End-of-Life Choice, Death with Dignity, Palliative Care and Counseling

Compassion & Choices

Poll: CA Voters Strongly Support Bill Inspired by Brittany Maynard

Catholics, Latinos among Many Groups that Favor Medical Aid-in-Dying Legislation 

(Sacramento, CA – June 23, 2015) Nearly seven in ten California voters (69%) support a bill the California Assembly is considering that “would allow a terminally ill adult who is mentally competent the option to request and receive aid-in-dying medication from a physician,” according to a bipartisan poll. Just two in ten (20%) voters oppose the bill, called the End-of-Life Option Act (SB 128), and 11 percent are unsure, according to the live interviewer public opinion telephone survey of 601 likely Nov. 2016 election voters in California.

The poll conducted June 16-21 by Goodwin Simon Strategic Research and Probolsky Research is timely because the Assembly Health Committee has postponed a hearing on SB 128 scheduled for this afternoon until July 7, so committee members could spend more time studying the bill.  Passed by the Senate just 19 days ago on June 4, SB 128 would allow terminally ill, mentally competent adults the option to get a doctor’s prescription for medication that they could take to shorten an unbearable dying process.

Notably, support for End of Life Option Act, sponsored by Senate Majority Leader Bill Monning and Senate Majority Whip Lois Wolk, is significant among every voter subgroup, including:

  • Voters in the Bay Area (68%), Fresno (66%), Inland Empire (63%), Los Angeles (76%), Sacramento (60%), and San Diego (77%)
  • Catholics (60%), non-evangelical Protestants (65%) and evangelical Christians (57%)
  • Whites (69%), African-Americans (67%), Latinos (70%) and Asian-Pacific Islanders (69%)
  • Men (70%) and women (67%)
  • Younger voters (69% ages 18-54) and older voters (68% ages 55+)
  • Democrats (73%), Independents (80%) and Republicans (55%), particularly Republicans over the age of 55 (58%)

“The strong support for the End of Life Option Act in every demographic group among California voters continues to increase,” said Toni Broaddus, California Campaign Director for Compassion & Choices, which sponsored the poll. “This poll sends a clear signal to assembly members in every district that their constituents overwhelmingly support this bill. It is my hope that legislators will listen and respond to California voters here and now, instead of waiting until the next election.”

A July 2014 poll conducted by Goodwin Simon Strategic Research for Compassion & Choices showed 64 percent of California voters supported the medical option of aid in dying, while 24 percent opposed it.

The End of Life Option Act was inspired by Brittany Maynard, the Californian who advocated for a death-with-dignity law in her home state during the last months of her life.  The law is closely modeled after the the death-with-dignity law in Oregon, which has worked well for 18 years, without a single documented case of abuse or coercion. Four other states authorize the option of medical aid in dying: Washington, Montana, Vermont, and New Mexico. Legislators have introduced medical aid-in-dying bills in the District of Columbia and at least 23 other states besides California.

Washington Post Endorses Death-with-Dignity Legislation in States Across the Nation

The Washington Post Endorses Medical Aid in Dying

By Katie Wingo

Brittany Maynard

(June 22, 2015) One of the nation’s largest, leading daily newspapers, The Washington Post, published a rousing endorsement for medical aid in dying legislation nationwide in today’s paper. The editorial focused on bills in California, the District of Columbia, and Maryland modeled after the Oregon law. It cited the stories about Brittany Maynard, John Rehm (Diane Rehm’s husband), national polling data, and the work that Compassion & Choices has done this year to advance end-of-life legislation in DC and at least 24 states.

Five states have authorized aid in dying as an end-of-life option, with Oregon being the first state to do so 18 years ago. California’s End of Life Option Act just passed through the state senate and now the state Assembly is considering it.

“Closely watched are events in California. Ms. Maynard lived there before moving to Oregon and in her final days she videotaped a plea to lawmakers to adopt a law similar to Oregon’s and lobbied California Gov. Jerry Brown (D) by phone. After the state medical association recently dropped its long-standing opposition, a measure passed the state senate and is set for a hearing this month in the lower house; a lawsuit – a route successfully used in New Mexico and Montana – also is being pressed with the claim that both the state constitution and existing state law allow the medical practice of aid in dying.”

John and Diane Rehm

The editorial summarized the usual criticisms of death-with-dignity legislation and refuted the religious and moral objections and fears of abuse that opponents typically cite:

“Oregon’s 18 years of experience do not confirm any of these fears. Enacted in 1997, Oregon’s Death with Dignity Act allows terminally ill adults who are residents of the state to obtain and use prescriptions for self-administered lethal doses. Stringent protections include a life expectancy of less than six months, a finding of mental capability, a concurring opinion from a second doctor, mandatory discussion of hospice and other options, waiting periods and more.”

