Judge's Ruling Threatens California's Assisted Suicide Law

Lawmakers approved bill during a special session. Now that process has been challenged.

Emilija Randjelovic / Dreamstime.com

California's assisted suicide law is in jeopardy after a judge ruled Tuesday that state lawmakers had passed it improperly.

The state legislature passed the End of Life Option Act in 2015, and it launched at the start of the following year. It allows doctors to prescribe drugs at patients' request to end their lives if they have terminal illnesses and less than six months to live.

The law was challenged in court in Riverside County in 2016 by some doctors and the Life Legal Defense Foundation.The plaintiffs object to the moral implications of assisted suicide, and they argued that the law doesn't adequately protect terminally ill people by requiring psychiatric evaluations before they are provided life-ending drugs. The law requires that two physicians determine that the patient is mentally competent.

Superior Court Judge Daniel A. Ottolia did not determine whether or not assisted suicide is itself permissible under California law. Rather, he ruled that lawmakers violated the state's constitution by passing the bill during a special session called by Gov. Jerry Brown to deal with health care issues.

You might think a bill authorizing assisted suicide would fall under "health care issues." That's how Compassion & Choices, a nonprofit group supporting end-of-life choices, reacted in a press release, saying that the court misinterpreted the constitution "because medical aid in dying is a recognized health care option."

But a review of Brown's proclamation for the special session shows it wasn't generically about "health care issues." The purpose of the session was narrowly stated to focus on health care funding, health care rate increases, and the state program Medi-Cal. There was nothing in the order to hint at the idea that setting policies for end-of-life care was on the agenda.

So it's possible to support assisted suicide yet still understand the judge's point here that lawmakers overstepped their bounds by pushing this bill through in an unrelated special session.

The judge gave the state five days to file an appeal. California Attorney General Xavier Becerra tells the Los Angeles Times the state disagrees with the judge's ruling and will be seeking an expedited review.

Ultimately, even a negative decision here will probably just be a legislative bump in the road. Polls show that a good two-thirds of the public support physician-assisted suicide. If the law didn't pass under the appropriate procedures, lawmakers can pass it again. That will be unfortunate, though, for terminally ill people who might end up suffering through the gap.

Comments

[Rich]

the law doesn't adequately protect terminally ill people by requiring psychiatric evaluations before they are provided life-ending drugs of legislators who purport to protect terminally ill people.

[Eidde]

"The purpose of the session was narrowly stated to focus on health care funding, health care rate increases, and the state program Medi-Cal. There was nothing in the order to hint at the idea that setting policies for end-of-life care was on the agenda."

Assisted suicide seems relevant to cutting medical costs.

You might think I'm being facetious, but consider the incentive structure with a quasi-socialized medical system (and who knows how much worse it is in California). We can expect a lot of poor people to "volunteer" to be killed by doctors and spare the state treasury - I mean themselves - further suffering.

The "voluntary" aspect of assisted suicide is questionable under these circumstances.

[Chipper Morning Baculum]

Then why is the State, always and everywhere, fighting against legalizing suicide? The State does not want to recognize self-ownership, and suicide is the ultimate expression of self-ownership.

[Eidde]

Flip the question and ask why the California legislature is such a pioneer in assisted suicide. Did they see the light and become libertarians?

[Chipper Morning Baculum]

Because there was a specific case that inspired activism to push this through. There was much opposition from those in power.

[EscherEnigma]

Assumption unsupported. California isn't a "pioneer", the issue became big here after a pretty famous case where a terminally ill woman moved out of state because that was the only way to end things on her terms.

[BYODB]

Who was stopping her from drinking bleach or shooting up enough Meth or Heroin to stop an elephants heart?

[BestUsedCarSales]

My fear is increased based on how "assisted" suicide of those with mental illness in Europe is going.

[Hugh Akston]

How is it going exactly that has increased your fear?

[BestUsedCarSales]

Europe has increasingly allowed euthanasia for people's with mental illness. This is fine, as I think there should be no limitations on when someone can kill themselves. But the problem is that there is increasingly times where people with mental illness considered significantly troublesome are euthanized by doctor's orders.

This is the fear I have in a country with a powerful association between psychiatry and government. That people deemed to be hopeless will be put down by the state under the guise of relieving suffering.

