Yesterday California joined the roll of enlighted U.S. states—including Oregon, Washington, Vermont, and Montana—where it is now legal for physicians to prescribe drugs to help the terminally ill end their lives with control and dignity. The bill has had a checkered history, having been turned down by the California legislature once before, and there were worried that despite his liberalism, Governor Brown would veto it. (He equivocated earlier when asked.) But a potent force behind the law was Brittany Maynard, a California woman afflicted with brain cancer who had to move to Oregon so she could take her life legally. She was 29 when she died. The bill is her legacy, and here is her testimony and plea to lawmakers, filmed only a few weeks before she died:
The “right to die” bill, AB15, will take effect in 2016, and allows doctors to prescribe life-ending medication, presumably barbiturates—to those who meet several criteria: the written assent of two doctors, the written testimony of two witnesses (one not a family member), two written requests by the patient herself, and the ability of patients to themselves take the medication.
Although people worried that such bills will be used to kill people unwillingly, as a form of euthanasia, that has not happened, for the legal requirements make that almost impossible. In truth, I don’t understand why anybody opposes this bill, save for those religious people who see suffering as a virtue. Those included, as TPM notes, the Catholic Church:
The Catholic Church targeted Catholic lawmakers before the bill’s passage and urged the governor to veto it.
“Pope Francis invites all of us to create our good society by seeing through the eyes of those who are on the margins, those in need economically, physically, psychologically and socially,” the California Catholic Conference said in a statement after its passage. “We ask the governor to veto this bill.”
But CNN reports some opposition I didn’t expect:
There were many, though, that opposed the effort and urged Brown to veto the legislation. They included those tied to Californians Against Assisted Suicide, whose spokesman Tim Rosales said that many spoke against the effort, including “progressive legislators representing low-income districts.”
On its website, Californians Against Assisted Suicide lists dozens of organization opposed to the billBrown signed Monday. They include the American Academy of Medical Ethics, the American Medical Association, the California Catholic Conference, the Disability Rights Center and many others.
“We all know that ‘choice’ is a myth in the context of our unjust health care reality,” the group said after the state Senate passed the bill last month. “End-of-life treatment options are already limited for millions of people — constrained by poverty, disability discrimination, and other obstacles.
“Adding this so-called ‘choice’ into our dysfunctional health care system will push people into cheaper lethal options.”
The American Medical Association? The American Academy of Medical Ethics? If you reject the slippery slope argument that right-to-die bills lead ineluctably to Nazi-style eugenics, what reasons are there to prohibit such laws? Religious belief of course is one: the notion not only that suffering is a virtue, but that only God has the right to end life. But such beliefs are based on fantasy. I won’t say that there is a “right” to die in such circumstances, as I’m wary of flat assertions of “rights,” but I think it’s a tenet of a humane and caring society that if one would prefer to die than suffer without hope of cure, one should be able to end one’s suffering
“Adding this so-called ‘choice’ into our dysfunctional health care system will push people into cheaper lethal options.”
That is a much better argument for reducing the dysfunctionality of the health care system than it is an argument for not allowing assisted-suicide.
That’s what I was thinking. When a healthcare system makes living so bad that some prefer the option of death, the solution is not to take away the option of death.
In the voice of .. is it Stan ‘American Dad’ Smith? .. “what are you, some sort of pinko commie subvresive?”
Or is that the base commander in Dr Strangelove. Or are they, essentially the same character, in different media?
I suspect that people are uncomfortable with this because it makes them confront their own deaths. And since emotion comes first, followed by the justification….
I read an article a few weeks ago that said that research suggested that people were uncomfortable with atheists for much the same reason.
Link to said article?
http://www.rawstory.com/2015/05/study-people-dont-like-atheists-because-they-serve-as-a-grim-reminder-of-deaths-finality/
Good to see and also a surprising good job by the Governor to get past all the interference and religious objection and do the right thing. Sometimes religious people can do the right thing. Also, thanks to Brittany Maynard for helping to make this happen.
