End-of-Life Options across the USA — The good, bad and the ugly

Let’s start with the good news. End-of-life doulas in California won a case in federal court that struck down the requirement that doulas—who do not perform traditional funerals—need a funeral establishment and funeral director licenses.

The ruling goes back to a 2020 lawsuit whereby the California Cemetery and Funeral Bureau required two Sacramento doulas operating a non-profit called Full Circle of Living and Dying had to have a brick-and-mortar funeral home and licenses for home funerals.

The attorneys representing the doulas had this to say about their victory:

“It was clear from the start that the state’s regulations had nothing to do with protecting the public or ensuring safety,” said Institute for Justice Attorney Ben Field. “These regulations only served one purpose, and that was preventing alternatives to traditional funerals from succeeding in the market. But now, Californians are free to choose the end-of-life care that best suits them.”

“We’re hopeful that this victory makes it clear to other licensing boards throughout the country that they cannot restrict free speech and economic liberty rights without a legitimate public safety reason for doing so,” said Institute for Justice President and Chief Counsel Scott Bullock.

Too early to comment:  New Hampshire has potential to pass! Stay tuned!

Now for the bad. Two states had defeats in their legislative sessions:

Colorado’s attempt to lift the residency requirement for their MAID law was defeated. Additionally, the attempt to shrink the waiting period from 15 days to 48 hours was negotiated to a 7-day waiting period with the possibility to waive the waiting period completely if it appeared the patient had less than 48 hours to live.

Maryland’s MAID bill was short one or two votes in the Judicial Proceedings Committee so it was pulled and shelved until next year. After much contentious debate and hours of testimony the pros and cons fell into two predictable columns:  dignity and bodily autonomy vs. religious, ethical and moral concerns.

And the ugly. Indiana lawmaker Sen. Tyler Johnson (R) introduced a resolution opposing MAID. Their Healthcare Committee approved the resolution along party lines 9-2. We will keep you up-dated on further votes. Looks like this type of resolution will appear in other states as a boilerplate way to strengthen a state’s “assisted suicide” laws to specifically include medical aid in dying. This will further challenge the MAID advocacy groups to overcome misinformation and MAID opponents.

What happened to our Arizona HB2254 Healthcare decisions; living wills bill?

As we know, the bill died in committee, as reported in our last newsletter. But now HB2254 is called “AZ Space Commission” bill? Huh? Thaddeus Pope asked me this exact question at an end-of-life conference in Utah.  If you’re new to Arizona politics this may be confusing. It’s called a “strike everything” amendment, or sometimes called a “striker” for short. By definition, the AZleg.gov website explains it this way:

“A ‘strike everything after the enacting clause’ amendment proposes to delete the entire text of the existing bill and substitute new language, essentially making it a completely different bill, possibly on an entirely different subject. These amendments are sometimes used to allow legislators to circumvent the deadlines on introduction of new legislation, deal with an issue that arises after the deadline or revive a bill that has previously been defeated.”

So yes, HB2254 is now on an entirely different subject (with the same sponsors). It forms an Arizona Space Commission with research for space aeronautics, astronautics and aviation. Yay science! And it passed 47 to 12. Using the striker amendment to pass a bill is quite popular in the second half of the legislative session: this year there were no less than 83 striker bills proposed and 57 adopted.

Can SB1196 broaden the California End of Life Options Act (EOLOA)?

California Senator Catherine Blakespear (D) is the SB1196 bill sponsor and it is also supported by End of Life Choices California (endoflifechoicesca.org). A group called A Better Exit is proposing three big changes to the California EOLOA (taken from their website abetterexit.org) as follows:

• Broaden the eligibility criteria for MAID to allow for inclusion of individuals that are suffering from grievous and irremediable diseases and have longer life expectancies than six months.
• Allow an individual the choice to self-ingest or self-administer the aid-in-dying drugs with an IV infusion in accordance with their personal preferences and medical needs.
• Allow a person with early to mid-stage dementia to be evaluated for and access MAID when two physicians find that they have sufficient capacity to understand the consequences of their choice.

Don’t underestimate California’s influence on the right-to-die movement: After they passed their MAID law in 2016 it was followed by passage of MAID in five states in the next five years (plus Washington DC)! While the chances of passing SB1196 may be slim, the debate is worthwhile and will, no doubt, advance the discussion of MAID qualifications in the U.S.