[Hugh Akston]

Are people actually being euthanized by doctor's orders? Like are there any documented cases of that occurring? My understanding of the European approach is that the patient themselves has to petition the assisted suicide board before the doctor is allowed to proceed.

[BestUsedCarSales]

Yes, the study is a bit old, but it should be enough to at least encourage some hesitance in the machinations of the state.

[BYODB]

Indeed, people like to pretend this is beyond the pale but it's the natural end point for socialized medicine. Remember: medical care is always a scarce resource, even more so in a socialized system, and a centralized system will be making value calls for you on what must be done with you and those with severe mental illnesses, from a utilitarian point of view, are a drain on society and that's something that isn't generally tolerated in a socialist system.

[$park? leftist poser]

That will be unfortunate, though, for terminally ill people who might end up suffering through the gap.

They're dying anyway.

[Mr. Gus]

I disagree with assisted suicide. It's effectively forcing physicians to deal out death, which is pretty much the opposite of the reason you get into being a doctor in the first place. (That, and money and chicks.) It's sick and wrong. You wanna kill yourself, do what the rest of us do: go down to Home Depot and BUY A ROPE.

[Chipper Morning Baculum]

Huh? Is it not the doctor's job to help the patient? If a patient wants to die, the compassionate doctor should help. Of course, no one is saying a doctor should be forced to do so if he or she does not want to do that.

[Eidde]

"Of course, no one is saying"

Until they do.

[Eidde]

If, as you say, a doctor who doesn't kill his patient isn't doing his job, then by that logic, the state licensing board should *require* him to do it.

[Eidde]

assuming the patient signs forms claiming to want to die, of course.

[Chipper Morning Baculum]

Are doctors today forced to treat patients they don't want to treat? No, they refer them out. That's why the new guy in town ends up with all the problem patients.

[BYODB]

Are doctors today forced to treat patients they don't want to treat? No, they refer them out.

Depends if they're taking Medicaid patients, I'd say, but of course not many M.D. are taking on new Medicaid cases. I wonder why. /sarc

[Mickey Rat]

That is an absolute statement which is really not supported by the facts. At the opposite end there are a number of people who are pushing for a requurement to perform abortions to be a medical doctor. A Catholic hospital has been sued for not performing sex change surgeries. The idea that one must be cool with euthanasia to be a medical professional is beyond the pale is laughable in today's political climate.

[Hugh Akston]

There's a perfect solution for people who don't agree with assisted suicide: Don't get one. Don't assist with one. What other people choose to do with their lives (or deaths) are none of your concern.

[Eidde]

You don't think doctors and patients will be under pressure to agree to this stuff?

If as CMB suggests, killing willing patients is in the doctor's job description, then if they fail to do that job they can have their medical license challenged.

[Hugh Akston]

All the more reason to do away with monopolistic medical licensing.

[Homple]

Why stop at licensing? Do away with laws altogether.

[Hugh Akston]

Patience, Grasshopper. We'll get there eventually.

[EscherEnigma]

It's effectively forcing physicians to deal out death [...]
Nope. Doctors are free to refuse. No doctor is required to take part that doesn't want to.

[BestUsedCarSales]

Can he continue to be a doctor after declining?

[EscherEnigma]

Yep.

[BestUsedCarSales]

I fear to see what will happen moving forward, as we have already seen doctor's sued for refusing to aid in their deaths.

[EscherEnigma]

Read your own article. They're suing because they were lied to.

[BestUsedCarSales]

The case is that they believe they were not given enough information. A doctor referring someone to another doctor for assisted suicide is 100% aiding in there deaths.

[EscherEnigma]

A lawsuit by her children will determine whether UCSF Medical Center, where Dale first went for treatment, was responsible for her suffering by allegedly concealing its oncologists' decision not to provide life-ending drugs to patients who ask for them. More broadly, their suit illuminates the inner workings of a law that confers new rights on terminally ill patients, but few obligations on their health care providers.

Judy Dale never learned why her doctor at UCSF and his fellow oncologists refused to provide life-ending medication. In fact, her two daughters said in their San Francisco Superior Court suit last month, she told doctors and others at the medical center from the time of her hospitalization in June 2016 that she wanted the medication and was assured it would be available, until she learned the truth from a social worker more than two months later.

