Compassion & Choices and the Compassion & Choices Action Network made history with the passage of the California End of Life Option Act. In the spring of 2014, we launched a five-year campaign to make medical aid in dying an open and accessible option for terminally ill adults in California. Despite overwhelming public support (our July 2015 poll showed 69% support by California voters), at least four legislative attempts and two ballot efforts to pass a death-with-dignity law had failed over the past three decades.
Our five-year goal to pass a law in California was achieved in just one year.
Key Highlights
The Brittany Effect. Brittany Maynard, who partnered with Compassion & Choices, was a 29-year-old Californian who brought international attention to aid in dying when she had to move to Oregon to utilize its death-with-dignity law, which she accessed to end her suffering from terminal brain cancer on Nov. 1, 2014.
The Latino Media Campaign. Compassion & Choices launched a Spanish-language media campaign to garner support for medical aid-in-dying legislation from Latinos. This targeted effort heavily influenced the passage of California’s End of Life Option Act.
Supporters and Volunteers. We conducted more than 1,300 legislative visits; held 300 educational events all over the state; nearly quadrupled our supporters from 25,000 to 95,000; trained over 1,000 volunteers and deployed them through 26 action teams statewide.
Aggressive Field Push. We sent out thousands of letters, emails, phone calls and tweets to the governor and held rallies outside the governor’s offices in Sacramento and Los Angeles to urge signing of the bill.
The California Story At-A-Glance
2024
Compassion & Choices filed a motion on behalf of three California patients with disabilities, the bill's sponsor, and two doctors requesting to intervene in a federal lawsuit claiming the state’s revised End of Life Option Act (EOLOA) discriminates against people with disabilities. The individual and group plaintiffs in the lawsuit, United Spinal, et al. v. State of California, et al., claimed that the updated California medical aid-in-dying law, which took effect in 2022, is discriminatory against people with disabilities. On March 27, a California judge dismissed the lawsuit seeking to void California's law."
SB1196, a bill with several proposed amendments that would pose significant risks to CA's current law, was submitted for consideration and ultimately pulled. Compassion & Choices did not advocate for nor against this bill, but we did release a public statement.
2023
On July 1, 2023, Planning Ahead for LGBT Seniors (PALS), as a result of Compassion & Choices’ sponsorship, traveled to the "Not Another Second” Exhibition, which portrays the years spent in hiding by 12 LGBT elders who came of age during the 1960s.
On April 25, 2023, a federal lawsuit was filed in the Central District of California, a court with the Ninth Circuit, against California officials, challenging the End of Life Option Act. Learn more.
2022
On May 18, 2022, Christian Medical and Dental Associations, et al. filed a federal lawsuit challenging the constitutionality of Senate Bill 380, the recently amended California End of Life Option Act (“the Act”). Compassion & Choices filed a motion to intervene on behalf of four clients: the bill’s sponsor, a terminally ill patient and two physicians who participate in the practice of medical aid in dying. More information can be found here.
2021
We defended against lawsuits seeking to invalidate the law. On October 29, 2021, Plaintiffs’ entered a stipulated motion to dismiss the lawsuit Ahn v. Hestrin, officially ending their 5-year legal attack on California’s End of Life Option Act. Compassion & Choices’ involvement in the lawsuit, first as amicus and then as defendant-intervenors, was critical to protecting access to medical aid in dying for terminally ill patients: when California’s End of Life Option Act was briefly suspended in 2018, Compassion & Choices filed a notice of appeal which led to the law’s immediate reinstatement. And, even after the law was reinstated via the notice of appeal, Compassion & Choices continued actively litigating the case, making sure that the court fully comprehended the legality of the Act and its importance for residents of California. While this legal attack is over, Compassion & Choices remains vigilant against all efforts to hinder access to medical aid in dying for qualifying terminally ill patients in California.
On February 11, 2021 SB 380 was introduced in the California legislature. SB 380 would improve upon the law so that more eligible Californians are able to access the law. On October 5, 2021, Governor Newsom signed SB 380 into law, and improvements took effect in January 2022. Key improvements include:
- It reduces the mandatory minimum 15-day waiting period between the two oral requests for aid-in-dying medication to 48 hours for all eligible patients. (The New Mexico legislature passed similar medical aid-in-dying legislation on March 15 that requires a 48-hour waiting period between the time the prescription is written and when it is filled.)
