California bill may extend assisted suicide to euthanasia.

Alex Schadenberg
Executive Director,
Euthanasia Prevention Coalition

There are currently three states, in 2025, that have bills to expand their assisted suicide laws (Vermont, Oregon and Washington State).

Senator Blakespear, who last year sponsored Senate Bill 1196, a bill that would have expanded the California assisted suicide law to include euthanasia and removed the terminal illness requirement from the law, indicated that she will be sponsoring Bill SB 403, a bill to expand California's assisted suicide law.

Thaddeus Pope

The text of SB 403 has not been released but on February 18, euthanasia and assisted suicide activist and academic, Thaddeus Pope, published on his Medical Futility Blog that:

California is again looking to amend its 2015 End of Life Option Act. S.B. 403 will likely call for a study committee to examine several amendments:

1. Permitting IV self-administration of medications - because it is significantly safer and more effective than ingestion of medications,
2. Permitting APRNs to prescribe - because this has improved access with no risk to safety in other states (NM HI WA CO),
3. Eliminating the 6-month terminal illness requirement - because it is arbitrary and excludes patients with serious irreversible illnesses who want to avoid intolerable suffering,
4. Eliminating the sunset clause - because the EOLOA expires in 2031,
5. Eliminating the residency requirement - because it is unconstitutional and patients are coming to California for MAID anyway,
6. Other amendments.

SB 403 is very similar to last year's SB 1196. Since the language of the bill is not released I can only comment on the concepts related to the changes.

 

1. Permitting IV self-administration will allow for euthanasia, which is homicide. Euthanasia is done in Canada by IV administration. Since there is no oversight in California's assisted suicide law, meaning, the doctor who assists the death is also the person who reports the death (no third party involvement) therefore allowing IV self-administration cannot be distinguished from IV administration. Therefore permitting IV self-administration in fact will also allow euthanasia (homicide).

2. Permitting non-doctors to assist suicide by prescribing lethal poison is based on the lack of doctors who are willing to assist the suicides of their patients. More people who are permitted to kill leads to more killing.

3. Replacing the 6 month terminal illness requirement with a definition of serious irreversible illnesses who want to avoid intolerable suffering eliminates the terminal illness requirement. 

 

Eliminating the terminal illness requirement leads to people with disabilities "qualifying" for death by lethal poison for reasons of poverty, homelessness, an inability to obtain necessary services or medical treatment as has happened in Canada. The Ontario Coroner's MAiD death review committee report indicated that some euthanasia deaths are driven by homelessness, fear and isolation (Article Link).

4. Eliminating the residency requirement allows for suicide tourism. Pope states that the residency requirement is unconstitutional. In September 2024 a New Jersey court disagreed with Pope. Further to that, Pope admits that non-residents are already dying by assisted suicide in California. Breaking the law is not a reason to change the law.

The Euthanasia Prevention Coalition will expose SB 403 and this article will be updated when the language of the bill is officially released.

California 2023 report indicates that there were 884 reported assisted suicide deaths

 Approximately 925 Californians died by assisted suicide in 2023.

Alex Schadenberg
Executive Director,
Euthanasia Prevention Coalition

The 2023 California assisted suicide report was recently released indicating that there were 884 reported assisted suicide deaths in 2023 and 4287 reported assisted suicide deaths since legalization in 2016.

As with previous years, the report implies that the deaths were voluntary (self-administered) but the information in the report does not address that subject.

California does not report assisted suicide death complications. This is important since the 2023 Oregon assisted suicide report indicated that there was almost a 10% complication rate.

The 2022 California assisted suicide report stated that there were 853 reported assisted suicide deaths. The 2023 report corrected the 2022 data and states that there were 890 reported assisted suicide deaths in 2022. That a difference of 37 reported deaths.

In 2022  there were 294 Californians who were approved for assisted suicide but their ingestion status was unknown. These people had received the lethal poison but the authorities did not know if they had died by assisted suicide, died by a natural death, or remained alive. 

