Why Brittany Maynard’s Home State Couldn’t Pass Assisted-Suicide Bill

NEWS ANALYSIS: After opponents raised concerns about the California bill's impact on vulnerable patients, including poor immigrants, it stalled in the state assembly.

(photo: ahardpill.org)

SACRAMENTO, Calif. — Last fall, Brittany Maynard’s effort to legalize physician-assisted suicide in California looked like a slam dunk.

An attractive and sympathetic young married woman diagnosed with terminal brain cancer, Maynard’s story was widely covered on television and social media. From Oprah to YouTube, she applauded the “death with dignity” law in Oregon and urged her fellow Californians to pass similar legislation so that patients with terminal illnesses would not suffer needlessly.

Maynard died in November 2014, after moving to Oregon, where she received lethal drugs to end her life. But her legislative mission was on track this June, when the California Senate passed S.B. 128, The End-of-Life Options Act, which would permit physicians to provide medication to cut short the dying process for some patients.

Yet on July 7, sponsors of the legislation announced they had pulled the bill, after it faced unexpected headwinds in the California Assembly’s Committee on Health. At that time, the Sacramento Bee had conducted an informal poll of the 19 committee members, and only four were prepared to support the bill in its present form.

At press time, it wasn’t clear if the measure could be brought back to the assembly in August or whether it might be introduced as a ballot initiative in 2016.

Why did the proposed measure lose political traction? For now, legislators, community leaders and commentators on both sides of the issue dispute the reasons for the bill’s defeat.

Proponents contend that the Catholic Church influenced Latino members of the assembly committee to block the measure, while representatives of Californians Against Assisted Suicide, a coalition opposing the bill, suggest that grassroots resistance, especially among poor immigrants, was more widespread than reflected in media coverage.

“A handful of southern California Democrats, mostly Latinos under pressure from the Catholic Church, are withholding support,” was how Los Angeles Times columnist George Skelton framed the political defeat.

However, Bishop Kevin Vann of the Diocese of Orange disputed that assessment.

“If you look at the people who led the coalition to oppose the bill, it was not the Diocese of Orange or the California Catholic Conference,” Bishop Vann told the Register.

“The coalition represents folks” who don’t agree with all the Church’s teachings, he said, “but together we showed that suffering during the end of life is not necessary, with hospice and palliative care. We were one of many organizations that were part of the coalition.”


Broad Opposition Coalition

Comprised of disability-rights activists, health-care professionals, hospice advocates and other faith-based organizations, the coalition — similar to the unified effort in Connecticut that has defeated assisted-suicide legislation for three consecutive years — sought to challenge Maynard’s message that terminally ill patients are doomed to a painful death in a lonely hospital room.

The California coalition also presented a second message that clearly hit a nerve: Legalized assisted suicide poses a threat to vulnerable patients, especially as governments and health-insurance companies seek to contain the costs associated with end-of-life care for an aging population. Those most at risk are the elderly, the physically and mentally disabled and the poor.

“Brittany Maynard, the main inspiration behind the bill, has a compelling story,” said Elliott Lapin, a wheelchair-bound college student at Stanford University, in a July 6 op-ed for the Sacramento Bee that urged state legislators to “block” the bill.

“But the desire to ease the suffering of people like her does not justify the avoidable loss of life that will happen if this measure is passed,” added Lapin, who reflected on the moments of despair and hope that shaped his own life as a physically disabled teenager.

Meanwhile, Latinos in the state legislature expressed their own reservations in personal terms.

“This was a very difficult vote for me, especially with the passing of my sister from cancer late last year. Her long fight against this terrible disease made this issue much more personal,” state Sen. Tony Mendoza, D-Artesia, told the Register.

“However, I was concerned that there were not enough safeguards in the bill to ensure that an assisted suicide would be done in a safe, humane and necessary manner, and for the right reasons.

"This is why I voted No on S.B. 128.” 

One assembly member, Jimmy Gomez, D-Los Angeles, issued a statement that linked his objections to his experience caring for his late father.

His father, said Gomez, had relied on his son to make up for his poor English as he completed medical treatment for pancreatic cancer. In his statement, Gomez said he needed to better evaluate how legalized assisted suicide might affect struggling Latinos and other immigrants, who might be unfamiliar with the choices available in the U.S. health-care system.