I was opposed to it in the 90’s. My primary opposition was because of the risk of improper use, and at that time the US had very little data on whether implementation of such laws would go as hoped or result in manipulation and abuse.
Now, we have decades of data, from several different countries implementing several slightly different systems. The data supports the notion that we can ‘safely’ allow euthanasia. The scenario of a greedy in-law killing the rich octogenarian or the scenario of some teen finding a legally viable reason to kill themselves over a breakup did not happen; the controls put in place were strong enough to prevent such things.
I suspect that at least some of the opposition is coming from people like me, but who don’t know the history of past successful implementations. They are opposers or fence-sitters because they still worry it can’t be done right, rather than because they are morally opposed to a terminally ill person being allowed to end their life when it becomes continuously painful.
Since we now have many years of experience with similar laws in neighboring Oregon and Washington without any such problems arising, there’s no basis for such secular objections. The opposition, as Jerry says, is first and always religion-based, and based on an ideal of suffering.
Impressive that Jerry Brown, once a Jesuit seminarian, did sign the bill.
There’s no well-educated basis for such secular objections, but part of my point was that some objectors may not be well educated as to the data supporting this policy.
Agreed, especially now with more of the data being easily accessible. The other step forward to challenge the religious objections is to demand evidence of misuse from any of the states that currently have such legislation.
As we’ve discussed this here in Canada, I’ve heard Christian bring up fuzzy stories about “someone” in Belgium, or “someone” in the Netherlands but never any details, and always claiming they couldn’t get them.
If this legislation causes terrible things to happen, then there should be evidence of those terrible things in the existing states, If not, it’s the same hypothetical claptrap that was asserted about marriage equality, and should be rejected in the same fashion. Governor Brown gave an excellent demonstration of using empathy, rather than irrational fear, as part of a moral decision-making process.
There was a time when I too was worried about such legislation because I was worried about suitable controls. However, reading the legislation that was proposed in NZ (which unfortunately failed to get even a first reading), I was confident that no one could be forced.
Also, internationally I’m not aware of a single case where such legislation has been used improperly.
Doctors here support it. I’m not sure about disability organisations, but in other places I know the worry was they would be forced to give consent because they were seen as a nuisance or valueless. I understand the fear, but I think the safeguards against such things are strong.
A minor correction: Brittany Maynard was 29 when she died, not 19.
I’ve been getting a bit annoyed with Jerry Brown, with his reluctance to deal with the scandal at the Public Utilities Commission and its back-channel communication with Pacific Gas & Electric; but he has made two good moves recently. The first was signing the bill that removed religious and personal belief exemptions from vaccination – now the only valid exemption is medical (bringing California into line with Mississippi and West Virginia, if you can believe that); this despite that he had weakened the previous law with a signing statement. The second is this assisted suicide law. I think it’s still too restrictive, but it’s a start.
Fixed, thanks!
“If you reject the slippery slope argument that right-to-die bills lead ineluctably to Nazi-style eugenics, what reasons are there to prohibit such laws?”
One argument I’ve heard is over concern that poor and disadvantaged people may have additional pressures to end their lives under circumstances where medical costs are becoming burdensome to them and family. While a legitimate consideration, I haven’t seen any evidence that this is true anywhere that physician assisted suicide is legal.
Why shouldn’t expense be considered?
Give me a choice between spending a million dollars to live an additional month in undignified pain confined to an hospital bed, or giving that same million dollars to a college scholarship fund, and I’ll demand you pull the plug this instant.
Of course, it’s a balance. If a $10 pill will give me decades more good life but not spending the money on the pill will mean death soon, I’d obviously spend the $10 without hesitation.
But I don’t see how we can possibly in good conscience deny people the right to make such decisions for themselves, or why we shouldn’t trust them in these financial matters the same way we would in any other. (And, of course, in the case of those with impaired mental faculties facing these decisions, that’s what living wills and powers of attorney are for.)
b&
I agree with you completely; expenses absolutely should be considered. But still I think it wouldn’t sit well with many people if poor people were being pushed to terminate their lives based on financial considerations when more well-off people did not. Again, I don’t know of any evidence of this being true where assisted suicide is legal, however.