Based on the 2023 report, we now know that at least 37 of the 294 (ingestion status unknown) died by assisted suicide in 2022 and 49 of the 294 died by assisted suicide in 2023. Of the remaining 208 people, whose ingestion status was unknown in 2022 it is likely that some of them died by assisted suicide but the death was not reported.

The 2023 report indicates that there are 276 Californians who received the lethal poison but whose ingestion status was unknown. Based on the yearly data we know that some of the 276 people have died by assisted suicide but the assisted suicide report was submitted late and some of them will die by assisted suicide in 2024. 

Based on the percentage of assisted suicide reports that were submitted late in previous years, it is likely that the 2024 report will indicate that approximately 925 Californians reportedly died by assisted suicide in 2023.

As stated earlier, it is likely that some of the 276 Californians who received the lethal poison but whose ingestion status is unknown are unreported assisted suicide deaths.

California uses a self-reporting system, meaning that it is impossible to know that a person died by assisted suicide when the medical professional fails to submit the assisted suicide report.

Who dies by assisted suicide?

The 2023 California assisted suicide report states that since legalization 87.6% of the reported assisted suicide deaths were White, 6.4% were Asian, 3.8% were Hispanic and less than 1% were black.

California's population data indicates that: 40% are Hispanic, 35% are White, 15% are Asian and .5% are Black. Clearly assisted suicide is an issue of white privilege.

The data suggests that the number of assisted suicide deaths in 2023 remained steady. Considering the massive growth in assisted suicide deaths from 2021 (523) to 2022 (890) the slower growth may be temporary. Nonetheless, as in previous years, when the law is being challenged the number of deaths moderates. 

In April 2023, The United Spinal Association, Not Dead Yet, Institute for Patients’ Rights, Communities Actively Living Independent and Free, Lonnie VanHook, and Ingrid Tischer launched a lawsuit to strike down the California assisted suicide law with the goal of the case going to the US Supreme Court to strike down assisted laws throughout the US. (Link to the complaint).

The case asserted that the assisted suicide act is a discriminatory scheme, which creates a two-tiered medical system in which people who are suicidal receive radically different treatment responses by their physicians and protections from the State depending on whether the person has what the physician deems to be a “terminal disease”—which, by definition, is a disability under the Americans with Disabilities Act. (Link to the article). 

The case was denied by U.S. District Judge Fernando Aenlle-Rocha but an appeal of Aenlle-Rocha's decision has been filed.

Senator Blakespear removed assisted suicide expansion bill.

The following article was published by Choice is an Illusion.

California Senate Chamber

Senator Catherine Blakespear has removed proposed Senate Bill 1196, seeking to expand assisted suicide and euthanasia in California, from consideration prior to its first hearing Blakespear said in a statement.

"At this point, there is a reluctance from many around me to take up this discussion, and the future is unclear,”

“The topic, however, remains of great interest to me and to those who have supported this bill thus far.”

Senator Susan Eggman, who authored the original act in 2016, commented that pushing forward now would would create a risk of pushback. She stated:

While I have compassion for those desiring further change, pushing for too much too soon puts CA [California] & the country at risk of losing the gains we have made for personal autonomy....

With just a few weeks left to pass bills through policy committees before the Legislature's summer recess, it's unlikely another lawmaker would propos[e] a similar measure this year.

Link to the original article.

Senate Bill 1196 shows us the direction of the American euthanasia lobby. The Bill was only withdrawn because, as Senator Eggman stated it was "pushing for too much too soon."

Article: Good news: California assisted suicide expansion bill is dead. (Link)

Good news: California assisted suicide expansion bill is dead.

Alex Schadenberg

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

I have great news. The California assisted suicide expansion bill (SB 1196) has been pulled. 

This is great news, but let's be clear, the language of SB 1196 is the goal of the assisted suicide lobby but the bill was determined to have gone too far too fast.