The case is that the doctors lied to them.

[BYODB]

The law allows a medically competent adult who has six months or less to live to ask a doctor to prescribe lethal medication. The patient, not the doctor, must be the one to administer the drug. Two doctors must agree on the terminal diagnosis, and the patient must make two requests, at least 15 days apart, before receiving the medication.

But doctors and hospitals are not required to take part in the process or to refer the patient to someone who will grant the request. Hospitals can prohibit their physicians from prescribing life-ending medication, something that medical centers affiliated with the Catholic Church and some secular hospitals have done. And a doctor who has decided not to prescribe the drugs is not required to disclose that fact until the patient asks for them.

The reason why Doctor's and hospitals aren't required to do those things is because it's a moral issue and referring someone to a hit man is usually a crime if not simply immoral in general.

Again, and hopefully this time it will sink the fuck in, Doctor's aren't there to kill you they are there to do the opposite and if you want to start making it the Doctor's job to play god than I don't think you'll like where it ends up.

I think the safest bet for Escher is to start asking the government to make it illegal for Catholics to own or operate Hospitals, because that's the only way you're terribly likely to get your way here.

[BYODB]

Also, a money shot for your consideration:

By the time the 77-year-old Dale and her family could locate a willing doctor elsewhere, the suit said, it was too late ? she requested the medication and died 14 days later, one day before the law's waiting period expired.

So you see, the state mandates that she suffer for 15 days instead of allowing her to put a bullet in her own head. So, this is the 'humane' option, eh?

[EscherEnigma]

@BYODB
I haven't said that doctors are required to take part or give referrals. In fact, I specifically said they weren't.

And again, that's not what the lawsuit is about. If the hospital had just said "no", then they'd be in the clear. But they didn't. They lied to a sick old woman and her family for months. THAT is the issue.

You aren't defending a hospital's right to not take part, you are defending a hospital's right to lie to a patient and string them along for months.

[BYODB]

I haven't said that doctors are required to take part or give referrals. In fact, I specifically said they weren't.

Yet, they are required by law to be involved and somehow you don't see how this can be a problem. Two doctors (Specialists, or just primary care doctors one might ask), at minimum, along with a minimum period of two weeks between diagnosis and two separate requests from the patient.

Riddle me this: have you ever tried to get an appointment with an oncologist within two weeks of making the call? How about other specialists?

Sorry, I've worked for hospital systems for almost two decades and I promise you this method of 'assisted suicide' is stringing out the length of time people suffer compared to just doing it themselves yet somehow this is touted as 'humane' because there simply must be an 'official' process for...reasons.

Fact: Anyone can kill themselves with morphine, the 'medical training' is there so you know how much you can give someone without killing them.

And, finally, the very stipulation of 'only six months to live' is itself arbitrary so I honestly don't know how you'd get two M.D. to agree on that point other than to get you out of their office and into the ground as soon as possible.

[EscherEnigma]

Jack, Joe and John are sitting at a table.

Jack turns to Joe: "can you pass me the salt?"
Joe responds: "No."
Jack turns to John: "can you pass me the salt?"
John responds: "Sure" and passes the salt.

That's the "involvement" you're objecting to. A patient might ask a question, and the doctor can say "yes" or "no" as their conscience dictates. If the patient can't find a doctor, then they're out of luck.

[BYODB]

That's the "involvement" you're objecting to. A patient might ask a question, and the doctor can say "yes" or "no" as their conscience dictates. If the patient can't find a doctor, then they're out of luck.

Gotcha, so you at least have no problem with the law effectively having no teeth you simply object to a Doctor that refuses to tell someone where they can find a Doctor who will kill them to the point of actually lying about the fact they'll kill them or not.

Of course, they were explicitly placed in that awkward position by the legislature, but you're more reasonable than some on the topic I will admit even while I still very much disagree.

If you're the type of person who thinks there 'outta be a law' but give essentially zero fucks about actual outcomes, this type of thing makes a lot of sense and as far as I can see this is basically the California modus operandi.

One thing I can say for sure is that I'm very, very glad the healthcare company I work for no longer does business in the state of California.

[Eidde]

It's (so to speak) sick that doctors have to fear prison for prescribing painkillers but there's a movement to let them kill patients in pain from lack of access to opioids.

