California To Permit Medically Assisted Suicide As Of June 9

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**Co'tor Shas**

California Gov. Jerry Brown signed landmark legislation last October that would allow terminally ill people to request life-ending medication from their physicians.

But no one knew when the law would take effect, because of the unusual way in which the law was passed — in a legislative "extraordinary session" called by Brown. The bill could not go into effect until 90 days after that session adjourned.

The session closed Thursday, which means the End of Life Option Act will go into effect June 9.

"We're glad to finally have arrived at this day where we have a date certain," says Sen. Bill Monning, D-Carmel.

"It's a historic achievement for California, and for a limited universe of people dealing with a terminal illness," Monning says. "It could indeed be a transformative way of giving them the option of a compassionate end-of-life process."

Disability-rights advocates fought hard last year against passage of the legislative act, and they continue to voice concern.

Marilyn Golden, senior policy analyst with the Disability Rights Education & Defense Fund, says it would be impossible to know, for example, if a depressed patient went to many doctors — who all denied the request for lethal medication — before finding one who agreed to write the prescription.

"We are looking ahead at measures to protect people from abuse," Golden says, "and to explore and inform doctors, nurses and pharmacists that they don't have to participate."

As written, the law requires two doctors to agree, before prescribing the drugs, that a patient has six months or less to live. Patients must be able to swallow the medication themselves and must affirm in writing, 48 hours before taking the medication, that they will do so.

California is the fifth state to permit this option at the end of life. It joins Vermont, Oregon, Washington and Montana.

Across the state, some patients with advanced cancer welcomed the news.

"It gives me a great peace of mind to know that I will not be forced to die slowly and painfully," says Elizabeth Wallner, in a release from Compassion & Choices, an aid-in-dying advocacy group. Wallner, 52, of Sacramento, is a single mother with stage 4 colon cancer that has spread to her liver and lungs.

"It gives great comfort to know that the agonizingly traumatic image of me suffering will not be my family's last memory of me," she says.

Monning says he's grateful to people who worked for passage of the law, some in their final days:

Brittany Maynard, an Orange County, Calif., woman with brain cancer, moved to Oregon to take advantage of laws there that allowed her to get lethal medication. Before she died in 2014, she recorded a video that was shown during hearings on the End of Life Option Act in Sacramento.
Jennifer Glass, of San Mateo, Calif., helped to launch the campaign in 2014, then died of lung cancer last year.
Christy O'Donnell, 47, of Los Angeles, died of lung cancer last month.
"I really believe," Monning says, "we use today to mark and dedicate the memory of some true champions."

This story was produced by member station KQED's blog State of Health.

http://www.npr.org/sections/health-shots/2016/03/10/469970753/californias-law-on-medically-assisted-suicide-to-take-effect-june-9

**djones520**

Can't say I'm against this.

**reds8n**

.....somewhat surprised they didn't wait until Nov. 9th -- just in case

**Deadshot**

Can't wait to see how this will blow up. My guess is the superchristians the US seems full of, specifically nurses and doctors, refusing to work and be party and refusing to allow it.

**TheWaspinator**

This is one of those things that, while it's an unpleasant and depressing subject, I have to admit makes a lot of sense. There are some really horrible ways to die and I can understand wanting to avoid them.

**Hulksmash**

Yep, going out after a proper goodbye with family and friends when you don't have to go thru the final, to painful, terminal stages just makes sense. Also helps those who love you remember you at your best instead of as a shell of who you were.

**Co'tor Shas**

I know some dementia patients have pushed for this so that they can die, still being who they are. And so their friends and families don't have to suffer watching them degenerate.

**Mr. Burning**

A dignified exit is something many of us would prefer, and would prefer to be an option that is legally available.

**Do_I_Not_Like_That**

I agree with what you guys are saying, but as always with this issue, I feel a deep sense of unease.

Humans being humans, somebody will be 'persuaded' to seek assisted suicide, just so a relative can get their hands on their house or money....

**Sinful Hero**

Hopefully more states will begin to follow suit.

**OrlandotheTechnicoloured**

I really hope they are strict about the 6 months to live bit

(ie there are no instances of a person with this diagnosis living longer than 6 months, ever, as opposed to on average 51% of people with this die within 6 months)

Otherwise a fear a fair number of deaths of those seeking not to be a burden on their families, or use up their kids inheritance on medical care

**DarkTraveler777**

Do_I_Not_Like_That wrote:
I agree with what you guys are saying, but as always with this issue, I feel a deep sense of unease.

