Monday, December 20, 2004
By Kate Folmar
Mercury News Sacramento Bureau
Alana Forrest remembers her dad as the kind of man who built his own home on a 40-acre plot he found in the Oregon woods. James Forrest was a daredevil who raced vintage motorcycles well into his 60s, a man so vigorous that few would have ever guessed he would be a candidate for physician-assisted suicide.
But something changed when he turned 72, remembers Forrest's daughter, a San Jose resident. His left arm weakened. A limp stilted his gait. Half of his once-handsome face drooped.
Alana Forrest called the doctors for more details: An inoperable brain tumor was quickly killing her father. He had weeks left, maybe a few months. As a resident of Oregon, the only state where physician-assisted suicide is legal, James Forrest set out to control his death. He settled his affairs, made amends with family and friends and found homes for his dogs.
Next year, two California lawmakers will try to legalize physician-assisted suicide in the state even as the Bush administration asks the U.S. Supreme Court to block Oregon's law. Under current California law, it is a felony to help someone end his or her life.
Similar efforts have failed twice before, but advocates hope that Oregon's experience and better end-of-life training for doctors will make a difference this time around.
From 1998 to 2003, 171 terminally ill Oregonians hastened their deaths using a prescription from their doctors. James Forrest was one of them.
Oct. 14, 2002, lying in a hospital bed placed in his living room with a view of the firs and pines outside, Forrest swallowed fast-acting barbiturates. As his eyes closed, he was surrounded by his brother, dogs and daughter. Soon, he started to snore. Within about five minutes, he died.
``He's a proud man. He didn't want to lose any dignity,'' recalled Alana Forrest, a captain with the Los Gatos-Monte Sereno Police Department. ``It was a very peaceful way to go.''
Early next year, California Assembly members Patty Berg, D-Santa Rosa, and Lloyd Levine, D-Van Nuys, plan to hold two public hearings and introduce a bill modeled on Oregon's Death With Dignity Act. They are working with the Oregon group Compassion & Choices, which advocated for that state's law.
The measure is expected to prompt a rare conscience debate in the often-partisan Capitol -- with votes determined more by religious convictions, moral beliefs and family stories than by the ``D'' or ``R'' beside a lawmaker's name.
Still, even before formal introduction, the bill is facing early opposition from the Roman Catholic Church, which asserts that only God should determine life and death, and from the powerful California Medical Association, which contends that doctors must help sustain life, not end it.
``What's the role of the medical profession?'' asked San Mateo oncologist H. Rex Greene, who has found that most patients who initially ask him for help ending their lives change their minds with counseling, pain care and hospice services. ``Is it to provide suicide on demand to people who are depressed, or is it to thwart suicide?''
If the measure eventually passes in the Assembly and Senate, it is hard to guess whether Gov. Arnold Schwarzenegger will sign it. A Catholic who breaks with church orthodoxy on some social issues, Schwarzenegger has not spoken publicly about physician-assisted suicide since taking office.
Berg, who also is Roman Catholic, prefers to describe the measure as ``aid-in-dying'' for the terminally ill. Almost 18 years ago, she watched her physician husband struggle through the final degeneration of diabetes before dying of a stroke. They had discussed her husband's desire to die on his own terms, but physician-assisted suicide was not available to him.
The legislation's aim is ``to help people who have run out of help -- people with no hope of recovery,'' she said. ``I believe both that they should be able to ease their own passing or have the comfort of knowing that option is there for them. We spend more time planning for a two-week vacation than for our own death.''
In Oregon, where voters have twice endorsed the practice, it is used infrequently. Since the law took effect in 1997, the state department of health reports, just one-seventh of 1 percent of Oregon deaths are physician-assisted suicides.
For a few of the terminally ill, physician-assisted suicide is ``the key out of the locked room,'' said Dr. Robert Brody, who heads the Pain Consultation Clinic at San Francisco General Hospital.
Oregon's law, which is a template for the California bill, does not permit euthanasia -- where a doctor or someone else administers fatal medication. Rather, it allows adults with less than six months to live to receive life-ending medicine from a doctor and take it themselves.
First, they must be determined mentally competent, see two doctors, make written and oral requests for the medicine and wait through a cooling-off period. Doctors with moral or personal objections to suicide are not compelled to write such a prescription. Only the patient can make the decision, not a family member or guardian.
Attempts at safeguards notwithstanding, Ned Dolejsi, executive director of the California Catholic Conference, is appalled that the concept is coming back. Any suicide, he said, is a ``failure of all of us.''
``We believe that life is a gift from God, from conception to natural death,'' he said. ``Society has always viewed it as not a good thing to have people going and killing themselves. It's certainly not a good thing for doctors to help them kill themselves.''
Public opinion is varied. The most current Field Poll on the matter, conducted in 1999, found that 75 percent of California adults believed incurably ill patients should have a ``right to ask for and get life-ending medication.'' National polls range from slight opposition to significant support for physician-assisted suicide.
``It's a matter of, `Gee, we'd like that choice to be there even if we'd never do it ourselves,' '' said John Benson, managing director of the Harvard Opinion Research Program at the university's school of public health.
Whether that sentiment will help make California the second state to allow physician-assisted suicide is unclear. In 1992, California voters rejected Proposition 161, which would have allowed both euthanasia and physician-assisted suicide. In 1999, Assemblywoman Dion Aroner, D-Berkeley, tried to pass a law allowing doctors to prescribe medicine that would speed the deaths of terminally ill patients. But she dropped the measure for lack of support and settled for a law that mandates that doctors be better trained in pain-relief and end-of-life care.
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