SACRAMENTO, Calif. — The California State Assembly has taken the state closer to legalizing assisted suicide May 29 by passing the Right to Know End-of-Life Options Act.

The bill, Assembly Bill No. 2747, is designed to sneak assisted suicide into law by replacing lethal drugs with the option of starvation. The measure passed by two votes and is headed for the State Senate.

The End of Life bill, written by assembly members Patty Berg and Lloyd Levine, changes the method of assisted suicide by mandating that physicians, nurse practitioners and physician-assistants, if asked, inform patients diagnosed with a year or less to live or with terminal illnesses about medical options that hasten death, including “voluntary stopping of eating and drinking” (VSED) orders, and “palliative sedation,” allowing patients to starve and dehydrate and be unable to communicate.

At least three assisted-suicide bills by Berg (a Catholic) and Levine have been defeated.

William May, chairman of Catholics for the Common Good, said the End of Life legislation is “extremely dangerous” because it sneaks in assisted suicide.

“They are trying to make the voluntary stopping of eating and drinking a ‘medical treatment,’ linking it with palliative sedation, where a person is sedated to the point of unconsciousness, after trying to pass a more direct bill allowing doctors to write lethal prescriptions.”

May said he knows who is behind this legislation.

“They authorize agencies that counsel people on end-of-life options and one of those agencies is Compassion & Choices, which used to be the Hemlock Society.”

The Hemlock Society, an organization devoted to assisting interested parties in suicide as well as in passing suicide legislation, changed its name to Compassion & Choices in 2003.

Reluctant to predict whether or not it will pass, May is concerned about the bill’s latest supporter: the California Medical Association.

“They are now supporting the bill,” May said, “but the group most staunchly opposed to it is the Association of Northern California Oncologists — cancer doctors who are experienced with the dying.”

San Francisco Archbishop George Niederauer and Oakland’s Bishop Allen Vigneron are advisers to Catholics for the Common Good. May also credits the California Catholic Conference for their opposition to the End of Life Bill.

“We’ve had to educate a lot of legislators to help them understand it because it’s not obvious when you read the bill,” he said. “It’s deceptive.”


Potential Problems

California Catholic Conference spokeswoman Carol Hogan agreed that the language is deceptive.

“Starting right off with the first paragraph, the bill said that when a person receives a terminal diagnosis or a prognosis of one year or less. Many chronic illnesses are terminal, but you can live a lot longer than one year with them. That or is huge. Most people don’t read it that way. They think it means a terminal diagnosis and a year to live, but it’s or.”

Hogan sees many potential problems.

“Oncologists have asked them to remove the language about voluntary stopping of eating and drinking and palliative sedation, but they won’t change it,” she said. “These are people who deal with dying patients. It’s irresponsible and very poorly written. Lower-income people and disabled are the ones most likely to be encouraged to end their lives with this statute.

Hogan hopes the bill will be defeated but said that it has a better chance of passing than previous bills. “A similar bill was introduced in Vermont but it failed,” she said. “This is being backed by Compassion & Choices and they have a national strategy.”

Will Shuck, chief of staff for Assemblywoman Patty Berg, doesn’t understand why anyone would object to the End of Life Bill. “The goal is that dying people have as much information as they need.”

Rita Marker is the author of one of the definitive texts on euthanasia, Deadly Compassion, as well as the founder of the International Task Force on Euthanasia and Assisted Suicide.

“It’s a really insidious type of bill — virtually identical to the bill in Vermont, a stalking horse for assisted suicide,” she said of the End of Life Bill. “Technically and legally it’s not an assisted-suicide bill, but ethically it is. Assisted-suicide laws give doctors the right to prescribe a deadly overdose. This bill is extremely dangerous for a number of reasons.”

For one thing, she said, it includes voluntary stoppage of eating and drinking. “Now that’s never been a legitimate medical option. People may think that means tube feeding. But this means the meals that come on a tray.”

She also said it relies on a nonsensical formula, “Any physician worth his or her medical degree will acknowledge that they can’t tell you whether a patient is going to die in six months and they certainly can’t tell you if a patient is going to die in a year.”

Shuck argues the bill changes nothing in the existing definition of terminal illness.

“That’s how people qualify for hospice care,” he said. “The prognosis period for qualifying for hospice is a year, which is the same period allotted in the bill. I don’t know that you need a lot of protection from information.”

But Marker counters, “What they will tell you is that on the average, people with a certain condition at a certain age have this much longer to go. But that’s like saying the average family has 2.4 children.”


Long-Term Strategy?

For Marker, the ambiguity of a patient asking what their medical options are is the key to the deception. “What terminal patient isn’t going to ask what their options are? They’re told that one of their options is Voluntary Stopping of Eating and Drinking, but they will be given drugs to keep them from feeling starvation or dehydration. It’s a self-fulfilling prophecy.”

He said that the bill will result in patients being given fact sheets from suicide groups.

Marker believes that these organizations will advance their agenda should the End of Life bill pass. To do so, these organizations are promoting a practice they once opposed.

“The assisted suicide people have long pointed to withholding food and drink as a very cruel way to die, hoping that the law would allow for a lethal injection or overdose,” she said. “So they promote this sort of thing, then they can claim that it would be cruel not to allow doctors to make lethal prescriptions.”

Will Shuck also points out that the information would only be offered if the patient asked for it. “If the patient said, ‘I want more information,’ this bills said that you need to answer the questions. This is an issue of physicians respecting their patients enough to answer their questions. Yet we have all these people trying to stop this because of their religious beliefs.”

Marker finds Shuck’s argument hollow.

“You are going to be just as dead whether you are baptized, bar mitzvahed or an atheist if you don’t eat or drink anything.”

She said, “Anyone with a terminal diagnosis is going to ask, ‘What can I do? What’s available?’ When a person asks, ‘What can I do?’ they might be wondering if chemotherapy or surgery might help. Instead, they are going to be hit with a whole bucket of things, not limited to treatment and care with the possibility of a cure.”

Underprivileged patients will be hurt the most because the suicide option will seem like all that is available to them, said Marker.

“The poor are the most likely to be victimized by this,” she said, “because these are people who don’t have a lot of access to medical care.”


Robert Kumpel is based in

Valdosta, Georgia.