When legislators in Sacramento passed a reasonable and conservative assisted-suicide law in 2015, California was only the fifth U.S state to allow terminally ill people to obtain a lethal prescription. Giving dying people who have six months or less to live an alternative to terrible pain and suffering was the compassionate and correct thing to do, so it's no surprise that Colorado and Washington, D.C., have passed similar right-to-die laws since then, and that more than two dozen states — from Hawaii to Maine — are now considering doing the same.
California can't take credit for this trend. Oregon passed the first such law more than 20 years ago, establishing a successful model that California and other states have followed, setting strict rules to safeguard against abuse. The widespread interest in assisted-suicide laws today owes much to Brittany Maynard, a 29-year-old California woman who in 2014 used Oregon's Death with Dignity law to escape the final, brutal days of end-stage brain cancer. After investigating the paltry end-of-life options in this state, she and her family decided to move to Oregon and use her remaining time to push for aid-in-dying laws in other states.
Not even a year after Maynard's death, California lawmakers revived and passed a proposal that right-to-die advocates had been pushing here for about a quarter-century. Now no dying Californian has to leave home in order to have assisted suicide as an option.
Nor is it surprising that some people are talking about expanding the scope of existing assisted-suicide laws. The six-month timeline shuts out some terminal patients, such as those with Amyotrophic Lateral Sclerosis, or ALS, and Alzheimer's Disease, who are often no longer physically or mentally capable of meeting the extensive requirements to qualify for the law once they are within six months of death. Assisted-suicide laws require both the physical ability to self-administer the lethal medication and mental competence to make an extraordinarily difficult decision.
Discussion about expanding the timeline has already begun. In Oregon, the chairman of the Legislature's healthcare committee, Rep. Mitch Greenlick, said he plans to introduce a bill in the next legislative session that would change the timeline from six months to 12 months. That idea was also discussed at a legislative hearing in Sacramento in January looking at how California's End of Life Option Act has been implemented.
It makes sense to study how the new law is working and to make changes if needed. But be prepared: Assisted suicide is a contentious, ethically complicated issue, and any attempt to expand it will engender fierce debate. That's fine — any law that broaches such sensitive life-and-death matters ought to be vigorously discussed. Indeed, California's law is still being challenged both legislatively (by a bill, for instance, that would add even more reporting requirements) and in court.
But data don't support some of the fears that were initially voiced, including the concern that family members would coerce their aging grannies to avail themselves of the new law. Rather, initial reports from California as well as two decades of data from Oregon show that the law is being used as was intended, sparingly and as a last resort by dying people. That was backed up at January's hearing by testimony from physicians, hospice providers, healthcare administrators and the families of sick people who used the law. In some cases, families reported, they tried and failed to use the law because the hurdles — including four physician meetings and approvals from two doctors, a 15-day waiting period, and a ton of paperwork — were too high.
As some physicians noted, the new law has had the unintended, though welcome, consequence of encouraging frank conversations about end-of-life care that they say is improving care overall. That's heartening and hopefully will help change attitudes about dying for the better.