California's Physician-Assisted Suicide Law

As of last Friday's signing by Governor Brown, California becomes the fifth state in which physician assisted suicide is legal, which affects 1 out of every 6 Americans.

Note that this is not euthanasia: doctors will not be giving lethal injections to people.  Rather, this law will allow terminally ill patients to ask for a prescription for medication they could take if they wished to die in a manner of their own choosing.

Similar to other states,

• a patient would have to request such a prescription twice, at least 15 days apart
• the requests have to be verbal and also must include a written request 
• the patient must be a consenting adult
• the patient would have to be agreed on by two different doctors to be terminally ill with six months to live (similar to the criteria for hospice care)
• the doctor cannot administer the medication; the patient must do so.

Oregon was the first state to pass such a law in October 1997.  Looking back over the last eighteen years of Oregon's experience, several things can be seen:

• since 1997, 752 people have died through lethal prescriptions at their request; 72 of these deaths were last year.  This comprised 0.22% of all deaths in Oregon last year (22 out of every 10,000 deaths).
•  1,173 prescriptions were written since 1997 and  752 (64%) were used.  It may be that for many patients, the prescription serves as an assurance that they will not have to suffer a horribly painful death.
• Oregon doctors wrote lethal prescriptions for only one out of every six patients who requested them.  Patients with untreated depression and patients indicating that they felt they were a burden to others were unlikely to be given a prescription.
• 53% of patients who requested lethal prescriptions were college-educated with at least a 4-year degree, and 97% had health insurance.  This argues against the notion that physician-assisted suicide laws are used to cull poor or under-educated patients.
• 85% of patients were already enrolled in hospice services; lethal prescriptions are an addition to hospice, and not so much a replacement for it.

My earlier postings on this matter make my position clear.  I do not feel this law will be abused and it will not be a mechanism for euthanizing elderly or disabled people.  Rather, it will allow dying patients an option to be able to die comfortably in a time and manner of their own choosing if and only if they should wish to do so.  My experience tells me that we do not so much fear dying as we fear dying in miserable pain and alone.

The law for California is likely to take effect some time later in 2016.