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Will California follow Oregon with PAS bill?
Legislation mirrors Oregon's Death with Dignity Act
A bill that would make California the second state in the country to legalize physician-assisted suicide (PAS) has worked its way through the state assembly's Judiciary Committee, but needs to clear the state House by June 8 to be eligible for consideration this year by the state Senate.
While committee voting so far has fallen along party lines, with Democrats endorsing the bill patterned after Oregon's Death with Dignity Act and Republicans voting against it, political observers say the bill stands a better chance of passage this year than it did last year, when a nearly identical bill failed to win assembly approval.
The state's two largest physician organizations, however, remain split on the bill.
"When physicians can no longer heal the disease or alleviate the symptoms, terminally ill patients have a right to control the circumstances of their death," said Wells Shoemaker, MD, medical director of the California Association of Physician Groups, based in Los Angeles.
The 35,000-member California Medical Association, which like the American Medical Association has consistently opposed physicians assisting with the suicides of patients, issued a statement in March reaffirming that opposition.
"Assisting someone to die is unethical and unacceptable, and is fundamentally incompatible with the physician's role as healer," said California Medical Association President Anmol S. Mahal, MD.
California bill mirrors Oregon act
The Oregon PAS act was passed in 1996, and has withstood attempts to strike it down at both the federal and state levels. Oregon voters passed the act via a referendum; California Gov. Arnold Schwarzenegger has said he believes the decision on passing a PAS law should be put directly to California voters, as was Oregon's act.
The proposed California PAS law would apply to patients who are terminally ill and within six months of death, only to residents of California, and only to adult patients who can make informed decisions.
Other points of bill AB 374 include:
The president of the 16,000-member Christian Medical Association (CMA), based in Bristol, TN, says the California bill "invites patient abuse, prevents investigation of patient abuse, and covers up incidents of patient abuse."
David Stevens, MD, CEO of the CMA, adds, "Instead of being called the Compassionate Choices Act, this bill should be called the 'Covert Abuses Act.'
"No one will ever know if patients were pressured to die because they had no health insurance, or because a greedy family member wanted to preserve his inheritance, or because a doctor or insurer calculated that suicide was more efficient than palliative care," Stevens insisted in a prepared statement. "The state health department relies on the very people who abuse patients to report their own abuse."
The CMA's statement opposing the bill is based on a number of concerns, including fear of:
Survey: Support for PAS among MDs
A national survey of 1,088 physicians conducted by the Louis Finkelstein Institute for Social and Religious Research, part of the New York, NY-based Jewish Theological Seminary, in 2005 revealed that a majority of those surveyed (57% percent) believe that it is ethical to assist an individual who has made a rational choice to die due to unbearable suffering. Thirty-nine percent say they believe it is unethical.
The Finkelstein survey revealed that while doctors tend to support legalization of PAS as a public policy, results were mixed when they were asked whether they would personally participate in assisting a patient. A plurality (46%) would not assist a patient for any reason, 34% would assist a patient in a few cases, and 20% would assist under a wide variety of circumstances. (To read the survey results, visit www.jtsa.edu/research/finkelstein/surveys/pas.shtml.)
Forty states have specifically outlawed PAS; six states prohibit it through common law, according to the Death with Dignity National Center in Portland, OR (www.deathwithdignity.org). Three states (other than Oregon) — North Carolina, Utah, and Wyoming — do not have laws prohibiting or permitting PAS.