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SB128, the End of Life Option Act that would allow terminally ill, mentally competent patients under strict regulations to request medication to end their lives peacefully, has been abruptly halted in its march through the California Legislature.

The Archdiocese of Los Angeles, represented by Jose Gomez, successfully lobbied Latino lawmakers to vote against it in its first appearance in the Assembly Health Committee.  Apparently alarmed by the seemingly easy passage through three committees of the Senate on a party line vote, the church mobilized itself, even taking to Twitter to warn, among others, Democratic Assembly members Jimmy Gomez of Los Angeles, Freddie Rodriguez of West Covina and Ed Hernandez of Chin  to withhold support.

Zen stones into the water with sunrise on the background

Realizing they did not have the votes, sponsors Bill Monning and Lois Wolk pulled the bill from the agenda shortly before the hearing.  Claiming it is not “dead,” however, they plan to try again within the two-year legislative session, but if their efforts to garner support fail again, supporters believe the bill will ultimately end up on the 2016 ballot — where it will likely succeed.

A recent bipartisan poll indicates that 70 percent of voters want the right to die to become law in California. Ironically, this level of support comes even from the most conservative areas of the state, such as San Diego and Fresno. Sixty percent of Latinos say they want it in place. Its long-time opponents, the California Medical Association and the California Hospital Association, have dropped their opposition, finally recognizing that it is the physician’s role to alleviate suffering, not to prolong a painful death.

Also opposed to  SB128 are some disabled groups, which claim that disabled or low-income people can be “pressured” into ending their lives, a claim that has no merit in fact. A similar law, the result of ballot measures, has been on the books in Oregon since 1997 and in Washington State since 2008, and similar provisions are in effect in Montana and New Mexico by court ruling. The only Legislature to enact such a law is Vermont’s.  In none of these states has even a single complaint been filed by any individual or any group.

In Oregon, only 770 people have ended their lives under the law since 1997, and the evidence is that they were well educated and insured.  Most were in hospice or palliative care, countering a claim from some physicians that good palliative care would obviate the need for the law. The “slippery slope” to which disabled groups refer has simply not come to pass and there is no support for their continual unsubstantiated allusions to “reports that have not been filed.” Perhaps most telling of all is that are no lobbies, including the Catholic Church, seeking repeal of these laws in other states.

It is worth pointing out that the opponents of aid in dying repeatedly use the phrase “assisted suicide,” a politically charged term that like “partial birth abortion” arouses irrational fear. Those who commit suicide are willingly closing off the possibility of a future.  The people who would benefit from the End of Life Option act have no possibility of a future. They are dying. This distinction is crucial to grasp.  Those who choose Death with Dignity, as the law is called in other states, simply want control over just how much suffering they are willing to inflict on themselves and their families as their inevitable end is close.

Despite the pleas of Dolores Huerta, long-time Latino activist, and editorial support from “La Opinion” and from first-tier newspapers all over the state, the long arm of the church was apparently all the Assembly members needed to disregard the wishes of their constituents. The only option for those who want it is to lobby just as hard, withholding their support at the ballot box from legislators who ignore the will of their constituents. They should recognize that the Catholic Church doesn’t vote – Catholics do, and if these voters want this bill passed in the numbers the polls indicate, it is up to them to convince their representatives that it is not acceptable to impose personal beliefs on legislation that affects a large population that does not share their views.

Compassion & Choices, the leading organization concerned with end of life issues and a chief supporter of this bill, has indicated that the heat around it will only increase.  They believe that, either through legislation, by judicial decision, or by ballot initiative, the End of Life Option Act will become law in California.  All indications are that its time has come.

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Zen waterOn April 7, the End of Life Option Act (SB128), the bill co-authored by California state Senators Bill Monning (D-Carmel) and Lois Wolk (D-Davis), cleared its second committee hearing before the Senate Judiciary Committee, by a comfortable 5-2 margin.

