By Timm Herdt, therdt@VenturaCountyStar.com
April 13, 2005
SACRAMENTO -- A curious thing happened in Oregon back in 1994 after an emotional statewide debate over a ballot initiative that led to the nation's first law permitting doctor-assisted suicide, says former Gov. Barbara Roberts.
"Dying was discussed over dinner and in bowling alleys, in hair salons and barbershops," Roberts told members of an Assembly committee on Tuesday. As a result, she said, people wrote their wills and gave loved ones the power of attorney to make healthcare choices for them if they became incapacitated. Hospice care was improved, and doctors became more aggressive in treating pain.
"It has become clear in our state that what we can talk about, we can make better."
Californians may need to prepare themselves for such conversations.
Two doctors needed
The Assembly Judiciary Committee voted 5-3 to approve a bill that would have California follow in Oregon's footsteps by making it legal for terminally ill patients to receive a fatal dose of drugs if two doctors agree to prescribe it after determining the patient has been informed of alternatives and is mentally competent to make a reasoned request for the drugs. The patient would have to personally take the drugs; they could not be injected or otherwise administered by a family member, nurse or anyone else.
Coming on the heels of the intense national focus on the issue of withholding intravenous food and water to comatose patients, inspired by Terri Schiavo's death, the debate on the issue of physician-assisted suicide was emotional and personal. Doctors, medical ethicists and advocates for the disabled testified on both sides.
Chairman Dave Jones, D-Sacramento, who cast the deciding vote, said he was swayed by the 11-year track record of the law in Oregon and also by personal experience.
"My grandfather wanted to make this choice," Jones said. "He begged us to make this choice for him, and we could not."
Start down a slippery slope
Opponents asserted that a law legalizing suicide under any circumstance would start the state down a slippery slope that would inevitably overwhelm the bill's safeguards and lead to doctor-administered fatal drugs and other forms of euthanasia.
"Legalizing suicide leads to ambiguity in the doctor-patient relationship," said Dr. Robert Miller, a Northern California cancer specialist. "It is the ultimate patient abandonment. ... It's bad law, bad ethics and bad medicine. It grants physicians a right we don't want and our patients don't need."
Opponents said the answer to difficult end-of-life situations is to ensure the patient has ample access to pain medication and the medical and spiritual support provided by high-quality hospice care.
"It is in this direction that our ethical compass clearly points," said Dr. Michael Sexton, president of the California Medical Association.
Supporters argued that the issue is a matter of personal choice.
"It's about autonomy," said Assemblywoman Patty Berg, D-Eureka, one of the bill's two authors. "It's about whether we will allow people to listen to the calling of their own conscience."
Patients want sense of control
Roberts said the Oregon experience has shown that what terminally ill patients want most is a sense of control. Over the past seven years, she noted, 208 Oregonians have taken fatal drugs prescribed for them, most of them end-stage cancer patients.
The bulk of those who have requested and then purchased the drugs, she said, "opted not to do it and died naturally."
Having the option, she said, calmed those patients' greatest fears. "The biggest issue for them was a loss of control, a loss of choice."
Twice before, California has considered the issue of legal suicide. In 1992, voters rejected an initiative that would have allowed doctors to administer fatal drugs to terminally ill patients who requested them. In 1999, a similar bill advanced to the Assembly floor but in the face of heavy opposition was never brought up for a vote.
Public opinion polls, including a California poll conducted in March, have consistently shown substantial support for the idea, but critics say such polls do not truly measure public sentiment.
"The polls always show support until the public is well educated," said Marilyn Golden of the California Disability Alliance.
The bill, AB 654, next goes to the Appropriations Committee. If it passes there, it faces an uncertain political future.
Democratic Assemblywoman Cindy Montanez of San Fernando joined two Republicans in voting no on Tuesday, and a second Democrat, Assemblywoman Nicole Parra of Bakersfield, issued a statement declaring her opposition. If Republican opposition were to hold firm, it would take only eight Democratic defections to defeat the measure.
Copyright 2005, Ventura County Star. All Rights Reserved.
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