[EscherEnigma]

Nah. None of the assisted-suicide laws in the states allow someone to request it just for pain.

[Eidde]

No, but pain medicine could take some of the edge off if you're extremely sick and being pressured to volunteer for euthanasia.

[EscherEnigma]

So if you assume that someone is being "pressured to volunteer", and you assume that it's the pain that's driving them to acquiesce, and ignore that this is California we're talking about where legal MJ is a thing, you can imagine a scenario where someone is legally taking advantage of California's assisted suicide law because of their lack of meds (which is itself assumed).

That's seriously your argument?

[Eidde]

They have the incentive to reduce medical costs, this bill will give them the means.

Motive and opportunity.

How optimistic are you that this won't be taken acted on?

[$park? leftist poser]

Are you concerned about assisted suicide in general or just assisted suicide in California? Colorado has also has an assisted suicide law on the books for nearly two years. Does that also worry you?

[EscherEnigma]

Optimistic enough that I'm calling you out for relying on paranoia and fear to stop others from making personal decisions you disapprove of.

Will some folks abuse it? Sure, why not? Enough that it's better too restrict everyone's freedom? Not even close.

[BYODB]

Do you need a Doctor to tell you how to kill yourself, is my question. It seems that, just as a single example, the Japanese have this pretty well figured out without professional advice.

What California is saying is that if you want to kill yourself, you need to go and consult with a Doctor who's job is to keep you alive. Not 'give you what you want', as some people here seem to believe.

Would you consult with a mortician on how to get rid of your persistent migraines? I doubt it.

Know what else California could do to help out people that want to kill themselves? Legalize heroin. Done.

[EscherEnigma]

Legalize heroin.
Also something I'm in favor of. We should go back to being able to order cocaine through the Sears catalog.

Wait, was that supposed to be the "bridge too far" that would make me balk? Am I more libertarian then you on both assisted-suicide and drugs?

[BYODB]

No, it was pointing out a rational alternative that would achieve a better end result and more freedom. If you agree, great.

You're not 'more libertarian' than anyone by demanding the state get involved in your decision to kill yourself though. If you think your position is even moderately libertarian, it could be amusing to hear how.

Although, thing is, I don't see any downside for a terminally ill patient to go out looking for black market heroin to kill themselves with. Honestly, it would probably take less time than jumping through the hoops from the state.

[EscherEnigma]

You're not 'more libertarian' than anyone by demanding the state get involved in your decision to kill yourself though.
... well, I only have myself to blame for getting suckered this long.

Peace out.

[BestUsedCarSales]

Why not?

[EscherEnigma]

Legally, because the condition is "terminally ill that is expected to result in death within six months". Pain is irrelevant to the decision.

Morally, because Americans at large really aren't comfortable with giving folks unfettered power over their own lives.

To be clear, someone that qualifies could consider their pain when making their decision, but pain alone is not sufficient to qualify.

[BestUsedCarSales]

It's such a stupid limitation. And it highlights that the decision is completely unlibertarian. It has nothing to do with the rights of a person choosing when they die, and is just a clarification on when the state is willing to let you go.

In cases such as this, it becomes even MORE important to loosen the ties and control government, and other structures have over people making these decisions.

[EscherEnigma]

/shrug

Nothing's perfect. But it is better then what we had before, and better then what most of the US has.

[BestUsedCarSales]

Okay, then know that you are saying institutional murder is an acceptable side effect.

[EscherEnigma]

Deaths from malpractice rate at somewhere between 50,000 and 100,000 each year. Injuries rate up to around 300,000 a year.

So to put it bluntly, "institutional murder is an acceptable side effect" of modern medicine.

If someone abuses this law, then they can and should be punished. But we have years of trying this in California, Washington, Colorado and elsewhere, and it's not happening at any appreciable rate (if at all). So yes, it's an acceptable risk. But freedom and security and all that jazz.

[BestUsedCarSales]

There is an obvious and clear moral distinction between malpractice and involuntary euthanasia. That's a silly point to make.

But freedom and security and all that jazz.

I'm advocating for removing the state further from the equation. This law is not freedom, this law is simply a way for the government to deem those they say can die.

