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Physician-Assisted Death Legislation Moves Forward In California


This past week, the California Senate advanced a bill that would protect doctors who help terminally ill patients die. The bill had been stalled for years in part because doctors didn't support it. But the California Medical Association changed its mind. It's the first state medical association to lift its opposition to physician-assisted suicide. Theodore Mazer is a physician who worked on the policy change. Welcome to the program.


RATH: So first, could you lay out what is the new California Medical Association policy on physician-assisted suicide?

MAZER: We have gone from an opposed position of physician aid in dying to a neutral position. So in summary, we've gone from we don't think physicians should participate in it - it's not the role of the physician - to a neutral position, where physicians feel that they should participate or would participate. They would be able to make that decision with the patient with proper safeguards.

RATH: And can you talk about how the members and leadership decided to stop opposing physician-assisted suicide or at least change the position to neutral?

MAZER: The public has clearly moved into an acceptance of physician aid in dying nationwide and in California in virtually every poll. We needed to be prepared to see whether our membership still felt that the role of the physician was not to participate in this act of ending life, so we internally polled our membership to discuss whether or not our position of opposition was still representative of where the physicians were in California separate from the public opinion.

RATH: I want to make sure I'm understanding this properly because you say that this is separate from public opinion. But it sounds like it is still reflecting what's happening more broadly in society - maybe a more broader acceptance of this practice.

MAZER: Well, I think physicians are part of society, so clearly we might reflect that. But physicians are also guardians of public health, and we have an ethic going back to the Hippocratic oath about doing no harm. So the decision that had to be made is is that participating in killing someone as the people who are opposed to this say, or is that a portion of the treatment of the patient to end suffering, both physical and emotional suffering at the end of life and give the patient some control over the end of their life that they otherwise would not have? So while we may reflect public opinion, we had to look at this as a profession, not just as the public.

RATH: The bill in California - it's going to go to the full California Assembly for a vote in coming months. If it becomes law, how will things change? How is it going to affect care for the terminally ill in California?

MAZER: Well, on the one hand, it will give a new option to people, much like Oregon has, where they can go to a physician where they've been determined to have expected life span of less than six months with terminal illness. This is not for any other purpose. They would have to ask a physician on two different occasions for a prescription for life-ending drugs that they would have to take by themselves. They would have to be deemed to have the capacity to make that decision. They would be interviewed by two physicians, and they would have to be interviewed in a way that they would have no undue coercion by family or any other party that might be pushing them in the direction to end their life with this medication.

We know that most physicians - probably all physicians - prefer hospice care and palliative care at end-of-life to anything approaching physician-assisted suicide or physician aid in dying. That said, sometimes that is not enough for patients who cannot get the relief they need with current care or can't even access that care. Having lack of access is a big problem, and we need to correct that as well. This will be part of the drive if this becomes law to make sure that they have the other options, not just this option.

RATH: Theodore Mazer is a physician in California. Ted, thank you very much.

MAZER: Thank you. Transcript provided by NPR, Copyright NPR.

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