Advocates for aid-in-dying legislation across the world were heartened and relieved when Gov. Jerry Brown of California signed into law the state’s “death with dignity” bill.

The new law creatively addresses every legal concern possible and offers new safeguards not present in the laws of Oregon, Washington or Vermont — three of the four states where aid-in-dying is a safe, legal option for competent, terminally ill adults who qualify.

California’s new law prohibits health insurance carriers from communicating to patients about the aid-in-dying option to have a life-ending medication, unless such information is specifically requested by the patient. This answers the frequent argument that insurance companies might want to force terminal patients into the cheaper end-of-life option, rather than paying for more expensive treatments. It’s not something that has ever occurred, but opponents always assert it might. With California’s law, such communication is prohibited.

California’s law spells out in clear language that it would be a felony to coerce anyone into taking end-of-life medication, whether by force or trickery, and that anyone involved in any attempt to persuade, coerce or give the medication without the patient’s knowledge would face severe consequences if convicted. This language also answers opposition concerns around poor, elderly or disabled populations being taken advantage of by greedy relatives — none of which has occurred as a result of death with dignity laws in any other state. But still, those who oppose end-of-life legislation say that it might.

The fact is, we live our lives on a slippery slope. There isn’t a federal or state law on the books that actually prevents crime. The best any law can do is be clear, as specific as possible, and in the case of aid-in-dying legislation, be safe-guarded. They should be clear that violation of the law will carry consequences if convicted.

California’s new law takes safe-guarding to the next level and is a good model to show that when physicians and lawmakers work together, smart legislation and sound policy is the result.


During the very long debate throughout California’s legislative process, something fascinating happened. The California Medical Association reversed its opposition to aid-in-dying legislation and adopted a neutral policy, one that honestly acknowledges that despite absolutely exceptional palliative and hospice services, that isn’t effective for every dying patient.

The California Medical Association is the first state medical association in the nation to change its position on the long-debated issue of physician aid in dying. Its president said, “It’s up to the patient and their physician to choose the course of treatment best suited for the situation — and CMA’s new position on physician aid in dying allows for that.”

The American Nurses Association of California supports medical aid in dying, as do a number of national organizations, including the American Public Health Association, American College of Legal Medicine, American Women’s Medical Association, Gay & Lesbian Medical Association and American Medical Student Association.

The Maine Medical Association and the Maine Osteopathic Association publicly opposed L.D. 1270, the 2015 bill sponsored by Sen. Roger Katz, R-Augusta, which would have made medical aid-in-dying a safe option here in Maine. Medical aid-in-dying is not exclusive to palliative or hospice care, and in states that have approved it, organizations work together to create policy that includes this important patient option.

A 2014 Medscape survey of more than 17,000 physicians in the United States indicated majority support for a legal medical aid-in-dying option.

Valerie Lovelace, is executive director of It’s My Death, Wiscasset, a public charity organization providing information for people who wish to explore the meaning of life by embracing the certainty of death.

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