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California’s new assisted suicide law is challenged in court

BMJ 2016; 353 doi: https://doi.org/10.1136/bmj.i3471 (Published 21 June 2016) Cite this as: BMJ 2016;353:i3471
  1. Owen Dyer
  1. Montreal

Five southern California physicians and a Christian doctors’ organization have filed suit to strike down the state’s new law on physician assisted suicide, which has been in force since last week.

The plaintiffs include two oncologists, a neurologist, two palliative care specialists, and the American Academy of Medical Ethics, which has around 15 000 physician members across the United States, including 600 in California.

In papers filed with Riverside County Superior Court they argued that the End of Life Option Act “violates the equal protection and due process guarantees of the California Constitution in that it fails to make rational distinctions between [eligible patients] with supposedly terminal diseases, and the vast majority of Californians not covered by the Act.”1

The law stipulates that California residents are eligible for a prescription of lethal drugs if their physician diagnoses a terminal condition that is likely to lead to their death within six months. The plaintiffs argue that this is a “vague and arbitrary cutoff” with no rational basis. They also claim that California’s state legislature passed the act in a manner that contravened California’s constitution, as it passed in an extraordinary session not convened for that purpose.

The law’s challengers are helped by attorneys from Life Legal, a Christian lawyers’ group. Life Legal’s executive director, Alexandra Snyder, said the End of Life Option Act “is irreparably flawed as it removes crucial protections from individuals who are most susceptible to depression, abuse, and coercion.”

Snyder added, “The act provides virtually no safeguards for labeled individuals who may suffer from untreated mental illness or mood disorders and grants full immunity for doctors to participate in the killing of their most vulnerable patients.”

The act’s opponents failed this week to persuade the court to issue a temporary restraining order halting its implementation. A full hearing on application for an injunction against the law will be held on 29 June.

Kevin Diaz, national director of legal advocacy for Compassion and Choices, a group that lobbied for the assisted dying law, told the Los Angeles Times that he expected the challenge to fail. “I don’t really think it has legs,” he said. “I just don’t understand exactly what their assertions are, given that this legislation treats all people . . . no matter what their condition, equally, and is respectful of their end-of-life wishes.”

California legislators have failed many times in the past to pass assisted dying legislation, but support for such a law rose sharply in 2014, when the California resident Brittany Maynard, a 29 year old teacher with a diagnosis of terminal brain cancer, moved to Oregon to legally end her life.

Oregon, Washington state, and Vermont already have assisted dying laws, and courts in Montana have also declared the practice legal. But last week saw the number of North Americans with access to assisted dying increase 10-fold, as it became legal in both California and Canada.

The level of public support for assisted dying is 75% in California and 68% across the United States. Some hospitals and hospices in the state, however, have already said that they would opt out of providing assisted dying services.

There have been no reported deaths under the new law in its first week, but such assisted deaths would be public knowledge only if patients chose to make them so. Physicians must report them to the state, which will publish annual statistics.

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