For the sixth time in the state’s history and the third year in a row, California lawmakers are debating the rights of terminally ill patients. Once again, the Legislature is considering whether patients in the final stages of their illness should have the option to seek a doctor’s assistance to end their lives in a humane and dignified manner, and again the battle lines are drawn between those who advocate for the patients’ right to choose and those who argue that legal assisted suicide inevitably will lead to abuses and amounts to an endorsement of a “culture of death.”
But some things are different this time around. In the years since California’s first such patients’ rights proposal, 1992’s Proposition 161, went down to defeat, Oregon passed its own Death with Dignity Act, offering a real-world example of the law’s impacts that stands in stark contrast to the alarmist predictions of opponents. Meanwhile, California lawmakers have fine-tuned this state’s proposal to address virtually all practical objections to the law. The result has been the current Assembly Bill 374, the California Compassionate Choices Act, a well-written and truly humane measure that deserves our support.
For years, disability-rights advocates have argued that passage of any form of doctor-assisted suicide inevitably would lead to the euthanizing of people with diminished capacities as insurance companies would be tempted to pressure physicians to cut treatment costs. In Oregon, that simply hasn’t happened, and assisted suicide has remained an option exercised only in extraordinary circumstances by a very few individuals—only 292 since 1998. Moreover, under AB 374, the process is entirely patient-driven, eliminating the potential for abuses by insurers.
The new law does not permit anyone but the terminally ill themselves to initiate the process. To participate, a patient must be evaluated by two physicians to confirm that all treatment options have been exhausted and that the individual has less than six months to live. The patient also would need to submit to a psychological evaluation to confirm competency. At that point, he or she may request a prescription for drugs that would hasten the end of life. No physician would be required to prescribe the drugs, and only the patient could administer them. The patient is in charge every step of the way, so it’s hard to see how the process could be abused by insurance industry bean counters.
Of course, the supposed potential for abuse is not the only reason some people object to the bill. Some argue that doctor-assisted suicide, even among the terminally ill, is an affront to religious values. Such views are a matter of personal religious belief, and those who hold them have every right, if they become terminally ill, to reject assisted suicide as an option. They do not, in our view, have the right to reject that option for others.
The California Compassionate Choices Act is not a rejection of life. It is an affirmation of patients’ rights and places responsibility for decisions regarding care for the terminally ill directly in the hands of the patients themselves. We urge the Legislature and governor to support it.