California bill would mandate discussions of end-of-life options

Doctors agree that patients have a right to know about choices, but most say lawmakers should not meddle in physician-patient relationships.

By Kevin B. O'Reilly, AMNews staff. July 14, 2008.

The California State Assembly in late May passed a bill requiring physicians to have comprehensive discussions about legal end-of-life care options with terminally ill patients who request such information.

The measure, up for consideration in the Senate at AMNews press time, would be the first of its kind to gain passage nationally. A similar bill in Vermont is stuck in House committee.

The California proposal requires doctors to tell patients whose prognosis suggests less than a year to live about hospice and palliative care, and about alternatives such as palliative sedation and refusing food and water to speed the dying process. Although palliative sedation is at attempt to relieve a patient for whom pain control efforts have failed, it can, in rare instances, hasten death.

The bill "shifts the decision-making ability to the patient," said Barbara Coombs Lee, president of Compassion & Choices, the organizational sponsor of the bill.

"Without this bill, the physician is in charge of what the patient knows. After this bill, the patient gets to know their options, and then they can make a decision on the basis of that knowledge," she said.

The measure, dubbed the "Terminal Patients' Right to Know End-of-Life Options Act," garnered strong opposition from Catholic, pro-life and disability-rights groups that expressed concern it is "setting the table for future assisted-suicide legislation."

The bill's authors, Assembly members Patty Berg and Lloyd Levine, both Democrats, have in previous sessions unsuccessfully attempted to pass legislation modeled on Oregon's Death With Dignity Act.