At the hearing, news was made: Assemblyman Luis Alejo, whose district includes Salinas and who chairs the Latino Caucus, has signed on as a principal sponsor of the bill. This is notable because he represents a constituency that has traditionally opposed such legislation on religious and/or cultural grounds. His support is indicative of the attitudinal shift in confronting the challenges of end of life care on the part of both voters and physicians.

A recent poll indicates that over 70 percent of Californians favor an aid-in-dying law, mirroring the national percentage. For the first time, a majority of physicians – 54 percent, up from 46 percent in 2010—also favor it.

For those of you unfamiliar with this bill, it would allow terminally ill, mentally competent adults, who meet a number of strict requirements, to end their lives with medication that they must be able to ingest themselves, at the time of their choosing. Two physicians must certify that the patient has a terminal condition. Other safeguards in the bill address concerns about coercive family or financial pressures. Patients must initiate the request and they can decide at the last minute not to use the medication, making the process entirely patient driven.

The End of Life Option Act is modeled on Oregon’s very successful Death with Dignity Act, which has been in place since 1997 without a single complaint of abuse to any authority. A very small percentage of the Oregon population has requested medication under the law; an even smaller percentage has taken it. It seems that merely having the medication available is such a comfort that many terminally ill patients feel no need to use it. Oregon and Washington passed the Death with Dignity Act via ballot initiative; New Mexico and Montana allow it by judicial order. Vermont’s legislature is the only one that has approved it, which is the best way in the view of experts to embed the required safeguards into the law. California now appears poised to do the same, though if the bill does not pass the many hurdles ahead of it, especially in the Assembly where many more votes are needed, it is sure to appear on the 2016 as a ballot initiative.

The traditional opponents of such bills include the Catholic Church – which has already signed on an expensive lobbying organization to oppose SB128. Some organizations representing the disabled, who are very aware that being disabled or old does not meet the strict rules under which one would qualify for aid in dying, are able to raise a lot of money by opposing the legislation on a “slippery slope” rationale made moot by the many years of data from Oregon. It is also opposed by some medical organizations, including oncologists. In the past, the California Medical Association (CMA) has opposed it, though it is hoped that this time around the CMA will take a neutral stance and allow its members to decide whether or not to participate in carrying out provisions of the bill, which would be strictly voluntary. (For reasons difficult to comprehend, the CMA opposed the End of Life Notification Bill recently signed into law by Governor Brown, requiring physicians to inform terminally ill patients of their options end of life options at the time of diagnosis.)

Infinite warehouse

SB128 is appropriately named the “End of Life Option” Act because the authors and supporters have made clear that aid in dying is part of a continuum of care for the terminally ill that includes both palliative care and hospice — vital options even though they are not always available or effective in relieving the pain and suffering of the terminally ill. The recommendation to consult palliative care and hospice experts is included in the bill, though it is not a requirement because access might be a problem, especially in rural parts of the state.

Many supporting this bill believe it is a basic human right to determine how to exit an untenable situation when one is terminally ill. Opponents like to call it “assisted suicide,” a politically charged phrase that summons distaste. The very definition of “terminal” connotes the inevitable ending of life, whereas “suicide” connotes the possibility of a future that is willingly foreclosed. When all viable treatment options have been exhausted, the only issue remaining to those patients is how peaceful their end will be, not whether or not there is an end. If the End of Life Option Act allows those facing the emotional and physical pain of a prolonged and painful death a peaceful departure, it is difficult to imagine why it would be opposed. Neither religious doctrine nor a misconceived notion that everyone can be healed should stand in the way of a crucial personal freedom.

If you agree, your voice needs to be heard. The next hearing – as yet unscheduled – will be before the Senate Appropriations Committee where the sponsors are not certain that they have the votes to send SB128 onto its next legislative gantlet. This link will take you to a list of members, and you can send emails to them by clicking on their names. You may not be in their district, but theoretically they represent all Californians, and so far, the majority of Californians say they want the right to decide how they die when their circumstances are grievous and irremediable. It would be far more expedient for our state legislators to agree than force an expensive ballot initiative, but for that to happen, we need to make ourselves heard.

Meister is a journalist who lives in Pebble Beach. She is a frequent contributor to the Partisan.

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