The California State Assembly passed a bill this Wednesday legalizing physician-assisted suicide — also referred to as the “Right to Die” or “Death with Dignity.” The legislation permits doctors to prescribe lethal doses of medication to patients who are terminally ill who have voluntarily opted to end their life via drugs rather than continuing to endure the pain and disorientation of their incurable condition.
The bill is expected to pass in the state senate, though California governor Jerry Brown (D) has not publicly commented on whether or not he will sign the bill into law.
California’s right-to-die bill is generally considered to be at least partly inspired by the case of a terminally ill California woman, Christy O’Donnell, who moved to Oregon to end her life.
Known as the The End Of Life Option Act, the bill requires the decision to invoke the right to die be made by patients acting voluntarily, with the mental capacity to make medical decisions, and in the presence of two witnesses who testify that the patient is acting under their own volition.
Right-to-die activists argue that patients should have the opportunity to die with dignity, free from fear that they will lose their mental or physical capacities. The right-to-die option empowers patients to arrange their own goodbyes, organize organ donation, and reduce overall financial burdens on surviving family members if they so choose. Some right-to-die activists argue that “forcing someone who is in pain and suffering to live little or no relief should be a crime.”
The bill is controversial from a medical perspective due to the fact that it seems to contradict the Hippocratic Oath, but many would argue that keeping terminally ill patients who are in pain alive contradicts the first rule within the oath to “First do no harm.”
California joins a total of five other states whose citizens currently enjoy the right to die: Oregon, Washington, Vermont, New Mexico, and Montana. Oregon made it legal for terminally ill adults to request prescriptions for fatal dosages of drugs or medications from their physicians in 1997. Another dozen years would pass before Washington state and Montana made physician-assisted suicide legal in 2009. Washington’s law is modeled after Oregon’s — as is Vermont’s, passed in 2013 — but Montana has no law on the books setting a protocol for aid in dying. Rather, in Montana (and in New Mexico) the right to die is underwritten by a court decision. The Montana court decision established that doctors are protected if they write a lethal medication prescription at the request of a terminally ill patient, whereas the New Mexico court decision (2014) established that residents who are terminally ill have a constitutional right to obtain aid in dying. New Mexico’s attorney general is currently appealing the ruling.
At this point, aid in dying is still available only to a minority of U.S. citizens, but the California decision more than doubles the number of citizens who are covered by legal protections allowing them the right to die. Prior to legalization in California, 13.6 million citizens had the right to request lethal prescriptions from their physicians, should they become terminally ill. Once the California decision is officially signed into law, this protection will be expanded to cover almost 51 million individuals. It should be noted, however, that most of the laws exclude children from the law which reduces the real number of citizens who are actively covered.
It is notable that passage of the law does not seem to strongly correlate to party affiliation, religious preference, or per-capita income. There is a plurality of agnostics, atheists, and individuals claiming no religious affiliation in Washington and Oregon, according to the ARIS survey, but New Mexico is deeply Catholic, while California and Vermont have a significant though not overpowering Catholic plurality.
[Image from Piktochart]