[BestUsedCarSales]

And that it's not even worthy of taking pause. It's so meaningless of a side-effect to you that it's not even worth considering whether the law is badly written.

[$park? leftist poser]

Institutional murder is a side effect of having a police force. Can you think of ways to eliminate institutional murder by police? Could that be applied to doctors?

[EscherEnigma]

@BestUsedCarSales
There is an obvious and clear moral distinction between malpractice and involuntary euthanasia.
To be clear, just what are you trying to conflate as "institutional murder"? Doctors maliciously killing patietns that don't want to be killed ("involuntary euthanasia"), safeguards failing (the mythical "pressured to suicide" patient), or the system working as intended?

Because the first is straight-up murder and remains a crime. The second could be called malpractice on the doctor's part and murder on the part of the those pressuring. The third is "working as intended", and calling that "institutional murder" is just trying to discredit the system through fear-mongering.

This law is not freedom, this law is simply a way for the government to deem those they say can die.
And yet, it is still better then what most of the US has. The alternative to physician-assisted suicide is not your utopia.

And that it's not even worthy of taking pause.
Sure. That pause happened a long time ago. Folks can have informed opinions on things you know.

[BYODB]

And yet, it is still better then what most of the US has. The alternative to physician-assisted suicide is not your utopia.

The alternative is killing yourself, which is still an option that's eternally on the table. Notably, the law in question still makes you kill yourself. If you're not physically capable of killing yourself, too bad you gotta live out your term.

[Nardz]

Oddly, this is a bit like the gay marriage debate.
What Escher seeks isn't the ability for people to kill themselves, but for State sanction/official approval for the process.
Sidenote: How long will it take before a doctor is sued on the basis that s/he is refusing service to a protected class?
Just like gays have always had the ability to get married despite the lack of or presence of State recognition, people always (99.99%) have the ability to kill themselves.

[Mickey Rat]

A Readon writer against another inalienable right.

[Eidde]

Again, some libertarians are discussing a proposed California statute as if it's being adopted in Libertopia.

But it's California, people.

[$park? leftist poser]

Seems to me that libertarians are discussing a libertarian proposition. But then again, I don't think suicide is a sin and I'm not against assisted suicide so they may be looking at this from the wrong angle.

[$park? leftist poser]

I like how my phone just casually changed 'I' to 'they' like there's no difference. Thanks, Apple.

[Hugh Akston]

Sparky has been assimilated.

[EscherEnigma]

Passed, not proposed. It's actually be in effect for something like two years now dude. Washington state's similar law has been in place even longer.

[Eidde]

They should study it and see if it's like the Netherlands.

[EscherEnigma]

You should study it so you stop giving out misinformation on it.

[John]

Once you go down the road of allowing doctors to murder their patients, it always ends with doctors doing just that without bothering to wait for the patient to ask.

Involuntary euthanasia" is a term that disturbs the Dutch. The Dutch define euthanasia as the ending of the life of one person by another at the first person's request. If life is ended without request they do not consider it to be euthanasia. The Remmelink report uses the equally troubling expression "termination of the patient without explicit request" to refer to euthanasia performed without consent on competent, partially competent, and incompetent patients.

The report revealed that in over 1,000 cases, of the 130,000 deaths in the Netherlands each year, physicians admitted they actively caused or hastened death without any request from the patient.

In about 25,000 cases, medical decisions were made at the end of life that might or were intended to end the life of the patient without consulting the patient. In nearly 20,000 of these cases, (about 80 percent), physicians gave the patient's impaired ability to communicate as their justification for not seeking consent.

[John]

This left about 5,000 cases in which physicians made decisions that might, or were intended to, end the lives of competent patients without consulting them.

In 13% of these cases, physicians who did not communicate with competent patients, concerning decisions that might, or were intended to end their lives, gave as a reason for not doing so that they had previously had discussed the subject with the patient.

Ye,t it seems incomprehensible that a physician would terminate the life of a competent patient, on the basis of some prior discussion, without checking if the patient still felt the same way.

A number of Dutch euthanasia advocates have admitted that practicing euthanasia with legal sanction has encouraged doctors to feel that they can make life or death decisions, without consulting patients. Many advocates privately defend the need for doctors to end the lives of competent patients, without discussion with them.

http://www.life.org.nz/euthana.....efault.htm

There seems to be no leftist culture war issue up to and including the murder of the sick that the Reason libertarians will not fall in love with.

