AB 654, California's proposed euthanasia statute (also called the "assisted suicide" or "physician aid-in-dying" law, depending on who is describing it) is moving along through the State Assembly. It was just amended yesterday, and the amendments tell us a lot. Protections are weakened and burdens on institutional health care providers like hospitals, nursing homes, and hospices are reduced. But-- and this is an important "but"-- the changes are only wonkish tweaks that do not change the bill's impact at all. Apparently no serious opposition has been mounted yet. I cannot believe that will continue for long.
The PDF version of the bill is here. The significant changes are:
- Removal of the courts from the process. In the prior version either a physician or a court could decide whether a person is capable of making his or her own health care decisions. Now only a physician would have that authority. This is a most interesting development in light of the judicial circus that occurred in the Terri Schiavo case. As a policy matter, one wonders whether resort to the courts should be foreclosed altogether. How confident can we be that leaving that decision to a single physician is in the patient's best interests?
- Healthcare facilities are no longer required to designate a qualified representative to witness the patient's request for life-ending medication. This probably something industry lobbyists requested in order to reduce the involvement of their employees in such sensitive and potentially controversial matters. I can't blame them.
- Patients requesting life-ending medication must be made aware of alternatives to suicide, such as hospice care.
- The patient must self-administer the lethal medication dose.