Humans being humans, somebody will be 'persuaded' to seek assisted suicide, just so a relative can get their hands on their house or money....

Sure, there likely will be some abuses that occur and those people can face the consequences of their criminal actions when such abuses come to light. I don't think the possibility of abuse should prevent a law like this from going into effect, however. Giving terminal patients a means to dictate when and how they die should be looked at as another form of treatment.

Looking at the existent Death with Dignity law in Oregon there are built in protections for patients to avoid coercion:

https://www.deathwithdignity.org/faqs/

Patients must meet stringent eligibility requirements, including being an adult, state resident, mentally competent, and having a terminal diagnosis with a 6-month prognosis.

Only the patient him or herself can make the oral requests for medication, in person. It is impossible to stipulate the request in an advance directive, living will, or any other end-of-life care document.

The patient must make two oral requests, at least 15 days apart.

The written request must be witnessed by at least two people, who, in the presence of the patient, attest that to the best of their knowledge and belief the patient is capable, acting voluntarily, and is not being coerced to sign the request. One of the witnesses cannot be a relative of the patient by blood, marriage or adoption; anyone who would be entitled to any portion of the patient’s estate; an owner, operator or employee of a health care facility where the qualified patient is receiving medical treatment or is a resident or the patient’s attending physician.

The patient must be deemed capable to take (self-administer and ingest) the medication themselves, without assistance.

The patient may rescind the request at any time.

Two physicians, one of whom is the patient’s attending physician, familiar with the patient’s case, must confirm the diagnosis. Each physician must be licensed by the state to practice medicine and certified to prescribe medications.

If either physician determines the patient may be suffering from a psychiatric or psychological disorder or depression causing impaired judgment, they must refer the patient for evaluation by a state licensed psychiatrist or psychologist to determine their mental competency. Medication cannot be prescribed until such evaluation determines the patient is mentally competent.

The attending physician must mail or hand-deliver the prescription to the pharmacy.

The patient must wait 48 hours from their written request to fill their prescription.

The request process must be stopped stop immediately if there is any suspicion or evidence of coercion.

The physicians must meet strict reporting requirements for each request.

Anyone who falsifies a request, destroys a rescission of a request or who coerces or exerts undue influence on a patient to request medication under the law or to destroy a rescission of such a request commits a Class A felony. The law also does not limit liability for negligence or intentional misconduct, and criminal penalties also apply for conduct that is inconsistent with it.

**NuggzTheNinja**

OrlandotheTechnicoloured wrote:
I really hope they are strict about the 6 months to live bit

(ie there are no instances of a person with this diagnosis living longer than 6 months, ever, as opposed to on average 51% of people with this die within 6 months)

Otherwise a fear a fair number of deaths of those seeking not to be a burden on their families, or use up their kids inheritance on medical care

Why do you feel entitled to dictate the circumstances under which people are allowed to end their own lives?

**d-usa**

There is no way to really guarantee that someone will die in 6 months, so if we were to implement a rule like that it would render the law invalid.

Using the same 6 month standard already used to qualify for hospice should be good enough.

**DutchWinsAll**

As long as you're at least semi-mobile the US already has a nationwide euthanasia measure. It's called the 2nd Amendment. Messier for sure, but not really less effective.

**Maelstrom808**

Suicide by firearm is no guarantee, and if it fails you can have some pretty horrendous consequences. More than one person has attempted suicide by gun and ended up simply removing thier face or turning themselves into a vegetable.

**AlexHolker**

NuggzTheNinja wrote:
OrlandotheTechnicoloured wrote:
I really hope they are strict about the 6 months to live bit

(ie there are no instances of a person with this diagnosis living longer than 6 months, ever, as opposed to on average 51% of people with this die within 6 months)

Otherwise a fear a fair number of deaths of those seeking not to be a burden on their families, or use up their kids inheritance on medical care

Why do you feel entitled to dictate the circumstances under which people are allowed to end their own lives?

Because I've already heard of one case where a European doctor killed a patient driven to suicide by abusive relatives.

