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State Agency Tries to Avoid Responsibility for Physician-Assisted Suicide

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July 19, 2016

Only one month after physician-assisted suicide became legal in California, a state agency is proposing to adopt emergency regulations that would transfer implementation and the potentially serious liabilities of the new law from state-run and funded agencies to the private sector. 

The Department of Developmental Services (DDS) is seeking approval of emergency protocol measures that would prevent physician-assisted suicide from taking place in state centers for the disabled. The DDS, arguing that many of its patients are vulnerable to abuse from the law, is asking that those individuals who wish to participate be transferred to private facilities, which would then be responsible for the care and coordination of end-of-life assistance.

In its argument, the DDS writes that the proposed regulations must be adopted on an emergency basis, “in order to avoid serious harm to the public peace, health, safety, and general welfare.” It goes on to read, “Given the intellectual challenges of persons residing in a state developmental center or state-run facility, the [law’s] requirement to provide patients with aid-in-dying drugs can constitute a threat... ”

The disabilities of individuals housed in state-funded developmental centers are wide and varied in scope, adding a layer of complexity to the administration of end-of-life assistance. While some are able to request lethal drugs, others may not be in a consistent mental state conducive to making that decision on their own. The new law does not call for a psychological evaluation of the individual requesting lethal drugs. It merely specifies that the same individual must make two separate requests to their physician 15 days apart.

This begs the question – do the lawful rights of intellectually disabled individuals outweigh their best interests? Clearly, DDS does not want to be the entity to make that determination. Instead, it’s looking to the private sector to take on that burden, washing its hands of any culpability in the matter.

There is also an obvious conflict of interest for state facilities as well, as it would be advantageous for the State to encourage end-of-life practices in its mostly overcrowded and understaffed centers. Terminally-ill individuals who may be deemed to be developmentally disabled and who are admitted to a state-operated facility through a court order or through Medi-Cal are at even greater risk of possible abuse or coercion.  

In these particular cases, it is the State of California that would stand to financially benefit from encouraging Medi-Cal patients to participate in the End-of-Life Option Act (EOLOA) and to take their own lives.  Facilitating the use of these lethal drugs to individuals in any way, who are already totally reliant and dependent on the State for their care, would be an obvious, less expensive “option” available and a direct conflict of interest, as compared to the substantive costs of “appropriate and necessary medical care for their terminal condition, including counseling, hospice, and palliative care” – which are general treatments options that, regrettably, are currently not equally offered or accessible in every part of our state.

It is unclear if the DDS brought its concerns to the attention of legislators prior to the bill being passed into law. However, disability rights advocacy groups such as The Arc have repeatedly voiced their concern for the need to address the abuse of physician-assisted suicide among vulnerable populations, as these proposed regulations clearly illustrate.  Yet, the EOLOA was quickly passed through the California legislature.

Rather than deflect the responsibility of the new physician-assisted suicide law, the CCC is recommending that the DDS not submit the proposed emergency regulations and entirely “opt out” of the EOLOA.

The public comment period for these regulations began July 13 and will end on July 23. Please join the CCC in advocating for the preclusion of state-run developmental centers in the EOLOA by submitting your comments by the posted deadline.

Physician-assisted suicide has become a tragic reality for Californians, but this is an opening to start the re-examination and possibly even the repeal of the devastating law.