[$park? leftist poser]

I guess people who want to die will just have to settle for waving a cell phone at panicky cops.

[BestUsedCarSales]

I believe fully that people own their own bodies, and can choose to die if they wish. But we have here cases where people are euthanized without consent (murdered) and you respond with a bitchy non-sequitur.

[BestUsedCarSales]

I'm sorry for calling your comment bitchy. That was rude of me, and not helpful to the discussion.

[$park? leftist poser]

There is an element of risk in every human endeavor. It sounds like you want to limit a person's freedom based on some possible risk.

[BestUsedCarSales]

No, I want to limit the machinations of the state. And there is a fundamental difference between risk taken by an individual of their own volition, and the doing something that puts risk on others.

This is distinctly the latter case, the state is creating a law which leads to possible death by people who have not consented to be a part of the process.

[$park? leftist poser]

possible death

Ok, you're good with that. I'm not, personally.

[$park? leftist poser]

How many of those doctors were charged with murder?

[BYODB]

And, after medical care is taken over by the government, well if you're too old to justify getting medicine guess what you'll get instead?

Not to say that assisted suicide isn't fine enough thing, I suppose, although I'd say there are a shit ton of ways out there to assist yourself with your own suicide if you're so inclined. Not sure why an M.D. needs to be specifically involved. No offense, but plenty of people seem to figure out how to kill themselves without medical advice and it seems this would put a Doctor in a somewhat awkward position as technically their job is to keep people alive which this does not really fall into that category.

In fact, it's sort of the antithesis of their job.

[$park? leftist poser]

although I'd say there are a shit ton of ways out there to assist yourself with your own suicide if you're so inclined.

Suicide is illegal. If you're found before you're dead some flunky is going to try to save you. Then you'll be arrested for attempted suicide.

[BestUsedCarSales]

Though, interestingly, California has laws for mandatory holding of people deemed to be a suicide risk.

Once again, emphasizing that this is only allowing to die within the full range and consent of the state.

Most states suicide is not illegal anymore, by the way. But allowing someone to kill themselves should be protected.

[$park? leftist poser]

If people are allowed (yeah, it's dumb that they have to be allowed) to just commit suicide, then doctor assisted suicide shouldn't even need to be a thing.

[BYODB]

Yes, this is rather the point. Politicians want to make sure that you can only commit suicide after submitting form 801-A to the Department of Health and Human Services and waiting six months to a year for a reply, at which point the problem has been solved.

It's not 'helping' it's putting barriers between people and killing themselves. Full stop.

It would actually make more sense for the government to create an entirely new 'medical' profession that does nothing except kill people, because at least then there isn't any ambiguity about why you're going to the Doctor. Notably, though, no one will ever know if you fuck up at your job because it's not like using too much of the legal drugs matters.

Of course, at that point we'd need to acknowledge that we've blown right past death panels in socialist healthcare systems straight to 'you're a drain on the social system, you're dead' which is an inevitable result.

[$park? leftist poser]

Sorry, I can't even follow what point you're trying to make here.

[BYODB]

Not surprising, it's more of a rant that agrees with your statement that people should just be allowed to kill themselves without a Doctor. The issue makes me angry since it makes very little actual sense for a Doctor to be the one who helps kill you. The main reason people push for this, I think, is because a Bureau of Ending Life doesn't sound as nice and people ( very generally) trust Doctors.

[BYODB]

Is suicide still illegal in the United States, to my knowledge it generally isn't. Furthermore even if it is this would seem to be extra encouragement to not fuck it up.

Also, if it's illegal to kill yourself one might ask how it could be that it's legal for a Doctor to kill you at your request.

Get rid of the middle man, fucko.

And no offense, but if you fuck up killing yourself you should kill yourself. It's super simple to do and if you fail at ending your own life that will probably send you into a suicidal spiral.

I know I could be nicer, but it's seriously one of the most bullshit and idiotic things I've ever heard of to require a Doctor to help kill you. As if you couldn't just load up a big 'ol heroin syringe and do a fantastic job of it all on your own without any pain and, in fact, I've heard it'll be an amazing ride.

