California law already gives terminally ill patients the right to end their lives, and a bill by state Sen. Catherine Blakespear, D-Encinitas, would expand those options.
The End of Life Options Act, SB 1196, would change the time limits, medication choices and California residency requirements of the current law. And it would open the door for people with early stage dementia to end their lives before they become incapacitated by their illness.
“What I’m trying to do is allow individuals suffering with serious ‘grievous and irremediable medical conditions’ to end their life on their own terms, instead of waiting until the very end when they’re in hospice and suffering, to access end of life options,” Blakespear said.
Her proposal arose from her previous work as an attorney in estate planning, and has sparked controversy among religious and medical rights groups, with some applauding the expansion, and others warning of potential abuses.
Under current California law, patients can end their lives under certain conditions. They must be a California resident, have a terminal disease that their doctor confirms is likely to cause death within six months, and have the capacity to make the decision of their own will.
Blakespear’s bill would end the California residency requirement, effectively allowing patients from other states to come to California seeking medical options for ending their lives. It replaces the diagnosis of a terminal illness with a six month prognosis to the term “grievous and irremediable.”
Under the bill’s language that means that the condition is serious and incurable, causes irreversible decline, creates suffering that can’t be relieved, and is expected to eventually lead to death.
The bill allows patients to administer an intravenous injection in addition to pills, since some patients lose the ability to swallow before death, and the pills can cause painful burning.
It also allows patients with dementia to end their lives if a doctor determines they have the capacity to make medical decisions, can administer the medication themselves, and are choosing medical suicide of their own volition.
The California Catholic Conference opposed the bill, particularly the provisions for patients with dementia.
“Most critically, by allowing dementia patients access to life-ending drugs, it opens up incredibly vulnerable people to the possibility of coercion or worse,” Kathleen Doming, executive director of the Catholic Conference, said in a statement.
Blakespear notes that the bill includes safeguards to ensure that patients with any condition make an informed choice to end their lives. A doctor must certify the severity of the illness, and determine that the patient is choosing medical suicide without pressure from anyone else. Patients have to be informed of options including palliative care and pain control. And a patient must make verbal and written requests for the medication, witnessed by two adults, including one who is not a relative or health care provider.
Groups advocating for end of life choices were split on the proposal. A Better Exit called the bill “another big step forward,” and urged members to write in favor of it. But Compassion and Choices expressed concerns that expanding the timeline for medical suicide beyond six months raised the potential for people to end their lives because they lacked adequate pain relief to control their symptoms.
While the bill requires doctors to consider and patients to be informed of palliative care and other treatment options, it doesn’t say what happens if those options aren’t accessible to a patient. Given how hard it can be to obtain routine healthcare, isn’t there a risk that some people could choose medical suicide because they don’t have good treatment options under their insurance plan, or can’t afford out-of-pocket costs?
“To me it’s a circuitous argument to say let’s wait until we have a perfect medical system before we let them make decisions for themselves,” Blakespear said.
Keeping Cannabis Permits Above Board
San Diego and other local governments aren’t meeting their own standards for permitting marijuana businesses, the state auditor said in a report released Wednesday.
“We determined that cities and counties (local jurisdictions) could improve their cannabis‑permitting processes to increase public confidence and mitigate the risks of corruption,” California State Auditor Grant Parks wrote.
The audit examined permitting practices for San Diego and five other jurisdictions, including the cities of Fresno, Sacramento and South Lake Tahoe, and Monterey and Santa Barbara Counties. All those local governments had policies and procedures that complied with cannabis laws, but failed to follow them to prevent “conflicts of interest, abuse, and favoritism.”
For instance, all six local governments were inconsistent about documenting criminal background checks of applicants. They all had at least one person involved in the permitting process who didn’t didn’t disclose financial interests, such as investments, businesses, real estate and income, that could pose conflicts of interest. And four of them, including San Diego, didn’t ensure that people involved in the permitting process filed impartiality statements.
Supes Want to Back Bills to Crack Down on Border Pollution
Last week we covered some bills by state Sen. Steve Padilla, D-San Diego, to improve handling of sewage spills that affect beach water quality in San Diego.
One would require public water agencies to report sewage spills and then fix the contamination themselves or pay for cleanup. Another would ban a regional water board from issuing permits for new landfills located within the Tijuana River National Estuarine Research Reserve or near a tributary to the Tijuana River.
Supervisor Terra Lawson-Remer and Board Chair Nora Vargas are calling for the board to endorse those bills at its regular meeting next Tuesday.
“We need to hold large companies that discharge toxins into our waters accountable,” Lawson-Remer said.
Digital Democracy Spills the Beans on California Politicians
CalMatters recently introduced “Digital Democracy,” an AI tool that tracks “very word spoken in public hearings, every dollar donated to politicians, every bill introduced, every vote cast.”
The homepage includes a dashboard that ranks lawmakers on votes, campaign dollars and more. So, where do San Diego’s politicians stand?
Three San Diego lawmakers made the top 10 list for “gifts received.” Those were:
- Assemblymember Marie Waldron, R-Escondido, came in second with $5,100
- Tasha Boerner Horvath, D-Encinitas, was in third with $4,900
- Senate Pro Tem Toni Atkins, D-San Diego, was in fourth with $4,500
Their political tchotchkes ranged from theater tickets, golf, wine, champagne and meals, to a humidor and cigars.
Meanwhile Assemblymember Chris Ward, D-San Diego, earned the distinction of seventh most talkative legislator, with 156,697 words spoken in the current session, as of today.
The Sacramento Report runs every Friday and is part of a partnership with CalMatters. Do you have tips, ideas or questions? Send them to me at deborah@voiceofsandiego.org.