The Washington Post endorsement is absolutely spot-on in its conclusion:

“Death with dignity laws need to be carefully thought out, written and monitored. Oregon and the states that followed its example show that such care is possible. We hope the rest of the nation catches up with this humane option for life’s end.”

You can read the complete editorial by clicking here.


“Doc2Doc” Consultation Service to Combat Unwanted Medical Treatment Crisis

Free Service Helps Physicians Provide End-of-Life Care Patients Want 

(Washington, DC – June 15, 2015) Responding to reports that millions of older Americans receive unwanted medical treatment, Compassion & Choices today launched a new, free “Doc2Doc” consultation service to ensure patients receive the end-of-life care they want.

According to a 2014 poll conducted by Purple Insights, nearly one out of four Americans (24%) aged 50 or older ­— the equivalent of about 25 million people — say that either they or a family member have experienced excessive or unwanted medical treatment.

Better and more frequent doctor-patient communication could help prevent this excessive and unwanted medical treatment, according to a 2014 report by the Institute of Medicine, Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life.

To improve doctor-patient communication, Doc2Doc is specifically tailored to offer practicing physicians a free, confidential and readily available telephone consultation from a seasoned medical director with decades of experience in end-of-life medical care.

“As physicians, I think we all secretly wish we could solve all of our patients’ healthcare crises by ourselves,” said Dr. David Grube, a national medical director for Compassion & Choices and a former chairperson of the Oregon Board of Medical Examiners. “But I believe we all recognize that it is our duty to consider any tools that minimize our patients’ suffering, especially at the end of life when curative treatments are no longer a viable option.”

Doc2Doc is based on the premise that a physician’s informed communication with each patient about the full range of end-of-life options should center on the healthcare goals of the patient, not the doctor. This communication is necessary to weigh the benefits and burdens of various treatment options to align them with the patient’s values and priorities. Ideally, these conversations often are uncomfortable, but are critically important, and should begin soon after a diagnosis of terminal illness and continue throughout the progression of it.

“Doc2Doc may not be the answer for every physician or situation,” said Dr. Grube. “But I think it is a resource worth exploring for physicians who care for dying patients and want guidance about how they can best support their patients’ decisions.”

The Doc2Doc consultation may include answers about these end-of-life care options:

  • Hospice, palliative care and effective pain and symptom management.
  • How to follow current clinical practice guidelines.
  • How specific state laws affect end-of-life care.
  • How to communicate with patients, pharmacists and family members.
  • What to expect in a patient-controlled death.
  • How to handle patients’ inquiries or requests concerning withdrawal of life-sustaining treatment.
  • How to handle a badly suffering, terminally ill patient’s request for assistance in achieving a painless, peaceful death.
  • Voluntarily stopping eating and drinking (VSED), including appropriate supportive care, to help a badly suffering patient to achieve a peaceful death. VSED is authorized nationwide.
  • Medical aid in dying: a medical practice that offers terminally ill, mentally competent adults the option to request a prescription for medication that they can ingest to shorten their dying process. Medical aid in dying currently is authorized in five states, Oregon, Washington, Montana, Vermont and New Mexico, but legislators in the District of Columbia and at least 24 other states have introduced medical aid-in-dying bills.

Physicians who want to utilize the Doc2Doc service can call the Compassion & Choices toll-free number: 800.247.7421, email: [email protected], or visit the Compassion & Choices website at: www.compassionandchoices.org/what-we-do/doctors-to-doctors.

In addition, Compassion & Choices, in collaboration with 18 leading aging and healthcare organizations, is conducting “The Campaign to End Unwanted Medical Treatment” to encourage healthcare providers and institutions to honor patients’ wishes.


Dying Calif. Mom Granted Urgent Hearing in Medical Aid-in-Dying Suit

July 24 Hearing Date Is Birthday of Mom Seeking Medical Aid-in-Dying Option

(San Diego, CA – June 11, 2015) A California judge has ordered expedited review of a suit filed on behalf of three patients and a physician asserting the state constitution and existing state law allow terminally ill adults to utilize the option of medical aid in dying to end their unbearable suffering. The court’s order is posted at: www.compassionandchoices.org/userfiles/2015-06-09-Minute-Order.pdf.