- It requires healthcare systems and hospices to put their medical aid-in-dying policies on their websites.
- It clarifies that the first oral request must be documented in a patient's medical record even if the physician chooses not to support the patient in the option.
- It ensures that patients will be given factual information about the End of Life Option Act when they ask so that physicians are upfront with their patients and tell them if they will not support them.
2020
Compassion & Choices continued working to make the California End of Life Options Act better.
Improving the law by removing unnecessary roadblocks
- Testifying. On February 25, 2020, Compassion & Choices President and CEO Kim Callinan and others testified during a select hearing on the California End of Life Option Act. Watch the full hearing.
Defending against lawsuits seeking to invalidate the law
Expanding access for patients, training providers and educating medical systems and hospices
- Presenting at public outreach events throughout the year. Last year alone we presented at more than 100 events.
- Assisting healthcare facilities develop more supportive policies. To date more than 80% of large health facilities have adopted policies supportive of medical aid in dying.
- Providing technical assistance and presentations to healthcare providers. We work with providers and facilities to help them understand and apply on end-of-life options.
- Compassion & Choices collaborates with City of Hope. Compassion & Choices collaborated with the City of Hope Comprehensive Cancer Center to host their End of Life Symposium Webinar Series. The webinars, each qualified for one continuing medical education (CME) unit for providers to expand their knowledge about providing care to patients whose treatment is transitioning from curative to comfort-focused care and medical aid in dying.
2019
- Religious medical system halted. Advocates in California stopped a potential affiliation between Dignity Health — a religious medical system opposed to medical aid in dying — and University of San Francisco (UCSF) health systems.
- Compassion & Choices collaborates with City of Hope. We worked with the City of Hope Comprehensive Cancer Center to host their 2019 End of Life Symposium for providers to expand their knowledge about providing care to patients whose treatment is transitioning from curative to palliative care.
- Survey shows support. In October, the California Health Care Foundation released a survey showing wide-ranging support for expanded end-of-life care options including the End of Life Option Act across demographics.
2016
- End of Life Option Act takes effect. The End of Life Option Act took effect June 9, 2016, but our work didn’t stop with enactment. Compassion & Choices has been on the ground working to implement the law by ensuring access for terminally ill residents, and working to educate healthcare providers about the end-of-life option — all while fighting legal challenges to the law.
2015
- Act Signed into law. Governor Jerry Brown signed the California End of Life Option Act into law on October 5, 2015.
- Dedicated resolution passes. The California Assembly recognized Compassion & Choices’ work to pass California’s End of Life Option Act with a dedicated resolution.
- Compassion & Choices mobilizes. Compassion & Choices and the Compassion & Choices Action Network led a multi-pronged approach, organizing supporters to pass local resolutions and prepare for a ballot measure; educating the Legislature; and filing a lawsuit asserting the right of Californians to choose medical aid in dying.
- Implementing field and legislative strategy. We implemented a robust field and legislative strategy, deploying staff and rallying thousands of volunteers on the ground in California. We also invested over half a million dollars into research to find out how a highly diverse state like California understands and talks about end-of-life issues, specifically aid in dying. California became an opportunity for Compassion & Choices and the Compassion & Choices Action Network to flesh out our strategy and expand our capacity. Our national Spanish-language media outreach and national storyteller project were both launched as part of this campaign.
- Brittany Maynard makes her voice heard. Brittany Maynard courageously shared her experience which had an incredible effect on the end of life movement. State Senators Bill Monning (D-Carmel) and Lois Wolk (D-Davis) approached us to help pass their bill, SB 128, End of Life Option Act. Despite an intense field and lobbying effort, SB 128 was assigned to a committee with not enough support to pass it. Our team proposed a strategy to introduce a new version of the same bill in a legislative special session, and Assemblymember Susan Talamantes Eggman (D-Stockton) led the final push to get the new End of Life Option Act through the Legislature and to the desk of Governor Jerry Brown. After a briefing from our staff and supporters and a request to Archbishop Emeritus Desmond Tutu to share his support, Governor Brown signed the bill into law.
2014
- Compassion & Choices and the Compassion & Choices Action Network launch a 5-year plan to authorize medical aid in dying.
Read the full history of passage of the End of Life Option Act in the 2015 California Annual Report.