**DutchWinsAll**

Maelstrom808 wrote:
Suicide by firearm is no guarantee, and if it fails you can have some pretty horrendous consequences. More than one person has attempted suicide by gun and ended up simply removing thier face or turning themselves into a vegetable.

No it's not perfect 100%, but neither is death by drug cocktail, as evidenced by some recent inmate executions. But generally a shot with a decent caliber aimed to the back of the head and not up will destroy the brainstem causing almost instant death. Or you can use a 12gauge like guy I found in the woods when I was 16. Basically had a lower jaw left and a flesh jigsaw puzzle scattered over a few square feet.

**NinthMusketeer**

Deadshot wrote:
Can't wait to see how this will blow up. My guess is the superchristians the US seems full of, specifically nurses and doctors, refusing to work and be party and refusing to allow it.

California is pretty liberal and progressive overall, that sort of thing tends not to gain as much traction as it would in other states.

**oldravenman3025**

Don't know if I'm comfortable with this.

**DutchWinsAll**

oldravenman3025 wrote:

Don't know if I'm comfortable with this.

Why do you care what others do to themselves? You're a gun rights proponent, yes? What happened to the idea of don't like it don't buy it?

Boggles my mind that in America, supposed land of the free, that we don't allow people to choose their own lives, and when they want that life to end. Nobody isn't dying at some point and you don't go to super-heaven for being against dying on your own terms.

**Mathieu Raymond**

Eh. I think it's ok not to be comfortable with it. Death is a very sensitive subject, in a lot of cultures. I'd rather we keep not being comfortable with it, but allow the discussion to take place. I don't think oldravenman3025 (mouthful, eh?) was using his discomfort to take away someone's option.

All I can say is if someone wants to suffer to the bitter end for ideological purposes, let them. If someone wants to avoid that bit, we ought to at least have something in place rather than only the back of the shed. I know I'd probably never have the nerve to pull the trigger on myself.

**oldravenman3025**

DutchWinsAll wrote:
oldravenman3025 wrote:

Don't know if I'm comfortable with this.

Why do you care what others do to themselves? You're a gun rights proponent, yes? What happened to the idea of don't like it don't buy it?

Boggles my mind that in America, supposed land of the free, that we don't allow people to choose their own lives, and when they want that life to end. Nobody isn't dying at some point and you don't go to super-heaven for being against dying on your own terms.

Nice assumptions there, Kudzu.

Gun rights and religion don't have a goddamned thing to do with why I'm uncomfortable with the idea of MEDICALLY assisted suicide.

You can take those "in your face" tactics somewhere else, or don't bother wasting time responding to my posts. It doesn't cut it with me.

**Grey Templar**

DutchWinsAll wrote:
oldravenman3025 wrote:

Don't know if I'm comfortable with this.

Why do you care what others do to themselves? You're a gun rights proponent, yes? What happened to the idea of don't like it don't buy it?

Boggles my mind that in America, supposed land of the free, that we don't allow people to choose their own lives, and when they want that life to end. Nobody isn't dying at some point and you don't go to super-heaven for being against dying on your own terms.

Here are some issues with that.

1) Its very very open to abuse. Old people might feel pressured into doing this to "lessen the burden on their families".

2) It requires the individual to be of sound mind to make this decision. However, suicidal thoughts are a proven link to being mentally unstable. So we really can't say that someone who wants to kill themselves to be of sound mind.

At the very least I think it should not be allowed if someone other than the patient brings up the idea. Medical staff and family members are not allowed to suggest it, no informational pamphlets anywhere visible to patients, etc... Not even a hint.

**DutchWinsAll**

oldravenman3025 wrote:
DutchWinsAll wrote:
oldravenman3025 wrote:

Don't know if I'm comfortable with this.

Why do you care what others do to themselves? You're a gun rights proponent, yes? What happened to the idea of don't like it don't buy it?

Boggles my mind that in America, supposed land of the free, that we don't allow people to choose their own lives, and when they want that life to end. Nobody isn't dying at some point and you don't go to super-heaven for being against dying on your own terms.

Nice assumptions there, Kudzu.

Gun rights and religion don't have a goddamned thing to do with why I'm uncomfortable with the idea of MEDICALLY assisted suicide.

You can take those "in your face" tactics somewhere else, or don't bother wasting time responding to my posts. It doesn't cut it with me.

