After nearly a quarter-century of efforts in California to afford terminally ill patients the right to end their lives with a doctor's help, state lawmakers and the governor may be on the verge of granting the dying that authority.
The state Assembly on Wednesday passed a bill that would allow physicians to prescribe life-ending drugs to the terminally sick. The End of Life Option Act, which the Catholic Church and others oppose, awaits final approval by the Senate -- three months after that chamber passed a similar bill by a thin margin.
The fate of the legislation is likely to rest with Gov. Jerry Brown, a former Jesuit seminary student who has yet to articulate his position on the measure. Brown has expressed concern about it, based more on legislative procedure than his own beliefs.
Modeled after an Oregon law enacted in 1997, California's aid-in-dying proposal generated passionate, often deeply personal, debate among lawmakers that cut across party lines. Their discussions touched on questions of morality and mortality; trust in doctors and God's grace; and the right of the dying to determine their own fate versus protection for the elderly and vulnerable.
Assemblywoman Susan Eggman (D-Stockton), a former hospice worker and the author of the legislation, accepted hugs from many of her colleagues after the 43-34 vote that ended a two-hour debate on Wednesday.
"This issue is of immense importance to all Californians," said Eggman, who was an associate professor of social work at Sacramento State before being elected.
"I was confident that the full Assembly, reflective of and responsive to the people it represents, would do the right thing and move us closer to making it possible for terminally ill Californians to decide for themselves how to manage their last days," she said.
Assemblyman Luis Alejo (D-Watsonville) said the bill would allow a peaceful and dignified end to suffering. Alejo choked with emotion as he talked about his father, a Vietnam veteran who is in pain from terminal bone cancer and wants to make his own decisions about the end of his life.
"Respect his choices," Alejo said.
Assemblywoman Cheryl Brown (D-Rialto) opposed the measure, arguing that doctors may be too hasty in declaring patients terminal. She told lawmakers about her son, who was near death with an infection. Physicians urged her to let him go, and she refused. Nineteen days later, he came off life support and is now a husband and father.
"Doctors don't know everything," Brown said.
Despite such heartfelt opposition, the proposal gained momentum after Californian Brittany Maynard, 29, moved to Oregon last year so she could end her life with drugs to avoid the debilitating effects of brain cancer. Her case was covered nationwide, and in a videotaped appeal before her death Maynard urged California lawmakers to pass the assisted-death legislation.
"I am heartbroken that I had to leave behind my home, my community and my friends in California, but I am dying and refuse to lose my dignity," Maynard says in the video. "I refuse to subject myself and my family to purposeless prolonged pain and suffering at the hands of an incurable disease."
In July, an earlier version of the assisted suicide bill stalled in an Assembly health committee. The legislation was revived in August after Brown called for a special session on healthcare spending, primarily to address funding for Medi-Cal.
After the bill was reintroduced, a spokeswoman for the governor said the issue merited "careful consideration," but debating it in the Legislature's normal course of business was "more appropriate than the special session."
The same objections were raised by Republicans but rejected by the Legislature's Democratic leaders.
Similar bills failed in the Legislature in 2005 and 2007, and California voters rejected a 1992 proposal that would have allowed physicians to administer lethal injections to their patients.
Eggman recently amended her bill, AB X2-15, to expire in 10 years, at which time lawmakers could review how it worked and decide whether to extend it.
The End of Life Option Act would require patients to submit two oral requests for a lethal prescription, a minimum of 15 days apart, as well as a written request. The attending physician would receive all three requests.
The written one would be signed in front of two witnesses who attest that the patient is of sound mind and not under duress.
Opponents of the bill, such as advocates for the disabled, argued that the legislation might lead those with disabilities to be coerced to end their lives prematurely.
During Wednesday's debate, Maynard's husband and mother were present, joined by a dozen activists who watched from the Assembly gallery. There were cheers, tears and hugs when the vote was cast.
Dan Diaz, Maynard's husband, was emotional in his response.
"There is a sense of pride in the Legislature," Diaz said. "Today it reaffirmed the reason Brittany spoke to begin with. The Legislature will no longer abandon the terminally ill where hospice and palliative care are no longer an option. They can have a gentle passing."