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CURRENT ISSUE:  April 9, 2007 • VOL. 45, NO. 7 • Oakland, CA

Assisted suicide bill moves forward

Opponents of a bill legalizing assisted suicide march in downtown Los Angeles March 21.

Cardinal Roger M. Mahony of Los Angeles took the occasion of the second anniversary of Pope John Paul II’s death April 2 to call proposed assisted-suicide legislation in California an “assault on life.”

“If Pope John Paul were standing here right now, he’d say, ‘We must not go down that path,’” the cardinal said at the noon Mass in the Cathedral of Our Lady of the Angels.

He urged parishioners in the nation’s largest Roman Catholic archdiocese and throughout the state to pressure Sacramento legislators “to vote down…this attack on life.”

The cardinal leveled unusually sharp criticism at one of the bill’s prominent sponsors, Assembly Speaker Fabian Nunez, D-Los Angeles, a Catholic, who recently met with the cardinal to discuss the legislation. Cardinal Mahony said he was saddened and confused by Nunez’s decision to endorse physician-assisted suicide.

“We should be troubled at his support,” the cardinal said of Nunez. “Somehow, he has not understood the culture of life.”

The legislation that would allow doctors to prescribe life-ending drugs to terminally ill patients passed the state Assembly’s Judiciary Committee March 27, after a lengthy hearing with passionate testimony offered by both sides.

The Judiciary Committee’s vote came down along party lines, with seven Democrats voting for the bill and three Republicans voting against. It is the third time the committee has approved essentially the same bill since 1999.

AB 374, called the California Compassionate Choices Act, is co-authored by Assemblywoman Patty Berg, D-Eureka, who is Catholic, and Assemblyman Lloyd Levine, D-Sherman Oaks.

The bill contains language identical to legislation sponsored by Berg and Levine that died in a Senate committee last June. It would allow a physician to prescribe a self-administered, life-ending drug for an adult who requested it and had been found by two doctors to be mentally competent and within six months of death.

The bill, which would require all state agencies to refer to assisted suicide as “aid-in-dying,” is similar to the nine-year-old Oregon law upheld by the U.S. Supreme Court last year.

During the hearing, Berg promoted the bill as an issue of privacy and choice. Those testifying in support said the bill would allow dying patients to avoid pain and debilitating conditions in the last stages of their lives.

Tom McDonald, a 77-year-old Lake Oroville resident, told committee members that he is dying of melanoma, a form of skin cancer. He said the bill would “give me the chance to have a peaceful death, looking presentable with my wife, daughter and son beside me. Don’t condemn me to a death that is so insidious, with unbelievable pain and no relief.”

Dr. Jay Cohen, representing the California Association of Physician Groups, which supports AB 374, noted that the measure has divided the medical community. “We can’t forget that patient care is all about the patient,” he said.

Opponents in their testimony said AB 374 would devalue life and could prompt some patients to hasten their death because the cost of health care would make them believe they were a burden to their families. They also cited the lack of safeguards in the bill and questioned whether doctors were always accurate in their predictions of how long “terminally ill” patients had to live.

“I think we get the diagnosis correct, but it’s the prognosis that’s often difficult,” said Dr. Richard Frankenstein, president-elect of the California Medical Association, which opposes AB 374.

“The concerns of patients near the end of life are important, but issues they face, whether they are pain or other symptoms, can virtually always be substantially eased or eliminated by the judicial use of pain management techniques,” he added.

The California Medical Association claims the bill would compromise medical ethics because assisting in someone’s death is in direct conflict with a doctor’s ethical duties. The group also says the bill could create a “slippery slope” toward allowing fatal prescriptions for people suffering from major disabilities or chronic but non-terminal illnesses.

Holly Swiger, a board member of the California Hospice and Palliative Care Association, said approving physician-assisted suicide “would be sending a message to the public that we’re not willing to do harder work to assure pain and symptom management at the end of life.”

“This type of care is available, but is not made available to the majority of the terminally ill,” she said.
Marilyn Golden, a policy analyst with the Disability Rights Education Fund, said the data from nine years of physician-assisted suicide in Oregon “still leaves too many unanswered questions.”

“Those who back this bill say there would be no significant impact on people with disabilities,” she
said. “But in reality there is no clear distinction between people who are terminally ill and people with a chronic illness. There is a significant danger that many people would take the ‘escape’ of assisted suicide due to external pressure.”

Catherine Campisi, director of the California Department of Rehabilitation from 1999 to 2006, stated at the hearing that she has joined Californians Against Assisted Suicide, a coalition of medical, ethical and disability rights groups fighting the effort to legalize physician-assisted suicide.

Assisted suicide “is a direct threat to anyone that is viewed as a significant cost liability to public or private health care providers,” Campisi, a member of St. Anthony Parish in Sacramento, said in a press release.

She added that assisted suicide has far more potential to do harm than good to thousands of Californians facing serious illness or disability that may be defined as terminal.

“While it is understandable that people in such situations may greatly fear loss of autonomy or being a burden emotionally or financially on their family, assisted suicide is not the solution since it poses such great risks to vulnerable people,” she said. “Increasing access and information to quality counseling, hospice and palliative care for those with an illness defined as terminal are far sounder public policy options than the legalization of assisted suicide.”

Legislators on the committee questioned the proponents of AB 374 on the issues of “doctor shopping,” misdiagnosis and prognosis of terminal illness, and the lack of oversight contained in the legislation.
Assemblyman Rick Keene, R-Chico, contended that some patients could kill themselves after receiving a mistaken prognosis of how long they would survive.

“If we are going to err, I want to err on the side of providing access to better quality of life for patients in this circumstance,” he said. “In my experience, we have better options than this. The people where we have made a mistake, they’re dead, they’re gone.”

Assemblyman Anthony Adams, R-Hesperia, said he has a moral obligation to defend life.

“My morality is an absolute,” he said. “I’m going to stand firm in my belief that life is an absolute, that it’s a fundamental right.”

Assemblyman Mike Feuer, D-Los Angeles, opposed Adams’ view, saying he didn’t see an ethical distinction between a patient choosing to withhold medical treatment and physician aid-in-dying.

In addition to the California Catholic Conference, members of the Californians Against Assisted Suicide opposing AB 374 include the Alliance of Catholic Healthcare, the National Council on Disability, the League of United Latin American Citizens, the American Academy of Medical Ethics, the Center for Bioethics and Culture Network, Not Dead Yet and about three dozen other organizations.

Among the organizations in favor of AB 374 are the American Civil Liberties Union, the California National Organization for Women, the Congress of California Seniors, the National Council of Social Workers and the National Council of Jewish Women.

AB 374 now moves to the Assembly Appropriations Committee, where a date for a hearing has not yet been announced.



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