SACRAMENTO (CN) - California's proposed end of life bill cleared another legislative hurdle Tuesday when a Senate committee approved it by 4-2 vote after a hearing featuring dramatic testimony on both sides of the contentious issue.
Senate Bill 128, by state Senators Bill Monning, D-Carmel, and Lois Wolk, D-Davis, was approved by the Senate Judiciary Committee.
It would authorize medical aid in dying in California, by allowing terminally ill patients with a prognosis of six months or less to obtain life-ending medication that they must self-administer.
"There can be terrible pain and suffering there can be agonizing descent into physical and mental deterioration," Wolk said.
"My own personal story is not unique. I was 17 when my young, vibrant mother ended a three-year struggle with metastatic breast cancer. It was brutal. Despite heroic efforts, the suffering was prolonged and unbearable. It does not have to be this way."
The bill is modeled after Oregon's Death with Dignity Act, but with two key differences. Translators will be required for non-English speakers, and pharmacists - not just physicians - would be given legal immunity for participating in deaths.
Senators revealed an amended version of the law at the Tuesday hearing, with tougher restrictions.
To get the prescription for life-ending drugs, the patient must make oral requests to two doctors, a minimum of 15 days apart, as well as a written request to his or her attending physician witnessed by at least two other adults, one of whom cannot be a relative or beneficiary.
"We believe that we've added more fortifications and protections," Monning said. "Establishing felony penalties for coercing or forging a request are a part of the broader oversight and safeguards."
Coercion formed the basis for much of the opposing testimony Tuesday.
Thomas Driscoll, a private practice lawyer and bioethicist, said the elderly are particularly vulnerable to feelings of burdensomeness, and could request the medication at the suggestion of relatives.
"I am not talking about legal notions of duress, menace, coercion or fraud, but the real life circumstances of someone who feels beholden to another," Driscoll said. "The availability of lethal pills is an insidious way of inviting the elderly not to burden their families or public assistance."
Disability rights activist Marilyn Golden voiced similar concerns.
"Outside pressures that distort patient choice, often from family, but not always, either emotional or financial, can get around any safeguard and lead to abuse," she said.
Committee Chairwoman Hannah Beth Jackson, D-Santa Barbara, a co-author of the bill, said Driscoll was "creating false assumptions" about who might request the drugs.
"I am concerned about the notion that seniors going to be coerced," Jackson said. "I am struck by the fact that in your argument you made no reference to the fact that these people had been told they were terminally ill. Age, hopefully, is not a terminal illness, though I guess you could argue that it is. It doesn't mean you are six months away from your death."
Jackson added: "We're talking about people who are feeling the pain, the lack of dignity. What I hear from people who support this measure is they're asking for an additional tool that only they are able to implement. If you don't want to go about your death in that fashion, that's your choice. But people who are in excruciating pain, they want to have that right."
Jackson said that 20 years ago, when her mother was dying of leukemia, her last request was not to die alone, and to die with dignity. "In the 20 years since that time, I've been committed to that notion, that people do have that right at the end of their lives," she said.
Responding to criticism that Oregon's law and California's proposed law offer insufficient safeguards, Wolk said: "In 17 years of data there has not been a lawsuit that has been brought forward. This is not an easy process. This is not something that is just done quickly without any thought."
Dan Diaz, who recently lost his wife Brittany Maynard, gave formal testimony. The couple moved to Oregon last year to take advantage of Oregon's law. Maynard had been diagnosed with aggressive terminal brain cancer. She became the face of the right-to-die movement in the months leading up to her death late last year. She was 29.
"Palliative care and hospice were not able to prevent or appropriately manage the pain and symptoms that Brittany was suffering from and the worsening symptoms that were coming her way," Diaz said. "She would have gone blind, lost motion, cognitive function, become paralyzed and eventually tortured to death by the horrible things the brain tumor would have done to her."
Diaz said that knowing she could chose to end her life on her own terms allowed her to enjoy the time she had left.
"She no longer had to live in fear of the horrible death that was coming her way. My wife took that control back from the brain tumor. She was the person calling the shots," Diaz said.
Christina Simon, who suffers from amyotrophic lateral sclerosis, said she also moved to Oregon, albeit unwillingly.
"I do not want to die, but unfortunately amyotrophic lateral sclerosis is killing me slowly. Doctors say I only have a few moths to live. I do not want to live my last days in a wheelchair, fully paralyzed, connected to a breathing machine. To me that is a picture of horror," Simon said.
While dozens of opponents lined up against the bill, the committee hearing room was also packed with an overwhelming number of supporters. At least 88 doctors, clergy, nurses, social workers and terminal illness sufferers took the microphone to urge a "yes" vote. People spoke of losing fathers, mothers, brothers and neighbors, some of whom starved themselves to death rather than live in constant pain.
"I represent all Californians who think they're going to die one day, because we're all going to want to have this," said Crystal Smith of Los Angeles, who was there in support of her friend Christina Simon.
"It's hard to argue with that," Jackson said.
The vote in committee split on party lines.
Senators Jackson, Monning, Mark Leno, D-San Francisco, and Robert Hertzberg, D-Los Angeles, voted for the bill. Senators Andy Vidak, R-Visalia, and Joel Anderson, R-El Cajon, voted against it.
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