Superior Court Judge Gregory Pollack will hold a preliminary motions hearing on July 24, which coincidentally is the birthday of the dying lead plaintiff, Christy O’Donnell, 46. Despite receiving chemotherapy every week for the last 10 months, O’Donnell’s physicians have told her that she will likely die painfully within the next few months from lung cancer that has spread to tumors in her brain, spine, rib and liver. Medical aid in dying gives mentally competent, terminally ill adults like O’Donnell the option to request a doctor’s prescription for medication they can take in their final days to end their dying process painlessly and peacefully.

“Christy’s cancer has spread and causes her more pain and suffering each day,” said John Kappos, a Newport Beach-based partner in the law firm of O’Melveny & Myers LLP, who argued the motion before Judge Pollack and is working with Compassion & Choices on behalf of Christy and other plaintiffs in the suit. “We thank the court for expediting review of any preliminary motions filed in this case.”

O’Donnell is a Christian, registered Republican, civil rights attorney and former sergeant in the LAPD, whose 20-year-old daughter, Bailey, lives with her in Santa Clarita. The video of her story, which was recorded on March 4, is posted at: www.compassionandchoices.org/new-litigation-in-california and www.youtube.com/watch?v=l_x3_5-Ip1M&noredirect=1

“The last thing I want is for my daughter, Bailey, to see me die in agony because I cannot utilize medical aid in dying,” said O’Donnell. “The judge’s decision gives Bailey and me a ‘chance’ to experience a less painful time at my death.”

“Judge Pollack’s decision is another positive step toward making medical aid in dying available to terminally ill Californians who suffer enormously in their final weeks and days,” said Kevin Díaz, national director of legal advocacy for Compassion & Choices. “This ruling shows the court’s sensitivity to Christy’s urgent situation. We welcome the opportunity to present the merits of the case to the court.”

The other plaintiffs are Sacramento resident Elizabeth Wallner, who has stage IV colon cancer that has metastasized to her liver and lungs; a retired landscape architect from Ventura, Wolf Breiman, who was diagnosed six years ago with an incurable cancer of the white blood cells called multiple myeloma; and La Jolla physician Lynette Cederquist, M.D., who is board certified in internal medicine, hospice and palliative medicine, and a clinical professor of medicine.

The suit also asserts that medical aid in dying is a more peaceful alternative to palliative sedation. Palliative sedation involves medicating the patient into a coma and withholding nutrition and fluids until the patient dies. Both the U.S. Supreme Court and California courts have recognized palliative sedation as a legitimate medical practice. The suit is posted at: www.compassionandchoices.org/userfiles/Complaint-CA-Lawsuit.pdf.

The suit coincides with the legislative campaign to authorize medical aid in dying in California by passing the End of Life Option Act (SB 128), recently approved by the Senate. SB 128 is closely modeled after the death-with-dignity law in Oregon, which has worked well for 17 years, without a single documented case of abuse or coercion. Currently, four other states authorize medical aid in dying: Washington, Montana, Vermont and New Mexico. A recent poll shows that California voters support the medical option of aid in dying by more than a 2-1 margin (64 percent vs. 24 percent).

New Legislation Would Give Patients More Power Over Their Own Care

Compassion & Choices Praises Senator Warner’s and Isakson’s Care Planning Act of 2015

(Washington, DC – June 11, 2015) Compassion & Choices, the nation’s leading nonprofit devoted to improving care and expanding choice at the end of life, praised yesterday’s introduction of The Care Planning Act of 2015 by U.S. Senators Mark Warner (D-VA) and Johnny Isakson (R-GA), a member of the Senate Health Committee.

The bipartisan bill would create a Medicare benefit for people facing grave illness to work with their doctor to define, articulate and document their personal goals for treatment. It would further help patients avoid excessive or unwanted medical treatment and receive only the care they want, consistent with their wishes, across care settings.

Responding to the bill’s introduction, Compassion & Choices National and Federal Programs Director Daniel Wilson said:

“Senator Warner’s and Isakson’s legislation empowers people to truly get the outcomes they want when they are facing serious illness at the end of life. Too often during a health crisis, patients defer to a medical system that is so focused on keeping a body alive, it can forget the person inside. A focus on the person is what we need and what this bill provides.

“For many Americans, spending their final weeks or months undergoing noncurative, exhausting, debilitating treatments is not the life they want. Individuals deserve choice at the end of life, and whether they choose a maximum quantity of days or a maximum quality of perhaps fewer days, their doctors need to support them. The Care Planning Act of 2015 goes a long way toward helping patients achieve personal clarity about their priorities, and helps healthcare providers honor those priorities. Compassion & Choices is proud to support this legislation.”

Full details of the Care Planning Act of 2015 are available at: http://www.warner.senate.gov/public/index.cfm/2015/6/warner-isakson-introduce-bipartisan-bill-to-improve-planning-options-for-patients-with-advanced-illness