Gun rights are intimately aligned with life and death, that should be pretty obvious. It's just a question, no need to compare me to an invasive plant. I'm also confused as to what assumptions I made as I asked questions. Trying to pretend that a lot of pushback on the right to die isn't religiously based is disingenuous at best, and at no point did I say that those were your views.

Why is medically capitalized? Does it change the fact of death when it's doctor? They can't stop death. Are you against hospices? They are medical professionally staffed places where people go to die. How is it that so different from a place where people go to die on their own terms all while still staffed by medical professionals?

Automatically Appended Next Post:

Grey Templar wrote:
DutchWinsAll wrote:
oldravenman3025 wrote:

Don't know if I'm comfortable with this.

Why do you care what others do to themselves? You're a gun rights proponent, yes? What happened to the idea of don't like it don't buy it?

Boggles my mind that in America, supposed land of the free, that we don't allow people to choose their own lives, and when they want that life to end. Nobody isn't dying at some point and you don't go to super-heaven for being against dying on your own terms.

Here are some issues with that.

1) Its very very open to abuse. Old people might feel pressured into doing this to "lessen the burden on their families".

2) It requires the individual to be of sound mind to make this decision. However, suicidal thoughts are a proven link to being mentally unstable. So we really can't say that someone who wants to kill themselves to be of sound mind.

At the very least I think it should not be allowed if someone other than the patient brings up the idea. Medical staff and family members are not allowed to suggest it, no informational pamphlets anywhere visible to patients, etc... Not even a hint.

1) Citation needed

2) Citation needed. The act of realizing we all die is not suicidal. And if it is, then literally every single person on Earth is suicidal, as we all quit at some point.

Suggesting it should be banned? You do realize we all die right?

**Grey Templar**

DutchWinsAll wrote:

Automatically Appended Next Post:

Grey Templar wrote:
DutchWinsAll wrote:
oldravenman3025 wrote:

Don't know if I'm comfortable with this.

Why do you care what others do to themselves? You're a gun rights proponent, yes? What happened to the idea of don't like it don't buy it?

Boggles my mind that in America, supposed land of the free, that we don't allow people to choose their own lives, and when they want that life to end. Nobody isn't dying at some point and you don't go to super-heaven for being against dying on your own terms.

Here are some issues with that.

1) Its very very open to abuse. Old people might feel pressured into doing this to "lessen the burden on their families".

2) It requires the individual to be of sound mind to make this decision. However, suicidal thoughts are a proven link to being mentally unstable. So we really can't say that someone who wants to kill themselves to be of sound mind.

At the very least I think it should not be allowed if someone other than the patient brings up the idea. Medical staff and family members are not allowed to suggest it, no informational pamphlets anywhere visible to patients, etc... Not even a hint.

1) Citation needed

2) Citation needed. The act of realizing we all die is not suicidal. And if it is, then literally every single person on Earth is suicidal, as we all quit at some point.

1) I shouldn't have to explain how it would be very easy to suggest to an elderly person how much of a burden they are to their family, or how they've lived a good life, etc... Plus if there are inheritances involved there could easily be massive incentive to pressure someone into it.

2)

https://toronto.cmha.ca/mental_health/the-relationship-between-suicide-and-mental-illness/
http://www2.isu.edu/irh/projects/better_todays/B2T2VirtualPacket/SuicidePrevention/Link%20Between%20Mentall%20Illness%20&%20Suicide.pdf

I could list many many more things. This is not a disputable thing. Suicidal thoughts are very closely linked and associated with mental disease.

Suggesting it should be banned? You do realize we all die right?

Yeah. We all die. Its not something we have control over, nor do I necessarily think we should.

As for medical assistance, its been a long held tradition(for damn good reason) that doctors are not allowed to kill their patients. The Hippocratic Oath is quite clear in this respect. Its tough, or even impossible, to argue that ending someone's life is not causing harm.

Plus you open up a huge can of worms if you suddenly make it legal for doctors to kill their patients. Botched surgery or prescription leads to patient death: suddenly the doctor claims the patient requested life ending medication!

**Gitzbitah**

This is hardly a case of doctors killing patients. The law states that they'd need a prognosis of 6 months to live- best case scenario.

A psychological evaluation ought to be mandatory for such an event, to determine if the patient is stable enough to make that determination. That should weed out the ones with sound mind who don't wish to die a slow and agonizing death, and those who are mentally unstable.

