Assisted suicide is already legal in California through the so-called End of Life Option Act, narrowly passed by the California Legislature and signed by then-Gov. Jerry Brown in 2015. The bill received opposition from both Democrat and Republican Assembly members and state senators but was passed, many feel inappropriately, during a special legislative session focused on Medi-Cal funding.
Despite the bill’s narrow passage, now just a few years into the new law, proponents of this law want to eliminate the very “safeguards” they used as arguments for its passage. The new bill, Senate Bill 380 by Sen. Susan Eggman, will get rid of the scheduled 2025 review process that doctors, patient advocates and legislators allowed for an examination of California’s experience with this controversial law. This new bill will also eliminate the 15-day safety period to receive the deadly prescription drugs.
During the 2015 debate regarding assisted suicide legalization, and the End of Life Options Act, former state Sen. Bill Monning (and bill author) noted in the publication Healthline that, “the joint and co-authors on this bill…endeavored to build in protections in this [measure] that are stronger than any of the states where this has been practiced.” Monning’s statement was far from the truth because the narrowness and limited data required by his bill about how assisted suicide was to be implemented along with how and where patients are really protected, is a big part of many of these problems today.
The Death with Dignity NationalCenter, proponents of the End of Life Option Act, contradict this new effort to eliminate “safeguards” with this note on their current website FAQs: “Death with dignity statues contain a number of safeguards, protecting patients from abuse and coercion … the patient must make two oral requests, at least 15 days apart.”
But in this new bill, these proponents want to eliminate the very “safeguard” they hold up.
This rush to erode assisted suicide “safeguards” included in the 2015 End of Life Option Act is not only unwise public policy, but there is simply no data or science to support removing these “safeguards” so soon.
Annual reports on the End of Life Option Act required by the state of California do not contain any data whatsoever regarding complications, reasons for requesting the lethal drugs and, for the limited data provided, much is listed “unknown.” Over the past year we have become all too familiar with how important medical and scientific data are in making informed public policy decisions, especially decisions involving life and death.
The latest California annual report on the End of Life Option Act law released in July 2020, reported that 10% of those requesting the lethal drugs had an “unknown” insurance coverage, and it was “unknown” whether 7% ever received information about hospice or palliative care options.
In a March 2021 New York Times Magazine interview of Dr. Diane E. Meier, longtime director of the Center to Advance Palliative Care at Mount Sinai Hospital noted, “All the heartfelt adherence to restrictions that are announced when you first get the public to vote in favor of this go up in smoke once the practice is validated.”
The annual reports on the End of Life Option Act do not, in fact, provide sufficient data to determine whether these restrictions or, as proponents called them, “safeguards” are being followed. And now with SB 380’s “safeguard” elimination, these “safeguards” they touted were simply a ruse to get the original law passed.
Given the controversial history of the End of Life Option Act law as well as a broken patient healthcare infrastructure pushed to the limit by the pandemic of the last year, it is neither wise nor appropriate to remove these so-called “safeguards.” The bill is set to be re-evaluated in 2025 under the current law.
Furthermore, any effort to expand this assisted suicide policy and the End of Life Option Act also comes in the midst of the debate on a systemic healthcare disparity and inequity within ethnic, minority and disability communities on access to palliative, hospice and other types of care for serious and terminal diseases.
This is simply not the time to eliminate what little patient protections that proponents themselves included in the End of Life Option Act – the lack of safeguards will do more harm to patients than good.
Matt Valliere is the executive director of the Patients Rights Action Fund, a national nonpartisan organization defending the rights of people with disabilities, seniors and people facing serious illness. Matt is an experienced caregiver to people with life-threatening disabilities.