Ruling could curb assisted suicide law

For more than 30 years, Dr. Leslee Cochrane has held sacred the Hippocratic Oath. For the past 18 years, he’s held himself to a higher standard still while caring for dying patients in Southern California.

Yet the hospice physician’s highest standard comes from the Bible.  He is one of 19,000 members of the Christian Medical & Dental Associations. When a California physician-assisted suicide law took effect in 2016, Cochrane clung to verses from Matthew 22:39, 25:36, and 28:19. Legally, he could still refuse to take part in taking lives.

But California clouded the medical landscape in 2022. Amendments to the state’s End of Life Option Act forced objecting doctors to document suicide requests and to refer patients to physicians who would end lives. That documentation would make Cochrane a responsible party to death.

“Whether you value human life or not, you will now be forced to participate in someone ending their life or else you may be subject to losing your license,” Cochrane said. “It’s unconscionable. … I cannot imagine how that could be viewed as good for society or good for patients.”

Cochrane and CMDA sued California Attorney General Rob Bonta and other state officials in February. This month, U.S. District Judge Fernando L. Aenlle-Rocha agreed with the plaintiffs in part. The Trump appointee ruled that California’s amended law cannot be applied to doctors who want no part of the assisted-suicide paper trail and referral process. Bonta is reviewing the case, and a state appeal is expected.

The ruling wasn’t a complete victory for Cochrane, CMDA, and their Alliance Defending Freedom attorneys. Aenlle-Rocha rejected other claims of violation of the 14th Amendment’s equal protection and due process clauses and the First Amendment’s protection of the free exercise of religion.

Still, the ruling favoring Cochrane’s free speech rights, if upheld, would allow him to stay out of the assisted suicide business entirely. So far, 10 states and the District of Columbia permit assisted suicides. Before 2022, California patients already didn’t need a physician to attend their suicide, only a prescription for drugs—typically barbiturates—to complete the process.

The amendments liberalized the 2016 law, reducing the time between a first and second oral request for drugs from 15 days to 48 hours. A final written attestation from the patient, required in the original law, was eliminated. State Sen. Susan Eggman, who authored the law, said in a tweet that the End of Life Option Act has “provided peace of mind to thousands of dying Californians since 2016.”

Patients following the letter of the law in ingesting “aid-in-dying” medication won’t be considered suicide cases, according to a Kaiser Permanente primer.

ADF attorney Kevin Theriot said states like California are seeking to liberalize laws because other states have not joined the assisted suicide bandwagon.

“I do believe that this is an important case nationwide,” he said. “As far as I know, it’s the first time any portion of an assisted suicide law has been enjoined [or] put on hold. I think that’s significant.”

A bulwark of Cochrane’s bid is another California case, National Institute of Family and Life Advocates v. Becerra. In the 2018 ruling, the Supreme Court ruled California could not compel pro-life pregnancy centers to distribute government-drafted scripts promoting abortion options.

Cochrane pointed to the American Medical Association’s Code of Medical Ethics, which asserts that physician-assisted suicide is “fundamentally incompatible with the physician’s role as healer.” Yet AMA delegates voted 360-190 in 2019 to support members who practice physician-assisted suicide.

“Unfortunately, I think the people who are most vulnerable in this are the weak, the frail, and the elderly who are least able to advocate for themselves,” Cochrane said. “What’s to stop the process from rolling downhill to all the disabled people, all the people in memory care facilities with dementia?”