The Golden State is turning gray. California has the largest senior population in the nation. Almost four million residents are 65 or older and those over 85 are increasing the most. In 2010 the first baby boomers will turn 65 and the state’s senior population will approach six million. Forty percent of the Baby Boomers are Latino and Asian and half are women. California is facing a diverse geriatric tsunami that will hit the state budget, taxes, charities, housing, health care, and more.Today “60 is 40.” Californians are living longer, healthier, active lives. Many will outlive their resources and also encounter forms of dementia and other age related disabilities. To prepare California for a senior society the State Health and Human Services Agency is developing a “Comprehensive Strategic Plan on Aging.” Two major components of the plan are Elder Abuse and End of Life Care. The plan is monitored by the California Commission on Aging, which is the principle advisory body to the Governor and the Legislature on senior issues.
Elder Abuse is epidemic. Adult Protective Service agencies throughout the state report marked increases and for every case, five are unreported. Elder abuse can be physical or mental but most abuse is financial and committed by a family member. APS agencies are understaffed, they need larger budgets to handle growing caseloads to protect vulnerable seniors.
End of Life Care involves the personal autonomy of dying patients. It now faces demands to legalize physician-assisted suicide which many call “the ultimate elder abuse.” On June 10th, AB 374, “The Compassionate Choices Act” was defeated in the Assembly for the second time. It would permit physicians to prescribe a self-administered lethal drug to mentally competent consenting adults diagnosed to be terminally ill. The American Civil Liberties Union and National Organization for Women support assisted suicide as the “ultimate civil right.” HMOs also support it. They will try again next year. Californians need to know more about assisted suicide and why this bill has failed.
Physician assisted suicide is opposed by over fifty organizations. They include the American Medical Association, hospice and disability rights groups and ethnic and religious organizations. They maintain physician assisted suicide is immoral, unethical and unnecessary. The State Probate Code permits adults to determine their own medical treatment with an Advanced Directive for “provision or withholding of all forms of health care.” This directive can include palliative sedation to relieve pain and hasten a peaceful death. Polls that show 70% support for assisted suicide are misleading because they do not inform respondents of an Advanced Directive. Opponents of AB argued that subtle coercion by family and health professionals can result in chronically ill or disabled seniors to feel they have a "duty to die." They also noted that although the Bill required assisted suicides to be reported, it had no penalty for Doctors who do not report.
The slippery slope argument by opponents is a deadly reality in Holland where physician assisted suicide has “slipped” from assisting the terminally ill, to assisting the chronically ill, to assisting the disabled to assisting the depressed. It gets worse; the Dutch Government’s own studies report doctors “terminate without request” approximately 1,000 patients a year. In Holland a peaceful death for those thought not to have a "livable life" has also “slipped” into the pediatric wards. A study published in the British medical journal The Lancet reports 8 percent of all Dutch infant deaths are from lethal injections and 45 percent of neonatologists and 31 percent of pediatricians who responded to Lancet survey have committed eugenic infanticide.
The proponents of assisted suicide will undoubtedly bring it back next year. If so, it should be decided by ‘we the people” via an initiative, not by a gerrymandered legislature that is unaccountable to voters. (Not one seat in the legislature has changed parties in the last two elections.) Twenty-one 21 states have defeated proposals for assisted suicide. California is the seventh largest economy on the planet. How we decide this life or death issue will resound across the entire nation and the world.
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