California will become the fifth state in the nation to allow terminally ill patients to legally end their lives using doctor-prescribed drugs after Gov. Jerry Brown announced Monday he signed one of the most emotionally charged bills of the year.
Brown, a lifelong Catholic and former Jesuit seminarian, announced that he signed the legislation approved by state lawmakers after an emotional and deeply personal debate. Until now, he had refused to comment on the issue.
Here is the full text of Brown's signing message:
"ABx2 15 is not an ordinary bill because it deals with life and death. The crux of the matter is whether the State of California should continue to make it a crime for a dying person to end his life, no matter how great his pain or suffering.
"I have carefully read the thoughtful opposition materials presented by a number of doctors, religious leaders and those who champion disability rights. I have considered the theological and religious perspectives that any deliberate shortening of one's life is sinful.
"I have also read the letters of those who support the bill, including heartfelt pleas from Brittany Maynard's family and Archbishop Desmond Tutu. In addition, I have discussed this matter with a Catholic Bishop, two of my own doctors and former classmates and friends who take varied, contradictory and nuanced positions.
"In the end, I was left to reflect on what I would want in the face of my own death.
"I do not know what I would do if I were dying in prolonged and excruciating pain. I am certain, however, that it would be a comfort to be able to consider the options afforded by this bill. And I wouldn't deny that right to others."
"This is the biggest victory for the death-with-dignity movement since Oregon passed the nation’s first law two decades ago," said Barbara Coombs Lee, president of Compassion & Choices, the organization that sponsored the legislation. A former ER and ICU nurse and physician's assistant, Coombs Lee coauthored the Oregon legislation.
"This victory is hugely significant in both substance and scope," said Coombs Lee. "Enactment of this law in California means we are providing this option to more than one in 10 Americans."
The coalition that fought the bill, Californians Against Assisted Suicide, issued this statement:
"This is a dark day for California and for the Brown legacy. Governor Brown was clear in his statement that this was based on his personal background. As someone of wealth and access to the world's best medical care and doctors the Governor's background is very different than that of millions of Californians living in healthcare poverty without that same access - these are the people and families potentially hurt by giving doctors the power to prescribe lethal overdoses to patients."
The coalition is reviewing "all of its options moving forward," the statement said. Those options include a possible court challenge or a ballot referendum, said spokesman Tim Rosales.
The bill passed Sept. 11 after a previous version failed this year despite the highly publicized case of Maynard, a 29-year-old Northern California woman with brain cancer who moved to Oregon to end her life last fall.
Opponents said the legislation legalizes premature suicide, but supporters call that comparison inappropriate because it applies to mentally sound, terminally ill people and not those who are depressed or impaired.
Religious groups and advocates for people with disabilities opposed the bill and nearly identical legislation that had stalled in the Legislature weeks earlier, saying it goes against the will of God and put terminally ill patients at risk for coerced death.
The measure was brought back as part of a special session intended to address funding shortfalls for Medi-Cal, the state's health insurance program for the poor. The governor had criticized the move to bypass the usual process.
The bill he received includes requirements that the patient be physically capable of taking the medication themselves, that two doctors approve it, that the patient submit several written requests, and that there be two witnesses, one of whom is not a family member.
Compassion & Choices says it now will launch a widespread education campaign about the new law in California.
"This means we need to do a significant amount of community education and education of physicians and health providers so that so that everyone is clear on what the act does or doesn't do and how folks actually can access medical aid in dying if they qualify under the End of Life Option Act," Toni Broaddus, the group's California campaign director told KPCC.
California's measure came after at least two dozen states introduced assisted suicide legislation this year, though the measures stalled elsewhere. Doctors in Oregon, Washington and Vermont already can prescribe life-ending drugs.
In Montana, while assisted suicide is not legal, the state's supreme court said in a 2009 ruling that there is nothing in Montana law indicating that physician-aided suicide is against public policy. The court added that under the state's living will law, a patient's consent to doctor-assisted suicide is an acceptable defense for a physician charged with homicide.
Broaddus said California's "End of Life Option" bill varies from Oregon's in several key ways. First, it contains translation requirements.
"Over 200 languages are spoken in homes across the state," Broaddus said. "And it’s very important to make sure Californians can access health care information in their own language."
Another difference from Oregon's law is that anyone in California who is prescribed lethal medication must also sign a form at least 48 hours before taking the medication attesting "that they do understand that they are choosing to do it of their own free will and that they understand they could change their mind if they want to," Broaddus said.
Maynard's family attended the legislative debate in California throughout the year. Maynard's mother, Debbie Ziegler, testified in committee hearings and carried a large picture of her daughter as she listened to lawmakers' debate.
In a video recorded days before Maynard took life-ending drugs, she told California lawmakers that no one should have to leave home to legally kill themselves under the care of a doctor.
"No one should have to leave their home and community for peace of mind, to escape suffering, and to plan for a gentle death," Maynard said in the video released by assisted suicide advocates after her death.
The Catholic Church targeted Catholic lawmakers before the bill's passage and urged the governor to veto it.
"Pope Francis invites all of us to create our good society by seeing through the eyes of those who are on the margins, those in need economically, physically, psychologically and socially," the California Catholic Conference said in a statement after its passage. "We ask the governor to veto this bill."
This story has been updated with additional information, and to clarify the status of assisted suicide in Montana.