Based on the summary of SB 1196 by Senator Blakespear I stated that the bill would have:

1. Allowed euthanasia by IV (intravenous), as in Canada. Currently, California permits assisted suicide (lethal poison that a person takes orally at the time and place of their own choosing, with or without witnesses). This bill allowed for death by IV. This constitutes euthanasia/homicide.
2. Changed the criteria from terminally ill (6 month prognosis) to the Canadian model: “a grievous and irremediable medical condition.” Thus, there would be no time limit  and no terminal illness requirement.
3. Allowed people with early to mid-stage dementia to consent to assisted suicide or euthanasia, even though they have a condition that impairs their capacity to consent.
4. Removed the California residency requirement. California would join Oregon and Vermont, dropping their residency requirements and allowing for suicide tourism.
5. Removed the 2031 sunset clause in the California assisted suicide law.

I published an article on March 18, 2024, stating that the California bill would legalize medical killing. After the language of SB 1196 was released I further explained how SB 1196 would have expanded medical killing in California.

SB 1196 would have changed the law from requiring ingesting of the lethal poison to utilizing the lethal poison. Utilize was not defined in the bill but it could be defined as: "to make practical and effective use of."

SB 1196 would have changed the law from requiring a terminal disease to a grievous and irremediable medical condition.

Terminal disease was based on a 6 month prognosis whereas grievous and irremediable medical condition had a long definition that essentially mean't that the person has a serious chronic condition that will continue to decline.

The bill stated:  

For purposes of this part, a “grievous and irremediable medical condition” includes a diagnosis of early to mid-stage dementia while the individual still has the capacity to make medical decisions. 

IV catheter

How would early to mid-state dementia have been defined in practise?

SB 1196 permitted non-doctors to participate in the law. SB 1196 added the following: nurse practitioners, physician assistants, and registered nurses.

SB 1196 removed the residency requirement in the California law by striking out the words - is a resident of California.

SB 1196 allowed the use of an IV (intravenous) catheter to "utilize" the poison. SB 1196 stated:  

death through ingestion, or through an intravenous pathway after a health care provider places an intravenous catheter if one was not already placed, to bring about the qualified individual’s own death. 

This statement did not limit the use of the IV catheter to assisted suicide and may have allowed for euthanasia/homicide.

Later SB 1196, stated:  

For purposes of this section, “assisting the qualified individual by preparing the aid-in-dying drug” includes a health care provider placing an intravenous catheter, so long as the health care provider does not assist the qualified individual in introducing the aid-in-dying drug into the qualified individual’s vein.

This statement inferred that the person must somehow utilize the IV catheter. The IV could be placed but the health care provider could not "assist". This was intentionally confusing. There may also have been circumstances, such as ALS, where the person has difficulty "utilizing" the IV catheter without assistance.

On June 22, 2022, a California federal judge rejected a case designed to permit euthanasia within California's assisted suicide act. Shavelson, a doctor that solely focuses on assisting suicide and Sandra Morris, who had ALS, argued that the state's assisted suicide law discriminated against people who had difficulty self-ingesting the lethal drugs and to remedy the situation the state needed to permit euthanasia in those cases.

In that case, Shavelson argued that allowing the administration of lethal drugs by IV catheter when a person has difficulty self-administering the lethal drugs was necessary. Justice Chhabria rejected the argument and stated:

Chhabria ruled the case could not proceed on the theory that it violates the ADA because the accommodation they seek would cross the boundary created by the End of Life Option Act, “from the ability to end your own life to the ability to have someone else end it for you.”

Chhabria further ruled:

“Such an accommodation would ‘compromise' the essential nature of the act, and would therefore fundamentally alter the program.’”

The judge said the law’s self-administration requirement is the “final safeguard” to ensure the act remains voluntary.

“A person seeking to end their life pursuant to the act can opt out at any point — after requesting or receiving the prescription, after the drugs are in their hand, after the feeding tube has been installed, after saying goodbye,” he wrote. “The accommodation that the plaintiffs seek would significantly undermine these protections by opening a window during which there would be no way of knowing whether the patient had changed their mind.”

If SB 1196 would have changed the California law by removing self-administer, removing the terminal illness requirement and allowing the utilization of an IV catheter, these changes would make it impossible to distinguish between an act of assisted suicide and an act of euthanasia/homicide. 

