Assembly Judiciary Committee Approves Physician Assisted-Suicide Bill

The Assembly Judiciary Committee on Tuesday voted 5-4 to approve a bill (AB 654) that would allow some patients diagnosed as having no more than six months to live to end their lives with a self-administered prescription, the Los Angeles Times reports (Vogel, Los Angeles Times, 4/13).

The bill, sponsored by Assembly members Lloyd Levine (D-Van Nuys) and Patty Berg (D-Eureka), would allow some terminally ill patients to receive lethal prescriptions after a series of patient-doctor consultations taking place over a minimum of two weeks.

The bill is modeled after an Oregon law enacted in 1998 that requires a person seeking a lethal prescription to make three separate requests, two verbal and one in writing. The bill also requires a 15-day waiting period. To receive a prescription, a person must be at least 18 years old, diagnosed with six months or less to live and deemed mentally competent. If a doctor believes the patient is depressed or otherwise mentally impaired, a psychological examination must be conducted.

Under AB 654, a person's terminal condition would have to be diagnosed by two physicians, and a patient who has been diagnosed as having depression would not receive a lethal prescription. The bill also states that it doesn't authorize lethal injections, mercy killings or euthanasia (California Healthline, 4/11).

Amendments to the bill would require patients to administer the dosage themselves, according to Berg and Levin (Los Angeles Times, 4/13).

Before voting Tuesday the committee heard testimony from supporters, including hospice workers, doctors, attorneys, religious and community groups, and opponents such as the California Medical Association and Roman Catholic Church (Geissinger, Los Angeles Daily News, 4/13).

Former Oregon Gov. Barbara Roberts (D) testified that Oregon's assisted-suicide law has been used sparingly and has improved end-of-life care in the state (Los Angeles Times, 4/13). "The issue was choice and having an option. More than anything, that is the message of this law," she said (Gledhill, San Francisco Chronicle, 4/13).

Robert Miller, former president of the Association of Northern California Oncologists, said, "Physician-assisted suicide is the wrong answer to the right question. The focus should be on doing everything we can to improve care at the end of life" (Lawrence, AP/San Diego Union-Tribune, 4/13). He added, "If my prognosis were wrong, the patient pays the ultimate penalty" (Sanders, Sacramento Bee, 4/13).

CMA President Michael Sexton said, "We have a clear understanding that our ethical imperative requires that at all times we act in the best interests of our patients. Our responsibility as a doctor is to work with patients to give them the compassionate care they need. We don't feel that ending their life is consistent with that responsibility. We wish to help our patients, we don't want to help them end their lives" (San Francisco Chronicle, 4/13).

Marilyn Golden -- who spoke on behalf of the Disability Rights, Education and Defense Fund -- said, "If patients are denied other health care treatments, the choice of assisted death will be a phony form of freedom because patients, in effect, will be steered toward assisted death" (Sacramento Bee, 4/13).

Berg said, "Our bill makes sure the patient is always in control." She added that some patients with terminal illnesses currently take prescription drugs to hasten their deaths, "but it's done in secret without regulation and with desperation and in fear of reprisal" (AP/San Diego Union-Tribune, 4/13).

Levine said, "We are trying to bring the everyday practice of aid in dying out of the shadows, into the light of public scrutiny" (Los Angeles Daily News, 4/13).

The bill now moves to the Assembly Appropriations Committee for consideration (Folmar, San Jose Mercury News, 4/13).

Although patients with terminal illnesses "should have the right to ask for and receive life-ending medications," the problems with AB 654 "are in the details," according to a Santa Rosa Press Democrat editorial. The editorial states that the bill "doesn't offer enough protections for low-income patients who may feel pressured to choose suicide for financial reasons" or "ensure family members will be notified before a loved one chooses this course."

Lawmakers must focus on providing the "safeguards needed to protect against problems and abuse, rather than allow this issue to turn into an emotionally charged debate over things that most likely will never happen," the editorial concludes (Santa Rosa Press Democrat, 4/12).

KPCC's "Air Talk" on Tuesday included a discussion of the legislation (Mantle, "Air Talk," KPCC, 4/12). The complete segment is available online in RealPlayer.

In addition, KPCC's "Talk of the City" on Tuesday included a discussion of the legislation. Guests on the program included H. Rex Greene, an oncologist, palliative care physician and member of CMA's Council of Ethical Affairs; Jim Kronenberg, chief spokesperson for the Oregon Medical Association; and Levine (Felde, "Talk of the City," KPCC, 4/12). The complete segment is available online in RealPlayer.