At Last — A Victory for Decency Over Dogma as California Right to Know End-of-Life Options Act Becomes Law4 min read


Heralding a rare and glorious victory of decency over dogma, Governor Schwarzenegger signed the California Right to Know End-of-Life Options Act (R2K) into law last night. When the law goes into effect in California this January the impact will reverberate across the nation.

For all the fuss among right-to-lifers, you’d think R2K opens some radical new practice, or forces doctors to violate their patients’ interests. Here’s what it does:

When a dying patient asks, “What are my options?” the Act instructs the doctor to answer the question. Period.

Answering the question completely and honestly, the doctor must disclose all legal and feasible options, or refer the patient to someone who will.

Is an honest answer too much to expect from your doctor?

Apparently, for some, it is.

Outraged, activists even now entreat the governor not to sign. They include the Alliance of Catholic Health Care, Eagle Forum, the Christian Medical and Dental Association, California ProLife Council, Crusade for Life and (inexplicably) disability rights organizations like California Disability Alliance and the Foundation for Independent Living Centers.

The offending end-of-life option — the one these folks don’t want patients to know about — is a merciful procedure called “palliative sedation.” When pain, breathlessness, diarrhea or other torment becomes unbearable for dying patients, doctors can use powerful drugs to sedate the patient to unconsciousness until death comes.

Palliative sedation is a well-accepted practice in hospice and palliative care environments. Knowing about this option comforts many as they anticipate the last few months or weeks of life. If pain, suffocation or other agony gets too bad, escape into a coma-like state can ease their suffering and spare their family the torture of watching such suffering. People find courage and hope in this knowledge.

Why would a doctor want to withhold knowledge that may bring hope and courage to life’s most difficult struggle? Is it because the Church orders Catholic institutions to strictly observe its “Ethical and Religious Directives for Catholic Health Care Services?” Is it because Directive #61 instructs that a person, “…should not be deprived of consciousness without a compelling reason” and “patients experiencing suffering that cannot be alleviated should be helped to appreciate the Christian understanding of redemptive suffering”?

Fair enough. Never would I intrude in another person’s expression of religious faith and belief. Government should not interfere with those who choose to emulate the passion of Christ on their death bed. But these activists want government to impose their choices on everyone.

The California Catholic Daily called palliative sedation “a morally questionable end-of-life option” as the excuse to keep it secret. There’s no excuse for holding a patient hostage to your own religious and moral code.

One religion simply cannot be allowed to bind everyone in a state, or a nation. Would we tolerate such parochial protection of the moral precepts of other religions?

Would we guard the right of a Christian Scientist to withhold information on antibiotics from a patient asking what can be done for her infection? Would we excuse a doctor who shares the Jehovah’s Witness belief that blood products are immoral and withholds knowledge of transfusions from his patient with a bleeding disorder?

Of course not. We’d call that entrapment, and would not tolerate healthcare professionals who put vulnerable patients at risk of suffering and harm in service to the professional’s own religious and moral beliefs.

But the R2K opponents feel outraged at losing a similar right: The right to entice patients into their healthcare systems with the promise of comprehensive care and then withhold treatment — even withhold information about treatment — that could relieve suffering but is deemed immoral by a religion the patient may not share.

Really, sirs, have you no decency?

Thank you, Governor, for signing a bill that promotes both good end-of-life care and religious freedom, all at once.

Barbara Coombs Lee, is President of Compassion & Choices, a nonprofit organization dedicated to improving care and expanding choice at the end of life. As a national organization with over 60 local affiliates and 30,000 members, we help patients and their loved ones face the end of life with calm facts and choices of action during a difficult time. We also aggressively pursue legal reform to promote pain care, put teeth in advance directives and legalize physician aid in dying.


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