Right-To-Die Law Gives Terminally Ill Californians Humane Options

Brittany Maynard was just 29 years old in 2014 when the California woman ignited a national conversation about dignity-in-dying. The young woman moved to Oregon, along with her husband and parents, to secure the right to die on her own terms. She chose when to give up her struggle against brain cancer by taking lethal drugs safely prescribed by a physician.

Following her death, her widower and parents returned to California to fight on behalf of other terminally ill patients, lobbying the California legislature for a right-to-die law. They had a power ally -- Brittany herself, who had recorded a video for lawmakers before her death. She told them, “I am heartbroken that I had to leave behind my home, my community and my friends in California. But I am dying and I refuse to lose my dignity. I refuse to subject myself and my family to purposeless, prolonged pain and suffering at the hands of an incurable disease.

“No one should have to leave their home and community for peace of mind, to escape suffering and to plan for a gentle death.”

Her testimony from the grave resulted in the End of Life Option Act which took effect on Thursday. California is the fifth state to legalize ending one’s own life after Oregon, Washington, Vermont and Montana.

Brittany’s widower, Dan Diaz, told reporters during a conference call on Wednesday that his wife was able to enjoy more moments of happiness at the end of her life because she didn’t live in fear of a brutal death. “This program, its very existence empowers the individual and it provides a great sense of control and relief,” he said.

Stanford Medicine physician Dr. Catherine Sonquist Forest agreed, saying, “Simply having the option of medical aid in dying and the ability to shorten an unbearable dying process provides great peace of mind to terminally ill people and to their families.”

A new industry

Although the act has just taken effect, a new industry for end-of-life decisions is beginning to spring up in California.

The new law has strict requirements:

• Patient must have a diagnosis of less than 6 months to live
• Prognosis must be made by two physicians
• Patient must be mentally competent
• Patient must make two oral requests at least 15 days apart to end life 
• Patient must make one written request to end life
• Patient must be able to take lethal drugs without assistance

A Berkeley physician, Dr. Lonny Shavelson, who wrote the 1995 book, "A Chosen Death: The Dying Confront Assisted Suicide," has opened a practice aimed at assisting patients who are struggling with this issue.

Bay Area End of Life Options is possibly the first office in the state with a focus on end-of-life matters.

"There will be a larger demand from patients who want to consider physician aid-in-dying than there are physicians who will be willing to work with them on it," Shavelson told the East Bay Times. He said many patients who’ve come to terms with their impending death are just “finished.” Their attitude is,“'I don't need the next two weeks of laying here, and my family sitting by my side, and everyone just waiting. I'm done."

The largest health care provider in California is Kaiser Permanente, which, according to Compassion & Choices, will offer patients the death-with-dignity option. Kaiser already keeps advanced directives on file, which allow patients to state in advance what treatment they want to receive should they become incapacitated.

The University of California, Stanford Medicine, Sutter Health and others are also quietly preparing to provide the service to patients. The life-ending drugs will also be covered under the state’s public insurance plan, MediCal.

Opposition to End of Life Option Act

Despite the new legislation, however, don’t expect to find lethal drugs offered at Catholic hospitals in California. Dozens of religious hospitals are refusing to offer the option, which is allowed in the new law.

According to AP, Los Angeles Archbishop Jose Gomez has warned that poor families, African Americans, Latinos and immigrants with a serious illness will be at risk of coming under pressure to take lethal drugs to avoid the high cost of cancer medications and other care along with insurance practices that limit hospice care.

That concern is echoed by Dr. Aaron Kheriaty, director of the medical ethics program at the University of California Irvine School of Medicine. "Because of California's ethnic and cultural diversity, we cannot ignore these economic and social realities and pretend that this option merely enhances everyone's choices," said Kheriaty.

Compassion & Choices is reaching out to minority communities in an effort to ease distrust over the law, utilizing bilingual workers of color to reach out to concerned residents.

Beyond California

After California’s right-to-die law was signed last October, Dan Diaz didn’t sit at home waiting for it to take effect. The next battleground state is New York. He’s been lobbying for a similar law, which passed a legislative committee less than three weeks ago.

--Image By Mercurywoodrose via Wikimedia Commons