Thankfully, California’s medical-aid-in-dying law isn’t like old milk, to be tossed out when the expiration date passes.
Why the End of Life Option Act had an expiration date at all is thanks to a near-extinct political impulse: compromise. Opponents feared that vulnerable people would be pushed towards death, exterminated for being too troublesome or expensive. So, as the tragedy of Brittany Maynard riveted our attention a decade ago, a sunset date of 2031 was built into the law to allow California time to gather statistics, see how it’s working, and decide whether death with dignity should remain a right of all Californians (of sound mind and body, who are 18 or older, and who have a terminal diagnosis and six months or less to live, and can administer the drugs themselves).
The data is clear: The law has not been abused. If anything, it has been greatly under-utilized. Still, opponents have been gunning for its elimination — often on religious grounds, saying only God can give or take life. So it’s a great relief that Gov. Gavin Newsom has signed Senate Bill 403 by Sen. Catherine Blakespear into law, eliminating the sunset date and protecting the medical-aid-in-dying choice for those of us who might need it in coming decades.
“It is such a relief to know that this option will now be permanently available for myself and Californians who qualify under the law,” said Lynne Calkins, a founding board member for End of Life Choices California who was recently diagnosed with ALS, by email. “This is about choice, compassion, and autonomy. I’m so grateful and relieved.”
Blakespear, D-Encinitas, recently held workshops on the bill attended by hundreds of people in Orange and San Diego counties. There, panels of experts addressed burning questions — Will life insurance pay? Does God approve? — and Blakespear made her case for choice.
“Californians with painful, debilitating terminal illnesses should have the option to avoid pointless suffering and die with dignity, if they wish, without fear of this option expiring,” she said in a statement, thanking the governor for his signature.
California Department of Public HealthSupporters stress the law’s many safeguards, which require a doctor to determine that the requestor has the capacity to make medical decisions and isn’t being coerced; that they’re informed of options (such as hospice and palliative care) and that they can change their mind at any time; that their diagnosis and prognosis are confirmed by a second physician; and that they directly make two oral requests for medical-aid-in-dying drugs at least 48 hours apart, as well as submit a written request witnessed by two adults.
There are no credible reports of abuse or people being hustled to their deaths. Last year, only 1,032 Californians took the medication and died. More than 15,000 Canadians did the same. Canada and California, incidentally, have almost identical populations.
Health CanadaCalifornians who used MAID in 2024 remained overwhelming White (86.7%) and had at least some college education (75.2%).
The majority had cancer (60%), followed by cardiovascular disease (13.8%), neurological disease (10.3%), respiratory diseases (6.2%) and other diseases (9.8%).
Their median age was 78, but nearly 1 in 5 was 90 or older (18.2%). Almost all of them were already on hospice and/or palliative care (94.8%), and most died in the comfort of home (85.3%).
Blakespear’s bill was sponsored by Compassion & Choices Action Network, with support from 17 different organizations and more than 250 individuals, her office said.
“End of Life Choices California is extremely pleased that Governor Newsom has signed SB 403, ensuring that terminally ill Californian’s maintain their right to death with dignity,” said Mark Greenberg, executive director of the nonprofit, by email. “This will provide critical comfort to Californians now and in the future.”
Drs. Jeff Levine and Susan Gardner were among the first to help patients access care through California’s End of Life Options Act after it took effect in 2016. (Photo by Teri Sforza)We can’t help but imagine Brittany Maynard smiling. The Anaheim-born woman became the brave, beautiful, tragic advocate for medically assisted death in California, after being diagnosed with brain cancer in 2014. She had to move to Oregon to seize control of her final days and die with dignity. Her outspoken advocacy led to the End of Life Option Act’s passage in California in 2015, and the work of people like Calkins has helped preserve it for the rest of us.
Eleven other states have similar laws, and none are slated to sunset. Opponents vow to continue fighting California’s law in court, though. For more information on medical-aid-in-dying, see www.autonomyhealth.org, (619) 786-8222; www.endoflifechoicesca.org, (760) 636-8009; compassionandchoices.org/, (800) 247-7421; www.socalendoflifeoptions.com/, (909) 709-0676; abetterexit.org/; and/or www.aadm.org.
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