Statement in Response to SB 1196, Legislation to Expand California’s End of Life Option Act (SB380)

Updated 3/29/2024

While we acknowledge that the California End of Life Option Act can be improved to enhance accessibility for those who qualify under the existing law, it's imperative to approach any additional proposals with empathy toward those seeking access to the law, an awareness of the risks to vulnerable populations, an understanding of the practicalities of medicine, and an appreciation of the evidence and data. Compassion & Choices and the Compassion & Choices Action Network respectfully oppose SB1196. Several proposed amendments pose significant risks to the current medical aid-in-dying law, potentially undermining its purpose and availability.

Expanding the eligibility criteria to include individuals with "a grievous and irremediable medical condition" raises concerns. The criteria in the existing law, requiring terminal illness with a prognosis of six months or less to live, were carefully crafted to parallel the qualification standards for hospice care. These criteria are in place to ensure that people don't feel compelled to access medical aid in dying because they lack availability to adequate pain management and symptom relief. Maintaining this balance is crucial to safeguard the well-being of all Californians facing end-of-life decisions.

Compassion & Choices and the Compassion & Choices Action Network want to emphasize that our primary goal is to safeguard and uphold the existing medical aid-in-dying law, which must be re-authorized before it expires on January 1, 2031. We are dedicating our resources to defending the law from hostile litigation and other opposition threats while securing greater availability to the existing practice.1  

Though we recognize the proposed amendments intend to provide more options for people living with dementia, it's imperative to approach this issue carefully and with compassion. Dementia affects millions of people, and it's clear that we need to address how people living with dementia experience the end of their lives. However, expanding medical aid in dying is not a suitable solution. This is why we advocate for enhancing and normalizing dementia-specific advance care planning. This approach ensures that those with dementia can fully exercise their existing legal rights and access better end-of-life options while protecting vulnerable populations.

Compassion & Choices offers a free Dementia Values and Priorities Tool that allows a person to document their wishes and create a customized dementia directive. For more information about our dementia program, please go to https://www.compassionandchoices.org/our-issues/dementia-end-of-life-care.

1  In the dismissal of the United Spinal, et al. v. State of California, et al., the judge specifically noted that he dismissed the case because of the stringent safeguards and the fact that the eligibility criteria were narrowly defined as only applying to terminal patients. This legislation's additional methodologies and removal of the terminal prognosis removes the safeguards that the judge pointed to and reinforces the concerns we have that led to our opposition. We anticipate an appeal or another suit to be filed and we will exercise continued vigilance to protect the law.