Assisted suicide is receiving lethal poison and self-administer it for the purpose of causing death.

Euthanasia is when another person, usually a medical professional, administers the lethal poison for the purpose of causing death. Euthanasia is a form of homicide/murder.

Since SB 1196 did not require a "third/independent party" to witness the act, therefore SB 1196 would have enable euthanasia under the guise of assisted suicide and achieve for the euthanasia lobby what was denied to them by Justice Chhabria in 2022.

SB 1196 was a "Trojan horse" euthanasia bill.

SB 1196 is the end goal of the assisted suicide lobby.

EPC April 8 Zoom event with Alex Schadenberg: Examining the growth of assisted suicide in the Western US.

This Zoom event will focus on Oregon, California, Washington state and Hawaii.

Alex Schadenberg

Alex Schadenberg, the Executive Director of the Euthanasia Prevention Coalition will be providing a Western US assisted suicide Zoom event update on April 8 at 7:15 pm (Pacific Time) / 8:15 pm (Mountain Time).

Register in advance for this Zoom event (Registration Link). 

After registering, you will receive a confirmation email containing information about joining the meeting. 

This event will uncover the incremental growth of assisted suicide, a reality that the assisted suicide lobby denies in states when they are trying to legalize assisted suicide.

Alex Schadenberg will examine the increasing number of assisted suicide deaths and the expansions to the assisted suicide laws in Oregon, California, Washington state and Hawaii and provide an analysis of the data and the assisted suicide expansion bills.

There will be a specific focus on recent legislation such as Oregon removing it's assisted suicide law residency requirement to permit suicide tourism and California Bill HB 1196, a bill that would blur the distinction between assisted suicide and euthanasia (homicide) in California.

Register in advance for this Zoom event (Registration Link).

Links to recent articles on these topics:

• Oregon assisted suicide poison prescriptions increase by 29% in 2023. (Link).
  
• The nationalization of assisted suicide in America (Link). 
• California assisted suicide deaths surge by 63% in 2022 (Link).
• Does California Senate Bill HB 1196 legalize euthanasia/homicide? (Link).
• Hawai'i expanded their assisted suicide law in 2023. Hawai'i assisted suicide deaths are increasing (Link).
• Washington State failed assisted suicide law (Link).
  

Does California Senate Bill 1196 legalize euthanasia/homicide?

SB 1196 is a "Trojan horse" euthanasia bill.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

In 2016 California legalized assisted suicide and expanded the law in 2021.

California is now debating further expansions and a change in the law to specifically "utilize" the lethal poison by IV (intravenous).

On March 8, 2024 I published an article based on the summary of the bill from Senator Blakespear, the sponsor of the bill, concerning California Senate Bill 1196. 

Based on the summary of SB 1196 by Senator Blakespear I stated that the bill would:

1. Allow euthanasia by IV (intravenous), as in Canada. Currently, California permits assisted suicide (lethal poison that a person takes orally at the time and place of their own choosing, with or without witnesses). This bill allows for death by IV. This constitutes euthanasia/homicide.
2. Change the criteria from terminally ill (6 month prognosis) to the Canadian model: “a grievous and irremediable medical condition.” Thus, there would be no time limit  and no terminal illness requirement.
3. Allow people with early to mid-stage dementia to consent to assisted suicide or euthanasia, even though they have a condition that impairs their capacity to consent.
4. Remove the California residency requirement. California would join Oregon and Vermont, dropping their residency requirements and allowing for suicide tourism.
5. Remove the 48 hour waiting period between first and second request by the patient - same day death. 
6. Remove the 2031 sunset clause in the California assisted suicide law.

I published an article on March 18, 2024, stating that the California bill would legalize medical killing. Now that the language of SB 1196 has been released I will further explain how the Bill expands medical killing in California.

The first issue is that SB 1196 would change the law from requiring ingesting of the lethal poison to utilizing the lethal poison. Utilize is not defined in the bill but it can be defined as: "to make practical and effective use of."

The second issue is that SB 1196 would change the law from requiring a terminal disease to a grievous and irremediable medical condition.

