EOLCCA celebrates 10 years of the End of Life Option Act this June, which legalized Medical Aid in Dying (MAiD), allowing for greater end-of-life options for terminally ill Californians. The article below is part of an occasional series where we will hear from people involved in the passage of or have been impacted by the law since its enactment. If you have a story to share, whether an anecdote or an essay, please feel free to email us.
Long-time advocate and EOLCCA volunteer, Robert Liner, MD was an early proponent of the law. Liner was on the front lines attending professional and community meetings, panel discussions and travelling for countless lobbying trips to Sacramento. EOLCCA Board Member Fran Johns talked with him about those years.
Looking back to the early 2000s, Liner recalled that opposition to Medical Aid in Dying came from three sources – “organized medicine, the Catholic Church and some disability rights groups.” In the medical community, it was not just the American Medical Association and California Medical Association (CMA), but also the majority of organizations representing oncologists. While the Association of Northern California Oncologists advocated for the law, disappointingly, a significant percentage of oncologists viewed death as a defeat and opposed it.”
Public opinion surveys at the time revealed that while the leadership of the Catholic Church and certain disability rights groups opposed the law, a plurality/majority of the membership actually supported choice at the end of life. “Despite the fact that many Catholics supported the law,” Liner continued, “opposition from the Catholic Church was intense (ed note: and continues to be as MAiD laws are considered across the country) and some disability rights group, actually reflected the views of a minority among the disabled.”
But it was among his fellow physicians (and the CMA) that obstruction was the most ferocious. Liner cites one “memorably deplorable moment” prior to enactment that paints a picture of just how bleak the situation was.
“Despite the fact that many Catholics supported the law,” Liner continued, “opposition from the Catholic Church was intense”
It happened “during floor debate among the CMA delegates at large, following an emotional but articulate, passionate testimony from Stephen Follansbee, a specialist in infectious disease with Kaiser and member of the San Francisco Medical Society.“ A gay man who had been on the front lines as a physician during the darkest years of the AIDs epidemic, attending many victims of the fatal disease, Dr. Follansbee spoke to the group of the profound need for a law like the one being proposed. Immediately following this poignant, logically reasoned testimony, the then Speaker of the House quipped, not realizing his microphone was on: “Well, there’s no law against any of them buying a gun.” But Liner, Follansbee and other physicians including current EOLCCA Board Chair Robert Brody, persisted.
“While the San Francisco Medical Society actively supported the law over the course of many years and presented one resolution after another to the CMA at its annual meetings, as did a few other local societies,” Liner recalls, “the majority of the membership voted against those resolutions – and the CMA annually used its purse and lobbying influences in Sacramento to oppose the proposed bills. Fortunately, the CMA modified it’s position from “opposed” to “neutral” in 2015, helping clear the way for passage of the law.
“The general opinion among CMA delegates at that time,” Liner recalls, “was that medical aid in dying would violate the physicians’ code of ethics by which they strive to be healers. This was the position of the CMA’s leadership. In private conversation with me, a president of the Association derided the notion of any legal form of hastening death, even for the terminally ill.
He argued that it would lead to people ‘scheduling’ their deaths.” Liner spoke for an increasing number of Californians when he responded, “and for terminally ill adults, what would be wrong with that?”
Today, after nearly ten years of a successful and widely appreciated law, it’s hard to imagine the depths of opposition that had to be overcome.
Robert Liner is a retired physician living in San Francisco with his wife (and active EOLCCA volunteer) Judith Bishop.
EOLCCA Board Member and freelance writer Fran Johns writes regularly at franmorelandjohns.substack.com