[EscherEnigma]

Hell with "nicer", try "more realistic".

You're pointing out how far we are from utopia as a reason to not take a single step.

[BYODB]

So in your view it's 'more realistic' to task healthcare providers who have taken an oath to protect life with ending it instead of simply allowing people to kill themselves? That's an interesting take.

This isn't a perfect being the enemy of the good situation, it's the plan being suggested is an elaborate plan to get around a much more simple solution. If you want to start being all utilitarian, I think you're doing it wrong.

[EscherEnigma]

Seeing as this system has actually been passed and put into place, and your preferred solution has not, yes, I think it's pretty obvious which is more realistic.

[BYODB]

Sorry, 'realistic' would appear to fit in this instance.

This option was more realistic precisely because it makes people suffer waiting for permission to kill themselves from the State, and realistically the State does put people into situations where the only way out is to beg for mercy.

It's why the ACA was 'more realistic' than deregulation, and why it's 'more realistic' to cut taxes without touching spending. Sometimes, when I hear 'realistic' I interpret it as 'what would be the simplest effective solution'.

[EscherEnigma]

Not sure why an M.D. needs to be specifically involved.
If you want your family to collect your insurance, then you'd have to make it look like an accident (most life insurance policies won't pay out for suicide, but will pay out for physician-assisted suicide).

And making it look like an accident makes it more likely that your family is going to get a big fat bill when the county dredges the lake for your body, or pulls your car out of the ravine, or combs the mountains looking for your corpse.

The less expensive ways (rope, knives and guns) are all pretty blatant. And lets face it, most folks are going to botch knives and ropes and make it way worse then it had to be, and guns leave a huge mess for your family.

And that's ignoring that folks in their last six months often aren't terribly equipped to be doing things like that anyway. Sure, if I wanted to die and make it look like an accident, I could just go for a hike and get "lost" in the woods and make sure I die from exposure, but I'm young and fit. My grandmother dying from lung cancer couldn't have pulled that off. Heck, she wouldn't have been able to hold the gun steady enough.

[EscherEnigma]

Oh yeah, and it covers the legal bases so the cops don't go around saying "did you kill your grandmother" treating grieving family like potential murderers.

[BYODB]

Do you think insurance will still pay out just because a Doctor helped you kill yourself? Does the assistance of a medically trained middleman that's specifically trained on how not to kill people someone make the underlying act any different? Do you understand why insurance doesn't pay out on a suicide, and why the exact same consideration will be there for an assisted suicide?

It appears you do not, which appears to go hand-in-hand with your baseline misunderstanding about how putting a middleman between someone and their own suicide is about as smart as nationalized sanitariums of the prior century. Good intentions in this arena virtually always lead to bad outcomes, yet we continually repeat the same mistakes.

[EscherEnigma]

Seriously dude? I wasn't guessing. Go google it for yourself if you don't believe me.

[BYODB]

Umm...no I don't think you're guessing I think you don't realize that your life insurance policy will pay out even if you drink bleach and put a bullet in your head past a certain point. That certain point is there so you don't buy insurance and turn around and kill yourself so your family gets a payout. The same stipulations are there for assisted suicide as far as I'm aware, so your example where you 'need to make it look like an accident' means that I'm assuming you're using an example before that time period expires I.E. it won't pay out either way.

[EscherEnigma]

So you didn't google it.

California Code, Health and Safety Code - HSC ? 443.13
(a)(1)?The sale, procurement, or issuance of a life, health, or annuity policy, health care service plan contract, or health benefit plan, or the rate charged for a policy or plan contract may not be conditioned upon or affected by a person making or rescinding a request for an aid-in-dying drug.
(2)?Pursuant to Section 443.18 , death resulting from the self-administration of an aid-in-dying drug is not suicide, and therefore health and insurance coverage shall not be exempted on that basis.

Despite your assumptions, they are treated differently.

[BYODB]

It's not an assumption on my part that life insurance policies can indeed pay out even if you kill yourself, but it wasn't clear that you were talking about law vs. insurance policies in general.

If you're talking about laws, California could have removed Doctor's and Hospitals from actually being involved with the suicide itself while still getting a sign off for insurance and it would have been superior from at least the providers point of view even if not the libertarian point of view.