The California Euthanasia Initiative

California Civil Code, Title 10.5.

The 1990 initiative was called the “California Humane and Dignified Death Act.”

For further detail on this interesting story in the state of Washington, see Carson Rob , “Washington's I-119,” Hastings Center Report 22 (March-April 1992): 7–9.

The term ‘ loosely legalized” is used to describe the situation in the Netherlands because administering euthanasia is technically illegal there, yet physicians enjoy almost total exemption from prosecution if the way in which they administer euthanasia is in accordance with a set of government guidelines.

The California Death with Dignity Act, Section 2525.8. Interestingly, most of this section applies to individuals who would administer aid in dying. It also exempts private hospitals such as Catholic and other religious denominational hospitals that might have religious ground for objecting to euthanasia. However, the initiative says nothing about public hospitals. Though individuals who work within public settings may be exempt from practicing euthanasia, it is unclear whether entire public hospitals are being offered the same kind of exemption as are private health care institutions.

Section 2525.10.

Section 2525.2 (k).

Section 2525.2 (h).

Section 2525.2 (j).

Section 2525.2 (i).

Section 2525.3.

Section 2525.3., pp. 9–11.

Section 2525.5.

Section 2525.4.

Section 2525.17.

Section 2525.17 (e).

Section 2525.17 (d).

Section 2525.17 (c).

Section 2525.18.

Section 2525.21.

For example, only a mentally competent patient can be a candidate for euthanasia. But how is competence defined and, more importantly, who determines it? As is clear from numerous courtroom proceedings, experts disagree commonly when testifying on a person's competence. A further ambiguity is the term “attending physician” who is to certify that patient's terminal condition. In many end of life settings, other specialists are called in, in addition to a family physician and internist. Which one is the attending physician?

The current California law, the California Natural Death Act, passed in 1974, states that for treatment to be justifiably withdrawn or withheld, the patient must be in a terminal condition and predicted to die within two weeks, with or without continued medical treatment. Predicting death with certainty within two weeks is not that simple a matter, but predicting it with a degree of certainty within six months is very difficult. Note that the current initiative does not specify what probability of the occurence of death within six months is sufficient to make one a candidate for euthanasia.

For further detail on this, see Keown John , “On Regulating Death,” Hastings Center Report 22 (March-April 1992): 41. In light of this failure to report cases of euthanasia, it is not surprising that supporters of the initiative insist that abuses of the practice are hard to document. It is also a simple matter to understand why such abuses are not documented.

Gomez Carlos , Regulating Death: Euthanasia and the Case of the Netherlands, (New York: The Free Press, 1991): 117–125. The most conservative estimate of the number of euthanasia cases in the Netherlands annually is around 3,500. There is general consensus that the actual number of cases is somewhere between 8,000 and 10,000 per year, and many opponents of the practice estimate that number is twice that. The Dutch Justice Ministry estimates that, based on the reports it receives, the number is around 300. It is clear that the number of cases reported to the prosecutors is only a small fracton of the number of total cases.

Leenen H.J.J. , “Legal Aspects of Euthanasia, Assistance to Suicide and Terminating the Medical Treatment of Incompetent Patients,” paper presented at a conference on euthanasia, Instituut voor Gezondheidsethiek, Maastricht, 2-4 December 1990, cited in Keown, “On Regulating Death,” 43.

Gomez , Regulating Death, 40-41, 97–98.

This is taken from Gomez , Regulating Death, 79–80.

Section 2525.18.

This “duty to die” has been articulated most recently by then Governor of Colorado Richard Lamm, who insisted that the elderly have a “duty to die and get out of the way.”

American Bar Association Commission on Legal Problems of the Elderly, “Opposition to Resolution No. 8 on Voluntary Aid in Dying,” unpublished paper, 17 January 1992.

Fenigsen Richard , “A Case Against Dutch Euthanasia,” Hastings Center Report Special Supplement, January/February 1989: 6; Gomez, Regulating Death, 120.

Fenigsen Richard , “A Case Against Dutch Euthanasia,” Hastings Center Report Special Supplement, January/February 1989, 6–7.

The following statistics are taken from Keown, “On Regulating Death,” 41–42.

Though, in fairness, it must be noted that in approximately half of these cases, there had been some discussion of euthanasia with the patient in which he or she had indicated some sort of desire for euthanasia.

Fenigsen Richard , “Euthanasia in the Netherlands,” Issues in Law and Medicine 6 (Winter 1990): 238.

This case parallels the first well-publicized case of infanticide in the United States, the 1974 case at Johns Hopkins Medical Center. I would argue that the parents’ decision to refuse to authorize the surgery cannot be morally justified, since the real basis for such a refusal was the child's handicap. Both allowing the child to die and active euthanasia should be considered immoral in this case. The surgery should have been approved, and many children with Down Syndrome grow up to enjoy reasonably productive adult lives. For the details on the case cited by Gomez in his research, see Gomez, Regulating Death, 83-84 (Case 20).

For further discussion of this part of the euthanasia debate, see Moreland J.P. , (give bib. data for the two pieces on CRI Journal in 1992).

Callahan Daniel , “When Self Determination Runs Amok,” Hastings Center Report 22 (March-April 1992): 54.