Terminal disease was based on a 6 month prognosis whereas grievous and irremediable medical condition has a long definition that essentially means that the person has a serious chronic condition that will continue to decline.

The bill states:  

For purposes of this part, a “grievous and irremediable medical condition” includes a diagnosis of early to mid-stage dementia while the individual still has the capacity to make medical decisions. 

How would early to mid-state dementia be defined in practise?

The next issue is that SB 1196 permits non-doctors to participate in the law. SB 1196 adds the following: nurse practitioners, physician assistants, and registered nurses.

The next issue is that SB 1196 removes the residency requirement in the California law by striking out the words - is a resident of California.

The most important issue is the use of an IV (intravenous) catheter to "utilize" the poison. SB 1196 states:  

death through ingestion, or through an intravenous pathway after a health care provider places an intravenous catheter if one was not already placed, to bring about the qualified individual’s own death. 

This statement does not limit the use of the IV catheter to assisted suicide and could allow for euthanasia/homicide.

Later SB 1196, states:  

For purposes of this section, “assisting the qualified individual by preparing the aid-in-dying drug” includes a health care provider placing an intravenous catheter, so long as the health care provider does not assist the qualified individual in introducing the aid-in-dying drug into the qualified individual’s vein.

This statement infers that the person must somehow utilize the IV catheter. The IV can be placed but the health care provider cannot "assist". This is intentionally confusing. There may also be circumstances, such as ALS, where the person has difficulty "utilizing" the IV catheter without assistance.

Justice Chhabria's decision can help us clarify this situation.

On June 22, 2022, a California federal judge rejected a case designed to permit euthanasia within California's assisted suicide act. Lonny Shavelson, a doctor that solely focuses on assisting suicide and Sandra Morris, who had ALS, argued that the state's assisted suicide law discriminated against people who had difficulty self-ingesting the lethal drugs and to remedy the situation the state needed to permit euthanasia in those cases.

In that case, Shavelson argued that allowing the administration of lethal drugs by IV catheter when a person has difficulty self-administering the lethal drugs was necessary. Justice Chhabria rejected the argument:

Chhabria ruled the case could not proceed on the theory that it violates the ADA because the accommodation they seek would cross the boundary created by the End of Life Option Act, “from the ability to end your own life to the ability to have someone else end it for you.”

Chhabria further ruled:

“Such an accommodation would ‘compromise' the essential nature of the act, and would therefore fundamentally alter the program.’”

The judge said the law’s self-administration requirement is the “final safeguard” to ensure the act remains voluntary.

“A person seeking to end their life pursuant to the act can opt out at any point — after requesting or receiving the prescription, after the drugs are in their hand, after the feeding tube has been installed, after saying goodbye,” he wrote. “The accommodation that the plaintiffs seek would significantly undermine these protections by opening a window during which there would be no way of knowing whether the patient had changed their mind.”

If SB 1196 is passed it would change the California law by removing self-administer, removing the terminal illness requirement and allowing the utilization of an IV catheter, these changes would make it impossible to distinguish between an act of assisted suicide and an act of euthanasia/homicide. 

Assisted suicide is to receive lethal poison and self-administer it for the purpose of causing death.

Euthanasia is when another person, usually a medical professional, administers the lethal poison for the purpose of causing death. Euthanasia is a form of homicide/murder.

Since SB 1196 does not require a "third/independent party" to witness the act, therefore SB 1196 would enable active euthanasia under the guise of assisted suicide and achieve for the euthanasia lobby what was denied to them by Justice Chhabria in 2022.

SB 1196 is a "Trojan horse" euthanasia bill.

California bill would legalize Medical Killing

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

In 2016 California legalized assisted suicide and expanded the law in 2021. 

 

California is now debating further expansions and a change in the law to permit 'Canadian-style' medical killing.

