Thursday, June 2, 2005
MEMBERS OF the California Assembly are about to cast one of the most innately personal votes they will ever make. It is not a comfortable subject. It is the issue of life and death.
The legislation, AB654 by Democrats Patty Berg of Eureka and Lloyd Levine of the San Fernando Valley, would establish strict guidelines for physician- assisted suicide in California.
Many Californians are outraged at the very notion of helping someone take his or her life, in any circumstance. Many physicians would want nothing to do with what they would regard as a direct violation of their Hippocratic oath. We respect those deeply held religious and moral objections.
The California Compassionate Choices Act approaches this delicate subject with the care and rigor it deserves. It is not designed to encourage physician- assisted suicide, but it does acknowledge its reality. It attempts to replace the uneasy and often unspoken interaction between doctor and patient with a clear process that encourages open communication and serious deliberation. It is modeled after a voter-approved Oregon law, which studies have found has not led to coercion of the elderly or terminally ill to take lethal drugs.
Under the Levine-Berg bill, the process would work this way:
-- A terminally ill California resident would have to request, in writing and by spoken word, medication to hasten the end of his or her life.
-- The physician then would be required to discuss the patient's medical diagnosis and prognosis, and to discuss alternatives to ease his or her final days -- such as comfort care, hospice care and pain control. The physician would also be required to refer the patient to another doctor for a second opinion.
-- Patients who were experiencing depression or other psychological disorders -- or were taking medication that could impair their judgment -- would not be eligible.
-- If the prescription is ordered, the patient would have to self- administer the medication.
An important value of this bill is the restraint and reflection that it requires of the terminally ill person who is ready to succumb to the physical and mental agony of impending death. In Oregon, where the Death with Dignity Act has been in effect since 1998, about a third of the 325 people who requested lethal drugs never took them. But they had the comfort of knowing they were in control of the final days of their lives -- and knowing they would not have to resort to a clumsy or violent method of suicide.
Many of us cannot answer the question of what circumstances, if any, would compel us to hasten the end of a battle with a terminal illness. It would be presumptuous, even cruel, to try to answer that searingly personal question for anyone else.
It should be an individual's choice, not the government's. The Assembly should pass AB654.
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