California Bill Would Fast-Track Assisted Suicide

Five years after California passed its assisted suicide law, state legislators are considering a bill that makes it easier to request lethal drugs.

California State capitol building in Sacramento.
California State capitol building in Sacramento. (photo: CC BY-SA 3.0)

SACRAMENTO, Calif. — Catholic leaders and disability rights activists have raised alarm over a bill moving through the California Legislature that would shorten the length of time needed between requests for lethal drugs and make assisted suicide permanently legal in the state.

Ned Dolejsi, interim executive director of the California Catholic Conference, told the Register SB 380 is “an ideologically driven bill,” adding, “it’s not protecting people who are vulnerable and it’s not protecting the common good.” 

Under SB 380, patients with a terminal illness who are expected to die within six months would be allowed to receive a lethal prescription by making two requests separated by 48 hours. Current law mandates a 15-day waiting period between requests. Patients would also no longer need to make a final attestation before their death. 

SB 380 would also eliminate a sunset provision in the End of Life Option Act, which legalized assisted suicide, that would have ended the law in 2026. 

State Sen. Susan Talamantes Eggman, D-Stockton, who as an Assembly member helped pass the state’s End of Life Option Act in 2015, introduced the new bill. Compassion & Choices Action Network, the lobbying arm of the assisted suicide advocacy organization, is the bill’s organizational sponsor. SB 380 passed the state Senate May 28 and has moved to the Assembly. 

“Now is the time to remove the sunset, address impediments to access while preserving essential safeguards,” Eggman said in a statement. According to the senator, the state’s assisted suicide law “requires individuals and their health-care team to comply with a lengthy and administratively burdensome multi-step process.” 

“The empirical and anecdotal data collected shows that the current process is unnecessarily cumbersome, with too many roadblocks for many dying patients to access the law,” she said.

California’s Department of Public Health indicated in its most recent report on assisted suicide that 405 people died in 2019 from taking a lethal prescription. Seven-hundred thirty-six people started the process of requesting lethal drugs that year and doctors wrote 618 prescriptions for them. 

Dolejsi said California lawmakers passed the End of Life Option Act in 2015 because of amendments, including the sunset provision, that promised to protect people at a vulnerable point in their lives. 

“Now we find ourselves six years later fighting a retraction of every argument proponents offered to pass the bill. All of those safeguards are now presented as obstacles,” he said. 


‘Strong and Dramatic Opposition’

The California Catholic Conference and other opponents of the legislation are “mounting a strong and dramatic opposition to the bill” as it moves through the Assembly, Dolejsi said. 

Dolejsi said people should be concerned how the state was putting a priority on assisted suicide rather than fix existing barriers to quality health care laid bare by COVID-19.

As the pandemic ran through the state, the disparity in health care available to racial minorities “was palpable” and should lead to a renewed focus on addressing access to health care and insurance for all, Dolejsi said. The difficulties with mental health and the challenges involved in addressing it also became more apparent during lockdown, he said. 

“Do we want to take a look at the emotional and mental realities that emerged as we worked our way through this as a society, or do we want to have a conversation about how more people can be taking their lives?” he said. 

Kathleen Buckley Domingo, director of the Archdiocese of Los Angeles’s Office of Life, Justice and Peace, agreed. 

“We’ve seen the effect of loneliness and fear on mental health,” she told the Register. “At this moment, to propose a faster way for people to take their life is just unconscionable.”

Domingo said losing the sunset provision means the state Legislature will not be able to hold a debate about the continuing place of assisted suicide in California. 

“Our goal was that in 10 years, when the bill sunsetted, we wanted to make California a place where people don't want or need this. That means good palliative care, good hospice care,” she said. “At this point, to remove the sunset is to really undermine the will of legislators who approved of this because they knew they would have a second chance to take a look at it.”

Domingo said California legislators should instead focus on bolstering palliative care and hospices. The state’s Catholic health care system “has made significant improvements” in palliative care and offers “excellent resources,” she said, and urged legislators to direct more funding for end of life care. 

“It doesn't make sense we would offer one option and not the other,” she said. 


Dangerous Public Policy

In an op-ed published in California’s Capitol Weekly, Marilyn Golden, senior policy analyst for the Disability Rights Education and Defense Fund, said, “This rush to erode the safeguards included in the 2015 End of Life Option Act is dangerous public policy. There is simply no data or science to support removing them so soon.” 

Golden said the mandated yearly state report on the use of assisted suicide includes no information about why people choose to end their lives. The state’s report indicated the insurance coverage of 10% of patients requesting lethal drugs was “unknown” and it could not verify whether 7% had been informed about palliative care. 

“Indeed, with the benefit of hindsight, it appears that the protections proponents touted as safeguards were no more than a ruse to get the original law passed,” she said. 

So far, nine states, plus the District of Columbia, have legalized assisted suicide. Oregon was the first state to enact a law in 1997. Six states legalized assisted suicide in the past five years. 

A 2019 report by the federal National Council on Disability found that safeguards in assisted suicide laws “are ineffective, and often fail to protect patients in a variety of ways.” 

The report highlighted the denial of expensive treatments by insurance companies that offer to subsidize lethal drugs, misdiagnosing terminal illness, financial and emotional pressure, demoralization in people with disabilities, and the risk of assisted suicide to people suffering from depression.

Assisted suicide laws also lack strong oversight protections, according to the report, which criticized the laws’ lack of data collection and of ways to investigate abuse. 

Diane Coleman, president and CEO of disability rights group Not Dead Yet, told the Register that state bills put forward recently have tried to undo restrictions on assisted suicide, through redefining who can apply for lethal drugs, expanding who can prescribe them, and reducing the waiting period between requests for a lethal prescription. 

“A significant number of bills are introduced each year, but diverse coalitions of opponents have managed to defeat almost all of them year after year, though not all,” Coleman said. “But as proponents of assisted suicide make those limited gains, now they’re trying to expand eligibility and reduce the already weak safeguards, so we need to fight that as well, so far successfully.” 

Assisted suicide laws “are just an expression of the devaluation of people with disabilities,” Coleman said. The reasons most often cited by people who choose assisted suicide are disability issues, she said, such as feeling like a burden, a sense of losing autonomy or dignity, or the inability to do what they used to.

She said, “It isn’t a leap to sweep in people with non-terminal disabilities, as well.”

Nicholas Wolfram Smith is a Register correspondent.