On March 8, 2024 I published an article concerning California Senate Bill 1196, a bill that would:

1. Allow euthanasia by IV (intravenous), as in Canada. Currently, California permits assisted suicide (lethal poison that a person takes orally at the time and place of their own choosing, with or without witnesses). This bill allows for death by IV. This constitutes euthanasia/homicide.
2. Change the criteria from terminally ill (6 month prognosis) to the Canadian model: “a grievous and irremediable medical condition.” Thus, there would be no time limit  and no terminal illness requirement.
3. Allow people with early to mid-stage dementia to consent to assisted suicide or euthanasia, even though they have a condition that impairs their capacity to consent.
4. Remove the California residency requirement. California would join Oregon and Vermont, dropping their residency requirements and allowing for suicide tourism.
5. Remove the 48 hour waiting period between first and second request by the patient - same day death. 
6. Remove the 2031 sunset clause in the California assisted suicide law.

Maggie Hroncich wrote an article that was published in the New York Sun on March 18, 2024 explaining the proposed changes to California's End of Life Options Act. Hroncich writes:

Dubbed by critics as the ‘most extreme’ expansion effort in America, the bill’s backers say it would give patients greater medical autonomy.

As efforts to expand physician-assisted death ramp up across the country, California lawmakers will consider a measure to expand access to the procedures for dementia patients, add new ways drugs can be taken, and open access to out-of-state residents. 

Senate Bill 1196, introduced by a state senator, Catherine Blakespear, would expand California’s End of Life Options Act to include patients with a “grievous and irremediable medical condition” to request doctor-assisted death in addition to patients with a terminal disease. 

Senate Bill 1196 uses similar language to Canada's euthanasia law:

In Canada, a shocking four percent of the country’s deaths were from assisted suicide — leading to it being the fifth-leading cause of death there, as the Sun has reported. Recently, reports have emerged that a father is asking a Canadian court to stop his 27-year-old daughter’s assisted suicide, whom he says has autism and doesn’t meet the criteria for assisted death.

The California bill would set new conditions that would require a patient to be in a state of “irreversible decline in capability” and experiencing “physical or psychological suffering” that is “intolerable to the individual and cannot be relieved in a manner the individual deems acceptable.” Additionally, it must be “reasonably foreseeable” that the condition would become the patient’s natural cause of death. 

The legislation, if enacted, would also expand assisted-death to allow patients with “early-to mid-stage dementia,” allow IV infusions of the drugs rather than the current requirement that it must be taken orally or through a digestive tract, remove the 2031 sunset date, and remove the state’s residency requirement. 

Hroncich states:

One vocal critic of the bill is the Executive Director of Canada’s Euthanasia Prevention Coalition, Alex Schadenberg, who is warning California lawmakers not to “follow Canada’s lead.” 

“Changing the criteria from a terminal illness (6 months prognosis) to having a ‘grievous and irremediable medical condition’ will lead to people with disabilities ‘qualifying’ for death by lethal poison for reasons of poverty, homelessness, an inability to obtain necessary services or difficulty with obtaining medical treatment as has happened in Canada,” he notes. 

The bill could lead to “homicide tourism,” he adds, and the IV infusion allowance would mean doctors are actively carrying out the death rather than assisting a patient in self-administering the fatal drugs. “Euthanasia is sold to the public as allowing competent adults who are capable of consenting to die by lethal poison,” according to Mr. Schadenberg. “Allowing euthanasia for people with dementia permits medical practitioners to kill someone who is not competent and unable to consent.”

Hroncich was careful in writing this article but clearly Senate Bill 1196 will not only expand the assisted suicide law, but it will also legalize euthanasia, otherwise known as homicide. This is not an expansion of the law. This would be the legalization of euthanasia.

California Senator drops the mask, proposes the legalization of euthanasia.

Gordon Friesen

By Gordon Friesen
President, Euthanasia Prevention Coalition

Critical statements have quickly appeared across the web, denouncing proposed "expansions" to California's assisted death system. However, with respect, I would suggest that this word is not nearly strong enough. For although it is still hard to say exactly what California is up to (considering that the full text of proposed Senate Bill 1196 is not yet available), a preliminary fact sheet clearly reveals that a new phase may be reached in that State's march towards a true, Canadian-style, poison death-medicine paradigm.