Well, how many poor people forego expensive medical treatments in the first place? Is it any more fair that a rich person can afford half a million dollars on an heart operation that the poor person can’t even think about?
The obvious solution is Medicare for all, a single-payer healthcare system that doesn’t even pretend to consider the personal financial situation of those receiving treatment. But that’s somehow more evil than making life-or-death medical decisions based primarily on the patient’s bank statement….
b&
Again, I don’t think we disagree over this law. I’m not putting that argument forward myself. But it is an argument outside of the “slippery slope” or religious arguments, flawed as it may be as you rightly point out.
I fully support this legislation.
Exactly! A single-payer health care system removes this issue.
It also means that people are less likely to get into a position where they need to consider assisted dying as health problems are identified at an earlier stage. This is so particularly among the poor who previously didn’t seek medical help until it was too late to help because of the expense.
Agreed. Although I consider myself quite liberal, I often find myself diverging from my liberal brethren in that I believe all of us have obligations to society, as well as just personal rights. The fact is that, to a greater and greater extent, the timing of your death may well be simply a function of how much money is spent to keep you alive. In my view, I have no “right” to demand that my fellow citizens spend hundreds of thousands of dollars a year to keep me alive. Nobody owes me that. To the contrary, when my health has passed the point of no return, I have an obligation to get out of the way.
If the state of Oregon is anything to go by, it turns out we as a society don’t form death panels, even when we have a right-to-die law on the books. Who knew?
Good news, indeed, especially considering that it’s only a few hours to drive to California from where I live, and I’ve lots of family throughout the state. Should I or my aging parents need to make use of such, it’s well within reach.
b&
I don’t know if the California law is different, but in other Death with Dignity laws, you have to be a resident of that state for eligibility.
Well, what’re the residency requirements? Both Mom and I were born in California and grew up there, and Dad obviously lived there for a couple decades at the same time. And we’ve family on both sides who’d be happy to have us move in.
b&
I think you have to live there for a year. Living with a family member who is a resident isn’t a work around. I was going to try that when I went to college there and it was a no go. I was also born in California, but once we moved to Nevada and lived there for 10 years, I had to re-establish my California residency.
The law requires California residency:
“(3) The individual is a resident of California and is able to establish residency through any of the following means:
(A) Possession of a California driver license or other identification issued by the State of California.
(B) Registration to vote in California.
(C) Evidence that the person owns or leases property in California.
(D) Filing of a California tax return for the most recent tax year.”
This doesn’t seem particularly onerous – I moved to California a long time ago, but I think all I had to do for the driver license was say I’d moved here and give my address, no proof. I was a renter and non-US citizen at the time.
As I recall from reading about Brittany Maynard, Oregon’s law requires 6 months of residency.
Well, in that case, no problem. I can see getting a driver’s license being a problem for somebody in poor enough health to wish to exercise the right to die in California, but there won’t be any problem getting a non-operator’s state ID. Voter registration is likely to be trivial. I’m sure family would be more than happy to lease a room.
And I’d personally be perfectly happy to honestly state that I wanted to return to the state so I could die in the same state I was born in. I don’t see how anybody could find such a sentiment objectionable.
b&
I suspect, optimistically, this is academic, as more states including most in the southwest will also have such laws before long.
All this is fascinating. In Australia we have no concept of state residency laws. I had no idea that the US was so fractured. I would have thought such laws would contravene the rules of Federation.
Good on governor moon-beam. I have many relatives who live in California, but most are devout born-agains, so they probably hate this law. I’m happy that the entire west coast has now been enlightened in this regard.
Well done my native state!
Well done my adopted state!
Ditto native state
The compassionate posturing of the Vatican is nothing more than their inflexible invitation to all citizens of the human race to receive an iota of the suffering of the Lord, Jesus Christ.
