California鈥檚 original law allowing terminally ill adults to obtain prescriptions for life-ending drugs was passed in 2016. Advocates say the that took effect last year removes crucial safeguards and violates the U.S. Constitution and the Americans with Disabilities Act.
Plaintiffs in the federal lawsuit, which was filed in Los Angeles County, argue that life-ending drugs are more likely to be used by people with disabilities and racial and ethnic minorities because those groups to receive proper medical and mental health care. The advocates fear that vulnerable people could be pressured into taking their lives by family members or caretakers or feel pressure themselves because they don鈥檛 want to be a burden.
The lawsuit contends that California鈥檚 approach, known as the End of Life Option Act, harks back to the discredited practice of eugenics, which once sought to keep people with disabilities and other minority groups from reproducing.
The system 鈥渟teers people with terminal disabilities away from necessary mental health care, medical care, and disability supports, and towards death by suicide under the guise of 鈥榤ercy鈥� and 鈥榙ignity鈥� in dying,鈥� the suit argues. The terminal disease required for assistance is, by definition, a disability under the Americans with Disabilities Act, it says.
Proponents of the law rejected those claims. 鈥淲e will do everything possible to ensure the law remains in effect,鈥� said Kevin D铆az, chief legal advocacy officer for Compassion & Choices, a group that backed the California laws, in a statement. Diaz said there was for 鈥渕edical aid in dying for terminally ill adults, who are destined to die, and just want to the option to die peacefully, rather than with needless suffering.鈥�
Sean Crowley, a spokesperson for the group, pointed to of the practice in Oregon and the Netherlands that found 鈥渘o evidence of heightened risk鈥� for vulnerable groups.
Michael Bien, an attorney for the plaintiffs, said the law violates constitutional equal protection and due process safeguards designed to protect people from discrimination and exclusion. Bien is one of the attorneys who sued on behalf of the United Spinal Association, which has at least 60,000 members with spinal cord injuries or who use wheelchairs, including 5,000 in California; , which opposes physician-assisted death; the Institute for Patients鈥� Rights, which advocates for those at the end of life facing health care disparities; and Communities Actively Living Independent & Free, an independent living center in Los Angeles County.
Bien pointed to statistics showing inequities in infant and maternal mortality, and covid-19 deaths.
鈥淭his is how our system works, and end-of-life care has the exact same problems,鈥� Bien said.
People who choose to use drugs supplied by a doctor to kill themselves may not realize they could instead , potentially including sedation that can render them unconscious, said Ingrid Tischer, one of two individual plaintiffs in the lawsuit.
鈥淚t really does create two classes of people鈥� based on whether they are perceived to be terminally ill, said the 57-year-old Berkeley resident. 鈥淥ne side gets [suicide] prevention, one side gets a [life-ending] prescription. And that is discriminatory.鈥�
Tischer was born with a type of muscular dystrophy, a progressive disease that now makes it difficult for her to breathe and requires her to use a walker or a wheelchair.
鈥淚 want the care that people get at the end of life, including my own, to be much better,鈥� she said. 鈥淎nd I don鈥檛 want assisted suicide to become the new American way of death.鈥�
California is one of 10 states, along with Washington, D.C., that have so-called aid-in-dying laws. The others are Colorado, Hawaii, Maine, Montana, New Jersey, New Mexico, Oregon, Vermont, and Washington.
Bien said his clients were looking for a way to challenge the laws and settled on California鈥檚 2022 statute because it removed safeguards in the original law.
reduced the minimum waiting period required between the time patients must make two oral requests for medication from 15 days to 48 hours. The suit notes that, by contrast, California has a 10-day cooling-off period between buying a gun and taking possession of it. The law also eliminated requiring patients to make a written attestation within 48 hours before taking life-ending medication.
Proponents of the revised law said those safeguards had and that other protections remain in the statute. Compassion & Choices, which advocates for assisted death laws, cited that found 21% of people died or became too ill to proceed with the steps. Supporters of the law said they weren鈥檛 aware of any abuse or coercion.
The suit argues that people who could live indefinitely with proper medical care can be considered terminally ill and thus eligible for the drugs if they likely would die within six months without such care. That, it says, could include diabetes patients who refuse insulin or people with kidney disorders who refuse dialysis.
Bien cited who wrote in a medical journal that she had steered two patients with anorexia to take prescribed life-ending drugs. Compassion & Choices said .
Even doctors unwilling to assist patients in killing themselves are required under California鈥檚 law to document the patient鈥檚 request, which still counts as the first of two required spoken requests. Christian Medical & Dental Association sued over that requirement and a federal in September. The state is appealing the ruling.
The California Attorney General鈥檚 Office had no immediate comment on the lawsuit, and the law鈥檚 author, Democratic state Sen. Susan Talamantes Eggman, did not immediately respond to requests for comment.
is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF鈥攁n independent source of health policy research, polling, and journalism. Learn more about .