In another place (please see appendix i table) I have demonstrated that there are two main regimes of medically justified assisted death (not to be confused with true "right-to-die" countries like Germany and Switzerland). And that one of these (including Canada, Belgium, the Netherlands and Spain) has a proportion of assisted deaths which is ten times greater that of its lessor competitor (commonly known as the "Oregon Model, and which includes all of the American States having legalized assisted death thus far).

What accounts for the lower numbers reported by American States lies in their common requirement of a "terminal condition" (usually understood to mean a six months prognosis) and self-ingestion (the exclusion of doctor-performed euthanasia). The basic idea being that someone who is already facing death might choose exactly how and when they would actually die. Hence the name of existing California Law: the "End of Life Options Act".

Crucially, there is no mention in this scheme of physical (or other) suffering, as we shall see: any legislation based on suffering is truly a "horse of a different color".

In Canada, by way of comparison, eligibility is all about suffering (for which euthanasia is explicitly defined as a medical treatment). And it is this fact which explains why all of the original Canadian "safeguards" have so rapidly fallen apart in that country (either through court challenge or new legislation). One after another --"major age", "capacity to consent", "death reasonably foreseeable"-- all have fallen by the way-side, because "suffering" knows no such boundaries.

Should SB 1196 pass (which, to be sure, it has every likelihood of doing) it is the Canadian model which California will effectively be adopting. The appropriate headline, therefore, should be: "California prepares to embrace Canadian-Style substitution of death for medical treatment".

Proposed changes in legal text

Getting down a little farther "into the weeds" (to satisfy the curiosity of those who have been following the nuance of legislative texts on this subject), the main change in SB 1196 is to be found in the replacement of "terminal disease" to "a grievous and irremediable medical condition", which term, as textually lifted from Canadian Law, is defined as "(a condition which) Causes the individual to endure physical or psychological suffering due to illness, disease, or state of decline that is intolerable to the individual and cannot be relieved in a manner the individual deems acceptable".

It will be most interesting to see whether or not California legislators will actually dare to take the final step of definitely defining "Medical Aid in Dying" like some other States have done, as "the medical practice of...". However, this is hardly even necessary, in light of the all-embracing "grievous condition" definition cited above, and of the fact that not only assisted-suicide, but euthanasia also (intravenous administration) will now be available in California. For how could euthanasia be considered in any other way than that of a true medical treatment, when it is defined as a procedure performed by a doctor in order to alleviate suffering?

In sum: we are rapidly approaching the end of any further obfuscation or deceit.

Practical effect of the medical definition

As seen in Canada, euthanasia (as a medical treatment for suffering) cannot be reserved for people at the end of life, or for those capable of consent, or for those of major age.

But there are also other factors which have, thus far, received little attention:

1) Euthanasia as a preventive measure, applied to perfectly stable patients, with the goal of avoiding not present, but potential future suffering (as presently practised in Canada, at the mere pronouncement of any serious diagnosis).

2) The systematic promotion and prescription of euthanasia (to all and sundry) by enthusiastic doctors who believe they are simply performing their most fundamental duty of proposing what they sincerely believe to be optimum medical treatment in specific circumstances.

3) (as also seen in Canada) The institutional normalization of euthanasia practice and promotion, which just happens to be in the budgetary interest of public health services such as the Veterans' Administration, Medicare and Medicaid.

4) Lessor development and availability of other treatments (for conditions such as cancer) which will inevitably be reduced in exact proportion to the adoption of euthanasia as a legitimate medical substitute.

In short:

California SB 1196 does not represent a mere expansion of eligibility requirements for a choice-based system of assisted death. It actually signals a full-blown tipping-point, where publicly funded medicine in that State will begin its transition to a euthanasia-based utilitarian paradigm of death-medicine --a routine substitution of death for care-- as already observed in Canada (from which place the relevant legal language has been textually copied).

One bright spot:

It will at least become more difficult for apologists of assisted death to keep a straight face --or even to make eye contact-- when using the word "safeguards" (or disparaging the "slippery slope").

Gordon Friesen, March 9, 2024