Compelling Personal Stories

Abel Sanchez, an accountant who leads the Orange chapter of the Catholic Association of Latino Leaders (CALL), told the Register that Maynard’s effort to control the dying process collided with the experience and values of many Latino Americans.

“We don’t put our elderly in a convalescent home. We take care of them,” noted Sanchez, who said he could not imagine “suggesting to my mother or grandmother: ‘How about taking this death pill?’”

Legislators who opposed the bill, said Sanchez, registered their constituents’ fears that poor patients could be victimized if the taboo against this physician-assisted suicide was lifted.

The Catholic Church had made its position clear, Sanchez agreed. But the assembly members responded to a range of issues posed by the legislation.

“When was the last time a liberal Democrat in the state of California listed the Catholic Church as the excuse for a social position?” asked Sanchez.

Pressed to explain why the Church had been identified as the driving force against the bill, Sanchez speculated that its proponents were trying to “blame the Church” for the outcome.

“For their constituents, the support of the Church looks bad,” he said.  “They are probably trying to make a separation-of-church-and-state argument, but I don’t understand why a Catholic or any Christian doesn’t have the right to have his or her opinion matter in a democracy.”

Still, the Latino assembly members' reservations about the bill exposed fissures within the state Democratic Party. And those who did speak on the record took care not to present their views in religious language.

“You’ve got to look at what I’ve done before the legislature ... working to help save and protect peoples’ lives,” Freddie Rodriguez, D-Pomona, a member of the assembly’s Committee for Health and an emergency medical technician, told the Bee on July 7.

“Letting folks have that option to end their life: It’s just something I can’t come to grips with,” added Rodriguez, who also noted his “pro-choice” record on abortion.

Despite his stance on abortion, Rodriguez’s view on assisted suicide reflects the principles that undergird Catholic medical ethics. Church teaching rejects assisted suicide as a grave moral evil and a reflection of a utilitarian ethos, which ignores the dignity inherent in every human person and instead subjects vulnerable patients to a cost-benefit analysis that discards those judged unworthy of life.


No Appeal for Poor Patients

Each assembly member “has their own particular view of what motivated them not to vote for the bill,” acknowledged Ned Dolejsi, the executive director of the California Catholic Conference.

“A common denominator may be the fact that their constituents come from districts with heavily subsidized public health,” said Dolejsi.

The issue of physician-assisted suicide “plays positively in communities that have many choices and are used to having many choices,” noted Dolejsi, who cited research collected in a number of states where Brittany Maynard’s story has gained political traction.

“But people who are struggling to exercise choices [in a health-care setting] do not view this as positively, and the same holds true … for the disability-rights community.”

Dolejsi said that political coalitions opposing physician-assisted suicide in other states had identified similar tensions and anxieties within the body politic. When asked about end-of-life concerns, people in poor communities were more likely to push for “more choices in medication, palliative care or nursing homes — not whether I can get a doctor to help me kill myself.”

Tim Rosales, a spokesman for the Coalition Against Assisted Suicide, suggested the attempt to blame the Church for the bill’s defeat was a transparent effort by the sponsors to deflect responsibility for failing to address the concerns that have surfaced since the legislation was introduced in January.

“One lesson we have learned is that even in a high-profile assisted-suicide case that had so much momentum, once people understand the nuts and bolts of the issue, and consider how it could play out in the day-to-day health-care environment, public perception starts to move against it,” Rosales told the Register.


Keeping Concerns in Focus

Going forward, Rosales said, “There is a need for all of the opponents of the bill to be out front and demonstrate why they are opposed. There is a critical need for people to tell their stories and to really get into this complex issue that involves life and death and shouldn’t be relegated to quick sound bites.”

But members of the coalition must also stay on their toes, in case the bill’s sponsors, California Sens. Lois Wolk, D-Davis, and William Monning, D-Carmel, decide to bring it back in August. The two lawmakers have said they will meet with the assembly members “to ensure they are comfortable with the bill.”

Latino leaders who back the bill have also suggested that lingering concerns could be neutralized if physician-assisted suicide is reframed as a basic civil right that can only be exercised by the patient in consultation with their doctor.

In a statement released to the public, union organizer Dolores Huerta outlined the new message: “This is a basic civil-rights issue offering a compassionate and dignified end-of-life choice that should be left between a patient and doctor.”

Joan Frawley Desmond is the Register’s senior editor.