As efforts to expand physician-assisted death ramp up across the country, California lawmakers will consider a measure to expand access to the procedures for dementia patients, add new ways drugs can be taken, and open access to out-of-state residents. 

Senate Bill 1196, introduced by a state senator, Catherine Blakespear, would expand California’s End of Life Options Act to include patients with a “grievous and irremediable medical condition” to request doctor-assisted death in addition to patients with a terminal disease. 

The California effort comes on the heels of a slew of more than a dozen states working to legalize or expand access to assisted suicide. Gallup polling indicates that for nearly 30 years a majority of Americans have “consistently favored doctor-assisted suicide,” yet the measures have sparked a heated ethical debate. 

Proponents of the measures cite the personal nature of medical decisions and say the government shouldn’t be able to interfere in the doctor-patient relationship. Opponents say doctors should heal patients rather than assist in their deaths, and they point to Canada’s liberal assisted suicide laws and the resulting surging death toll.

In Canada, a shocking four percent of the country’s deaths were from assisted suicide — leading to it being the fifth-leading cause of death there, as the Sun has reported. Recently, reports have emerged that a father is asking a Canadian court to stop his 27-year-old daughter’s assisted suicide, whom he says has autism and doesn’t meet the criteria for assisted death. 

The California bill would set new conditions that would require a patient to be in a state of “irreversible decline in capability” and experiencing “physical or psychological suffering” that is “intolerable to the individual and cannot be relieved in a manner the individual deems acceptable.” Additionally, it must be “reasonably foreseeable” that the condition would become the patient’s natural cause of death. 

The legislation, if enacted, would also expand assisted-death to allow patients with “early-to mid-stage dementia,” allow IV infusions of the drugs rather than the current requirement that it must be taken orally or through a digestive tract, remove the 2031 sunset date, and remove the state’s residency requirement. 

The language of the bill is still being drafted, Ms. Blakespear’s office tells the Sun, and she will introduce amendments this week.

“Nearing your end-of-life elicits strong emotions and is a human experience we will all inevitably encounter,” she tells the Sun, adding that each patient has different circumstances and experiences. “The intention behind the End of Life Option Act is to provide those nearing their end-of-life with medical autonomy that best suits their needs — not mine or yours, but their specific needs during this personal moment.”

Two provisions in current state law are “needlessly excluding many Californians from accessing aid-in-dying medicine,” a fact sheet about the bill notes. One is the six month prognosis required for a terminal illness — a “faulty metric” that can result in “improper determination,” her office says. 

Another issue is that dementia patients and people with “other progressive neurological conditions will likely lose the required cognitive capacity to obtain, and the physical capacity to inject, aid in-dying medication” before the six-month mark. Some patients lose the ability to self-administer through a digestive tract — which is why the bill expands to allow IV infusions. 

“People with a terminal, incurable illness or disease have the right to determine what is best for their health and how they leave this existence,” Ms. Blakespear tells the Sun. “No person should have to suffer as they near end of life, and they should have the right to leave peacefully, on their terms.”

One vocal critic of the bill is the executive director of Canada’s Euthanasia Prevention Coalition, Alex Schadenberg, who is warning California lawmakers not to “follow Canada’s lead.” 

“Changing the criteria from a terminal illness (6 months prognosis) to having a ‘grievous and irremediable medical condition’ will lead to people with disabilities ‘qualifying’ for death by lethal poison for reasons of poverty, homelessness, an inability to obtain necessary services or difficulty with obtaining medical treatment as has happened in Canada,” he notes. 

The bill could lead to “homicide tourism,” he adds, and the IV infusion allowance would mean doctors are actively carrying out the death rather than assisting a patient in self-administering the fatal drugs. “Euthanasia is sold to the public as allowing competent adults who are capable of consenting to die by lethal poison,” according to Mr. Schadenberg. “Allowing euthanasia for people with dementia permits medical practitioners to kill someone who is not competent and unable to consent.”