is indeed terminally ill, with less than six months to live, and is making the decision in sound mental condition. If the physician believes the patient is mentally ill, they may refer the patient to a psychologist for further discussion. A number of other gatekeepers exist within the law, in order to prevent abuse of the act. The full law can be found here.