Appeals court reverses ruling against assisted suicide

LOS ANGELES  — A California appeals court overturned a lower court ruling that found the state's assisted suicide law was unconstitutional.

A panel of the 4th District Court of Appeals in the city of Riverside on Tuesday said doctors who brought the case did not show they were harmed because they could choose not to help terminally ill patients die.

In finding the doctors represented by The Life Legal Defense Foundation did not have legal standing, the court bypassed whether the law was unconstitutional.

The End of Life Option Act allows adults to obtain a prescription for life-ending drugs if a doctor finds they have six months or less to live.

Riverside County Superior Court Judge Daniel Ottolia declared the law unconstitutional in May because it was adopted during a special legislative session that was supposed to address improving the medical system and health of Californians.

The ruling written by Presiding Justice Manuel Ramirez has no immediate impact on the current status of assisted suicide because the appeals court had reinstated the law during the appeal by the state attorney general.

However, it does set the stage for possible future legal actions. The case was sent back to the lower court and the lawsuit could be amended and refiled.

The court even spelled out how groups challenging the law might be able to show harm.

For example, a district attorney who wanted to prosecute a doctor for helping a patient die or a hospital or medical group that sought to discipline an affiliated doctor who participated in assisted suicide might be able to establish standing, the court said.

Supporters of assisted suicide cheered the ruling and said it would strengthen their defense of the law in the future.

"But the harsh reality is this case is likely to last several more years because the plaintiffs are hell-bent on depriving Californians of their constitutional right to end-of-life care options that ensure terminally ill Californians have access to a peaceful death, free of unbearable suffering," said attorney John Kappos, who represented Compassion & Choices, a group that supported the law.

While two justices ruled only on the issue of standing, Justice Marsha Slough dissented in part because she said the appellate panel should have ruled on the merits of the case and found the law was constitutional.

Slough said it was not a stretch for the Legislature to consider assisted suicide as an extension of a discussion on the efficiency of the health care system. She said there was no reason to "drag this case out" before finding lawmakers acted within their authority.

"We have a responsibility to expeditiously disperse the uncertainty this litigation has created for countless patients, family members, and loved ones, as well as physicians and workers in the health care sector," Slough wrote.

Katie Short, vice president of legal affairs for the Life Legal Defense Foundation group opposed to the law, said she was disappointed by the ruling and that her group would consider its options.

"We are particularly disappointed in the way the court continued to hold to what we see as a false dichotomy in terms of the doctors' standing to represent patients," Short said. "The court has taken a simplest view, which basically is between doctors with those patients who want assisted suicide and those who don't. If they want assisted suicide, then the court says these doctors don't represent them."

In 2017, the first full year assisted suicide was legal, 374 terminally ill people took drugs to end their lives, California health officials said. More than 575 people received aid-in-dying drugs last year, but not everyone used them.

Oregon in 1997 was the first state to provide an end-of-life option.

California passed the law after Brittany Maynard, 29, who was dying from brain cancer, moved to Oregon in 2014 to end her life.

The District of Columbia and five other states — Colorado, Montana, Vermont, Washington, and Hawaii — also allow assisted suicide.