Differing Perspectives on the Right to Die

On June 9, 2016, California’s physician-assisted dying law, also known as the “End of Life Option Act,” took effect. Passed by voters in October 2015 and later signed into law by Governor Jerry Brown, the law holds that under certain conditions, terminally-ill California residents may now legally take medication to end their lives. Under the “End of Life Option Act,” California now becomes the fifth state in the nation, joining Montana, Oregon, Vermont and Washington, to create a legal process for patients to obtain aid in dying. Proponents for the law maintain that people should have the right to decide whether they want “aid in dying,” while opponents argue that patients could feel pressure to take their own lives.

The California State Senate and Assembly passed the bill in September 2015, which allows terminally-ill patients to take a combination of deadly medications to end their lives. There are, however, several conditions which must occur before this may legally take place. Patients must have been given six months or less to live by two separate doctors and provide a written request along with two verbal requests for the medication at least 15 days apart. The patient must also be diagnosed as mentally capable of making decisions about his or her health by a medical professional.

California’s law passed just one year after terminally-ill California resident Brittany Maynard moved to Oregon to legally end her own life under that state’s right-to-die law. Ms. Maynard’s plight educated others and brought this issue to the forefront. Oregon’s similar law has been active for almost 20 years.

In deciding whether to exercise this option, the patient is encouraged, among other things, to discuss: the patient’s understanding of his/her diagnosis and prognosis, the patient’s hopes and fears, the benefits of palliative care and hospice care, and other options for pain control and symptom management.

The “End of Life Option Act” includes several important safeguards, which are aimed at restricting access to patients who are terminally-ill and mentally-competent and explicitly stipulates a number of requirements for documentation in the patient’s medical record, largely corresponding to these safeguards. However, the law is fairly new and both medical and legal professionals have brought forth concerns for each of those professions moving forward both theoretically and practically.

In this issue, Dr. Eric Freitag, founder and Executive Director of the Mt. Diablo Memory Center in Walnut Creek, will explore how attorneys and mental health professionals can navigate their respective roles and duties when following the wishes of clients who wish to pursue their end of life options under the law. In her article, attorney Shara Beltramo explores legal ramifications acknowledging that while the “End of Life Option Act” provides protections against undue influence, are those protections enough?

Recognizing that the impact of a decision under this law deeply effects the family of the patient as well, two articles in this edition address the important dynamic involved between the patient and his/her family and loved ones. In her article, Linda Fodrini-Johnson, licensed family therapist and founder of Eldercare Services in Walnut Creek, examines patient/client and family perspectives and how there can be conflicts due to the enormity and finality of this decision. Cindy Hatton, President and CEO of Hospice East Bay, details the many valuable resources of Hospice since their founding over 40 years ago and the specific types of compassionate end-of-life care which Hospice provides for our community.

As an educational component for this edition, Kathryn Schofield has prepared an MCLE Self-Study which addresses how estate planning practitioners can potentially prepare advance health care directives for clients who wish to have their documents reflect an intent and election to implement the provisions of the “End of Life Option Act.”

Finally, Justice James Marchiano, in his continuing fiction series involving Judge Raymond Carlton, writes of a particularly compelling case brought to his courtroom and how the Greek goddess of justice, “Dikē,” who uncovered concealed wrongdoing, may have played a role in the ultimate outcome of the jury’s verdict.

While the topic and issues surrounding the “End of Life Option Act” are serious and thought-provoking, we hope that you find the information contained in this edition of the Contra Costa Lawyer to be illuminating. Many additional resources, such as the Coalition for Compassionate Care of California, exist to answer questions and provide useful educational information to those interested in learning more about this important topic.