The Mercury News

More than 100 California­ns ended their lives under law

- By Patrick May and Tracy Seipel

One hundred and eleven. That’s the number of California residents who died with the help of doctor-prescribed drugs under the state’s new aid-in-dying law, according to a first-of-its-kind report released Tuesday. Nearly 200 received the drugs under the law, the report said.

The law allowing assisted suicide in the Golden State, called the End of Life Option Act, went into effect on June 9, 2016, ending years of passionate debate over whether the state should allow any mentally competent California adult, diagnosed with less than six months to live, to end their life with a lethal drug prescripti­on from their doctor.

The law also mandated that the California Department of Public Health publish an annual report that provides specific details about anyone who requested and may have ingested the drugs. The report analyzes statistics only from June 9 through Dec. 31 of 2016, so its numbers understate use of the law to date. Some report highlights: • Nearly 60 percent of those who asked their doctor for the end-of-life remedy were suffering from cancer;

• Eighteen percent had been diagnosed with a neuromuscu­lar disorder like ALS or Parkinson’s disease, while many suffered from heart and respirator­y diseases;

• The median age of people who used the new law was 73;

• Forty-two percent of those

who used it were age80 and over;

• Most of the people who used a prescripti­on — 102 out of the 111 — were white, while Asians made up six of the total; the number included three blacks and three Hispanics.

The data didn’t surprise Dr. Lonny Shavelson, a Berkeley-based primary care doctor who now specialize­s in helping patients access the law.

“California kind of looks like every other state in that respect — none of the informatio­n about the diseases or types of patients is any surprise,” Shavelson said.

If anything, he said, the numbers — even just six months worth — seemed quite low.

“You would think that more than 111 people across the whole state would have availed themselves of this law,” Shavelson said. Such small numbers, leads him to that patient access to doctors is still very difficult.

“It means that there are so many people who cannot get a doctor to work with them,” said Shavelson, who travels to meet patients residing everywhere from Northern California to the Central Valley.

Critics of the law are concerned about data that wasn’t included in the report.

“We are really shocked at how much informatio­n is missing,’’ said Marilyn Golden, senior policy analyst at the Berkeley-based Disability Rights Education & Defense Fund.

Among the informatio­n Golden wants reported — as right-to-die law states like Oregon and Washington do — are reasons why the person decided to use the law. Was the person afraid of losing his or her autonomy? Was it because of financial worries, concerns about being a burden to their family, or because of pain?

Golden also said the California report lacks pertinent informatio­n about time of death after ingesting the drug; whether or not there were any complicati­ons, and if anyone witnessed the death.

But unless the state legislatur­e changes the law, that informatio­n is not required to be collected.

The report does break down the types of illnesses reported by the people seeking assistance in ending their lives. Among those with malignant cancer as the underlying terminal disease, which constitute­d the largest group of individual­s asking for help, lung cancer accounted for 20 percent, while breast cancer made up 18.5 percent, pancreatic cancer comprised 12.3 percent, and 10.8 percent had prostate cancer.

In late May, the group Compassion & Choice pointed to anecdotal evidence from its Doc2Doc program — which puts California doctors in touch with their counterpar­ts in states where right-to-die laws have been in place for a long time — that suggested at least 504termina­lly ill adults in California received prescripti­ons since last June.

It had no informatio­n on how many used the drugs, but the group had initially predicted that about 1,500 lethal prescripti­ons would be written in California during the law’s first year — and about two-thirds of the medication­s would actually be ingested.

The numbers include people like Ray Perman, a 64-year-old Piedmont resident who employed the right-to-die law on Feb. 4, to ingest a lethal dose of sedatives. Perman passed away peacefully — in his own home, on his own terms — after years of battling cancer.

Andrea Witherell, Ray Perman’s 25-year-old daughter, said it was very meaningful to her father to have such a law available to him.

“It’s kind of difficult to explain,’’ Witherell said. “He did not want to die or throw in the towel. The cards he was dealt he played the best he could. But there were no options left. Science was not going to fix him.’’

The state report notes that not everyone who asked for the prescripti­on to end their lives actually went through with it. While 191 prescripti­ons were written, 111 people actually took the medicine and died. The report says 21 of those who received a prescripti­on died from other causes. It was unclear what had happened with the other 59 patients who had requested but not used the drug.

Shavelson, who is in regular contact with his patients, said he’s concerned that the drugs may languish inside a patient’s home and possibly fall into the wrong hands so he will not write a prescripti­on until the patient confirms that he or she wants to take the drug.

Any unused aid-in-dying drugs must be taken to the nearest qualified facility, such as a pharmacy, to be disposed of, according to the law.

From June 9 to December 31 of last year, the report said, 258individ­uals started the end-of-life option process, which under the law requires an individual to make two verbal requests to their physicians, at least 15 days apart.

The report said 173 unique physicians prescribed aid-in-dying drugs to the 191 individual­s.

Contact Patrick May at 408-920-5689 and Tracy Seipel at 408-920-5343.

 ?? PHOTO COURTESY OF ANDREA WITHERELL ?? Ray Perman of Piedmont used California’s end of life option in February 2016. A report released Tuesday reveals that only 111 people committed suicide with the legal help of a doctor in 2016.
PHOTO COURTESY OF ANDREA WITHERELL Ray Perman of Piedmont used California’s end of life option in February 2016. A report released Tuesday reveals that only 111 people committed suicide with the legal help of a doctor in 2016.

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