Sacramento Bee

By Jim Sanders -- Bee Capitol Bureau
Published 2:15 am PDT Wednesday, April 13, 2005

California would become the second state to allow doctor-assisted suicide by patients with terminal illnesses under legislation that cleared its first hurdle Tuesday.

AB 654, which sparked emotional debate pitting the desire to preserve life against the desire to die with dignity, was approved 5-4 by the Assembly Judiciary Committee.

Focusing new attention on right-to-die issues, the bill reached its first hearing two weeks after the fight over Terri Schiavo's life captivated the nation and launched a legal frenzy.

Schiavo, a Florida woman in a persistent vegetative state who died two weeks after courts allowed her feeding tube to be removed, would not have qualified for doctor-assisted suicide under California's new bill.

But the Schiavo case raised new questions about whether politicians should intervene in life-and-death medical matters.

AB 654 would allow mentally competent patients who are not expected to live more than six months to obtain a prescription for life-ending medication.

"Too many dying patients are forced to end their lives under the legal and accepted practice of 'terminal sedation' - through starvation, under heavy sedation for weeks," said the bill's author, Assemblywoman Patty Berg, D-Eureka.

The measure pits assisted-suicide advocacy groups, the American Civil Liberties Union and the California chapter of the National Organization for Women against a variety of opponents, including the California Medical Association, the California Hospital Association and the California Catholic Conference.

Berg, who wrote the measure with Van Nuys Democrat Lloyd Levine, characterized AB 654 as expanding the rights of terminally ill patients to privacy and free choice.

But critics argue that government has an absolute obligation to preserve life. The bill creates a "slippery slope" that could be expanded in the future to cover patients with chronic but not fatal illnesses, they said.

Dr. Robert Miller, representing the Association of Northern California Oncologists, said prognoses are not infallible and that some patients could die unnecessarily under the measure.

"If my prognosis were wrong," he said, "the patient pays the ultimate penalty."

Supporters say the bill contains numerous safeguards to ensure that decisions about doctor-assisted suicide are not made frivolously or under duress.

The bill requires that two doctors agree on a patient's prognosis. It also requires a 15-day waiting period and mandates that patients receive counseling if they suffer from depression or other psychological disorders.

Patients must administer the life-ending medication to themselves.

Assemblyman Ray Haynes, R-Murrieta, said it could be difficult to prove in court that such safeguards were met.

"The witness that knows is deceased," he said.

Marilyn Golden, representing the Disability Rights, Education and Defense Fund, said terminally ill patients could be pushed - directly or indirectly - toward assisted suicide.

"If patients are denied other health care treatments, the choice of assisted death will be a phony form of freedom because patients, in effect, will be steered toward assisted death," she said.

Michael Sexton, president of the California Medical Association, said patients' best interests are served by appropriate pain therapy, end-of-life care and hospice services - not by assisted suicide.

But Alan Toy, a UCLA professor, applauded the proposed law. Patients already have the right to refuse medical treatment to prolong life, he said.

"There is very little difference between the right to refuse treatment to continue life and the right to obtain medication to end life," he said.

AB 654 is patterned after an Oregon law that took effect in 1997 and has been used by 208 terminally ill patients, roughly one of every 800 people who die in the state.

Former Oregon Gov. Barbara Roberts testified Tuesday that her state's assisted-suicide law has been used sparingly and effectively.

"The family stories have been beautiful accounts of compassion, sharing, dignity and gentle exits," Roberts said.

Gov. Arnold Schwarzenegger has taken no position on the bill.

Poignant examples of life-and-death decisions were provided by both sides in Tuesday's debate.

Levine said it was extremely painful to watch his grandmother die. In the final days, he said, her only options were to suffer debilitating pain or to take medication that sedated her to the point that she didn't recognize relatives.

"All I could think of was that there's got to be a better way," Levine said.

But Anthony Moreno, 41, said he is a living example of an erroneous diagnosis.

A bicycle accident at age 7 left him so badly injured that a doctor said he wouldn't live through the night, Moreno said.

More than three decades later, the Rohnert Park resident is married with three children.

About the writer:

The Bee's Jim Sanders can be reached at (916) 326-5538 or jsanders@sacbee.com.

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