The California Medical Association (CMA) changed its decades-old policy and became the first state medical organization in the nation to not oppose physician-assisted end-of-life legislation. It is currently felony manslaughter to help someone end their life.

The association took a neutral stance on Senate Bill 128, which would make it legal for doctors to prescribe lethal medication to terminally-ill patients. The bill, mirrored on Oregon’s law, establishes procedures for requesting aid-in-dying drugs and provides immunity from civil or criminal liability to those who assist terminal patients in good faith.

“The decision to participate in the End of Life Option Act is a very personal one between a doctor and their patient, which is why CMA has removed policy that outright objects to physicians aiding terminally ill patients in end of life options,” CMA President Luther F. Cobb said. The association represents 40,000 physicians.

Democratic state Senator Lois Wolk, co-author of the bill, called the CMA decision “a major breakthrough.”

The legislation seeks to protect patients from being manipulated into an early grave by greedy or otherwise motivated parties. It makes it a felony to coerce an individual to end their life or fabricate paperwork for obtaining end-of-life drugs without a patient’s consent. And it tells insurance companies to keep their distance:

“The bill would prohibit an insurance carrier from providing any information in communications made to an individual about the availability of aid-in-dying medication absent a request by the individual, his or her attending physician at the behest of the individual, or the individual’s designee. The bill would also prohibit any communication from containing both the denial of treatment and information as to the availability of aid-in-dying medication coverage.”

The bill explicitly says that action taken in accordance with this act is not to be considered suicide or homicide. The CMA is now removing references in its internal policies to “physician-assisted suicide.”

The End of Life Act was introduced in the state Senate in January, just a few months after 29-year-old newlywed Brittany Maynard, diagnosed with a terminal brain tumor, moved to Oregon from San Francisco and very publicly ended her life on November 1.

Oregon, Vermont and Washington have physician-assisted death laws, and the courts in New Mexico and Montana have allowed it. But Maynard documented the difficulty for people from other states, without substantial means, to make that move. Oregon has had the law for 17 years and 752 people had used it as of January 1, out of the 1,173 who requested prescriptions for a fatal dose of drugs.

Californians have rejected similar efforts to permit aid-in-dying at the ballot box and in the Legislature. Voters rejected Proposition 161, the Aid-in Dying Act, in 1992 by a margin of 54.1% to 45.9%. The San Francisco Chronicle said legislation on the issue failed four times between 1995 and 2008.

Governor Jerry Brown has not spoken much about the issued and its unknown if the former Jesuit seminarian would sign the legislation if it’s passed. The bill has passed Senate votes in the Health, Judiciary and Appropriations committees.

–Ken Broder

To Learn More:

Medical Group Drops Opposition to Aid-in-Dying Bill (by Melody Gutierrez, San Francisco Chronicle)

California Medical Association Changes Aid-in-Dying Position (by Sydney Lupkin, ABC News)

California's End of Life Option Act Moves Forward (by Monica Luhar, KCET)

California “Right-to-Die” Bill Proposed (by Lisa M. Krieger, San Jose Mercury News)