It sounds like this already requires 2 requests, not even consents, with witnesses at least two weeks apart. It is exceedingly unlikely that those circumstances could be engineered to disguise a wrongful death.

In the dire circumstances involved, I am ok with it- and the implementation presented shows a very reasonable abundance of caution to me.

**DutchWinsAll**

Grey Templar wrote:

1) I shouldn't have to explain how it would be very easy to suggest to an elderly person how much of a burden they are to their family, or how they've lived a good life, etc... Plus if there are inheritances involved there could easily be massive incentive to pressure someone into it.

Yet you should, as you are putting forward the idea that it's "very very open to abuse". Don't talk in generalities, show me that assisted suicide is more open to abuse than traditional end of life care, which coincidentally is the one of the largest money-makers for health insurance companies.

Grey Templar wrote:

2)

https://toronto.cmha.ca/mental_health/the-relationship-between-suicide-and-mental-illness/
http://www2.isu.edu/irh/projects/better_todays/B2T2VirtualPacket/SuicidePrevention/Link%20Between%20Mentall%20Illness%20&%20Suicide.pdf

I could list many many more things. This is not a disputable thing. Suicidal thoughts are very closely linked and associated with mental disease.

In healthy adults, yes suicide is a sign of mental illness. But this bill and others like are not dealing with healthy adults, so that's disingenuous to even be talking about. We're talking about people with terminal diseases. People that have to have someone else wipe their ass as an adult. People with bone mets that are in excruciating pain. So to try and conflate people like that with an angsty teenager is a bad comparison.

Grey Templar wrote:

Suggesting it should be banned? You do realize we all die right?

Yeah. We all die. Its not something we have control over, nor do I necessarily think we should.

As for medical assistance, its been a long held tradition(for damn good reason) that doctors are not allowed to kill their patients. The Hippocratic Oath is quite clear in this respect. Its tough, or even impossible, to argue that ending someone's life is not causing harm.

Plus you open up a huge can of worms if you suddenly make it legal for doctors to kill their patients. Botched surgery or prescription leads to patient death: suddenly the doctor claims the patient requested life ending medication!

Now were getting into the debate between curative and palliative medicine, something far more murky, and worth discussing. But either way, no surgeon is gonna be able to claim a patient dying on the table while undergoing a tonsilectomy would be covered by this type of legislation. That's the type of slippery slope used by anti-gay rights activists or anti-gun activists.

**Ouze**

DutchWinsAll wrote:As long as you're at least semi-mobile the US already has a nationwide euthanasia measure. It's called the 2nd Amendment. Messier for sure, but not really less effective.

Maelstrom808 wrote:Suicide by firearm is no guarantee, and if it fails you can have some pretty horrendous consequences. More than one person has attempted suicide by gun and ended up simply removing thier face or turning themselves into a vegetable.

Indeed. I know anecdotal evidence... isn't, but I personally know a coworker who had her brother attempt to kill himself with a shotgun about 2 years ago. He did not in fact die - I don't know how that's possible with a shotgun - and he wound up with a slow lingering death after all.

Anyway, I fully support medically assisted suicide so long as the proper controls are there to make sure the person dying understands and consents to the decision they are making. Certainly if I had stage 4 pancreatic cancer, or something similar, it would be an attractive option.

**Grey Templar**

DutchWinsAll wrote:

In healthy adults, yes suicide is a sign of mental illness.

If someone has a mental illness they are by definition unhealthy. Suicidal thoughts are a sign of mental illness, full stop. Be it caused by depression or whatever.

Automatically Appended Next Post:

DutchWinsAll wrote:
Grey Templar wrote:

1) I shouldn't have to explain how it would be very easy to suggest to an elderly person how much of a burden they are to their family, or how they've lived a good life, etc... Plus if there are inheritances involved there could easily be massive incentive to pressure someone into it.

Yet you should, as you are putting forward the idea that it's "very very open to abuse". Don't talk in generalities, show me that assisted suicide is more open to abuse than traditional end of life care, which coincidentally is the one of the largest money-makers for health insurance companies.

Well one, most of the time when someone dies someone is getting their stuff. Currently its not legal to kill someone in end of life care. If you open up an avenue where its legal for someone in this situation to be killed by another person you are making it easier to get rid of an elderly relative.