Not surprised at the official stance of the AMA & Academy of Medical Ethics. Like IRBs tasked with oversight of scientific studies, they seem to be getting populated increasingly by groupthink types whose overriding concern is “what is the worst that could *possibly* happen?” That greater harms are allowed to perpetuate because of this brand of conservatism seems to never come up in these meetings, or if it does, it is likely to be overridden by the fears of the terminally risk-adverse.
…speaking of linguistic goofs: I meant “risk-averse”.
I would argue that these laws don’t go far enough … but they are a good start. There is a consensus amongst my age (54) peer group, many of whom do not have children, that we would like to die with dignity at a time of our own choosing, even if we don’t have a terminal illness. Because of the number of Catolicks in our legislatures that is not going to be allowed to happen any time soon here in Australia.
Considering that Catholics form only 25% of the pop, many of whom are no doubt lapsed if not outright atheists, it is amazing the amount of power the Catholic church wields in our fine country. Julia Guillard could not legislate for marriage equality due to their hegemony in the Labor Party, just for one example.
This law is good and I’m glad it passed, but it’s only a small step in the right direction.
The main problem with it is that it only applies to people who are going to die in a few months anyway. The plight of a person who will suffer for a few months is bad, but the plight of a person who must suffer for years is far worse, and they get no relief.
Another problem is the requirement that the person be able to administer the drug themselves. If you can’t use your arms, then what? No relief for you, no matter how much suffering you must endure.
While celebrating the passage of this law, let’s not forget the need to expand this right to others who face a fate worse than death.
Exactly right about the restrictive nature of right to die laws. In America, though, there seems no way to gain support and pass such laws without the severe restrictions. Montana is the lone exception to this, since the right to die is not from a law, but from a court decision in 2009, which found that, under Montana’s Rights of the Terminally Ill Act, physicians are shielded from criminal liability for acting according to the patient’s end-of-life wishes, including life-ending prescriptions. The court provided few guidelines, other than that physicians may provide aid in dying to consenting, mentally competent, terminally ill patients.
To me, this provides a fine real-life experiment, to show whether such a practice will really encourage abuse, absent the restrictions all other states have. Or whether such objections are just another empty argument, when the real objection is people having control over their own lives.
Yes, hopefully this law will show that their dire predictions are unfounded, and we can move forward in small steps. I guess it’ll still take decades…
I thought that Gov Brown’s statement on signing touched on one of the most significant points of such legislation. “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 consider the options afforded by this bill.” This has proven out here in Oregon. Whether or not people use the prescription, (and the majority of those who procure it, don’t use it), the peace of mind it enables, greatly improves their quality of life.
The right choice. Just in time for the winnowing of Republican Presidential candidates… 😉
As usual Professor Ceiling Cat hits the nail on the head with the last paragraph. Brilliant!!
The idea that anyone feels that HIS religious beliefs allows him to impose a law that insures that I, not holding any such beliefs, will suffer a dreadfully slow and painful death that I do not wish, is perhaps the most obscene sort of arrogance that I can imagine!
Absolutely agree.
cr
‘I won’t say that there is a “right” to die in such circumstances, as I’m wary of flat assertions of “rights,” ‘
If there is any right to have a life, that must surely include the right to end it if circumstances dictate. (And screw you sideways, ‘Right to life NZ’)
cr
That is my analysis too. It is better, and less hypocritical, to allow rights that doesn’t hurt others. (IIRC the consideration of family, friend and society is one of the arguments against, but that damage is consequential and not intended in the these cases.)
A warped Judaeo-Christian perspective on suicide is well-summarized here:
http://www.gty.org/resources/questions/QA143/can-one-who-commits-suicide-be-saved
Mind-boggling
sub
“Suicides are enumerated by Virgil among the unfortunate, rather than the guilty; and the poetical fables of the infernal shades could not seriously influence the faith or practice of mankind. But the precepts of the gospel, or the church, have at length imposed a pious servitude on the minds of Christians, and condemn them to expect, without a murmur, the last stroke of disease or the executioner.” — Edward Gibbon, Decline and Fall of the Roman Empire, chapter 44.
This is sadly a subject that the governments here is unwilling to touch. At least it isn’t a taboo to discuss it.
Oh, the irony!