Physician-assisted death is not suicide. The new End of Life Option Act, passed in August and signed by Gov. Jerry Brown on Sept. 8, makes it legal for a physician to prescribe a drug to end a patient’s life.

“But it is not suicide,” says Toni Broaddus, California campaign director of Compassion & Choices, the organization that lobbied hardest in favor of the bill, “and it will not say ‘suicide’ on the death certificate.” Physician-assisted suicide is still illegal in California.

“Californians like to have options,” she says. The issue is about choice: choice at the beginning and choice at the end.

The bill allows patients to choose to end their life rather than suffer until its “natural” end. “It’s a relief for people to know that it’s an option,” says Iris Lombard, who facilitates the Elders Salon Sonoma, an aging-issues discussion group.

While a majority of Californians hailed the passage of the controversial bill, advocates for the disabled say the implications are grim.

“Those of us born with visible or severe limitations are frequently told that our lives are not worth living,” writes Adrienne Lauby in the Peace Press, a bimonthly publication of the Peace & Justice Center of Sonoma County. “We don’t want our deaths determined by doctors working for HMOs who understand how much cheaper a suicide pill is than health treatments,” says Lauby, who hosts Pushing Limits, KPFA’s disability show.

All California organizations for the disabled opposed the bill.

“Until you’ve spent many years in and out of hospitals, you may not understand how flawed the healthcare system is,” says Lauby. “There are regulations, but mistakes are made and patients are manipulated. You have the basic problem of healthcare being profit-driven. . . . It’s easy to imagine people being given the medicine to save money.”

In the Netherlands, where a similar law has been in place since 2002, “the rate of assisted suicide has gone up many times, and the amount of money for long-term care and medical assistance at the end of life has gone down,” she says.

Dr. Ira Byock, a leader in palliative care in the United States, also cited the Netherlands in an Los Angeles Times op-ed that opposed the law. Instead of letting doctors assist in patients’ deaths, Byock wants to see better palliative care. “Last fall’s Institute of Medicine report “Dying in America,” detailed deficiencies in medical training and practice that contribute to needless suffering,” he wrote. “It also lays out steps that healthcare and long-term care systems, insurers, medical schools and policymakers can take to reliably resolve this crisis.”

In Oregon, the state whose legislation is the model for the California law, the experience has been different. There, less than 1 percent of patients ask for a prescription, and of those, only one-third actually take it.

If not actually pushing people toward suicide, will the new law tend to decrease the amount of time and money allotted to palliative care for people with prolonged terminal illnesses? This is of special concern to poor people who are dependent on state insurance: Will the law push them to take the pill rather than endure prolonged suffering without the comforts of quality palliative care?

And what about the elderly? With a steadily rising population of elders, many of whom are disabled and lack essential services, pressure to expedite their deaths could increase.

But Broaddus believes safeguards in the law protect against such dark outcomes. The process of obtaining the prescription is cumbersome. Patients must be in hospice care and diagnosed with a terminal illness and then interviewed by a mental-health provider to assure mental competence.

Two doctors, seen separately, two weeks apart, must agree that the prescription is warranted. For their protection, patients with terminal dementia are not permitted to request a prescription, another wrinkle in this complicated issue.

The concern is not so much that patients will be routinely forced to choose death by their insurance companies, but that cutbacks in palliative care will push people to choose to die before it’s their time.

For those whose disease cannot be ameliorated, the value of this option is clear. Brittany Maynard moved to Oregon to take her life after she was diagnosed with a virulent form of brain cancer that blocked the effects of pain medication. An unassisted death would have meant unrelieved misery for Maynard, whose right-to-die advocacy started a national conversation about the issue.

For now, most patients aren’t running off to die under the new state law, says Yvonne Baginski, publisher of Born to Age, an annual digest of information for seniors. Baginski has done end-of-life work for three decades and says, “I don’t expect to see a huge onslaught of people seeking this. People are afraid to die. They expect a miracle until the end.”

DOJ GO HOME

Last week a trio of California lawmakers sent a letter to United States Attorney General Loretta Lynch that implored the Department of Justice to lay off the medical marijuana busts in California, forever, in light of “comprehensive, stringent and enforceable industry regulations recently signed into law.”

In their letter, U.S. Reps. Barbara Lee, Dana Rohrabacher and Sam Farr wrote that they were “concerned that the Department of Justice [DOJ] continues to threaten individuals and businesses acting within the scope of states law on the medicinal use of marijuana despite formal guidance on exercising prosecutorial discretion and recent changes to federal law. It is counterproductive and economically prohibitive to continue a path of hostility toward dispensaries.”

Hostility, you say? It’s running strong locally. The Sonoma County Sheriff’s Office, for example, has adopted a generally hostile posture when it comes to its relationship with local medical cannabis providers. The federal ban on cannabis has in recent months been toted out by Sonoma law enforcement as the department has shown exactly zero interest in backing off from weed busts locally.

For example: Following the recent destruction of hundreds of cannabis plants in Forestville that were reportedly being grown for AIDS patients by “Oaky” Joe Munson, a department spokesperson told the S.F. Weekly that it reserved the option to enforce the law as it existed before the advent of Proposition 215—the 1996 measure that created the nation’s first medical cannabis law.

The letter to the DOJ highlights “counterproductive” efforts by the DOJ to crack down on dispensaries that are legally permissible under state law—efforts that have been ongoing since 2011 at the insistence of locally based U.S. attorneys, reports the San Francisco Chronicle, which noted last January that the crackdown had led to hundreds of dispensary shutdowns around the state.

Lee and Farr are Democrats, while Rohrabacher remains in the death grip of a Republican Party that has shown little interest in legalizing pot. Yet Rohrabacher supports the legalization of recreational cannabis and he surfs. He also supported George Bush’s torture policies at Gitmo on his way to becoming an unapologetic Islamophobe who also ran with the mujahideen in Afghanistan during the Soviet occupation. He must be high, since Rohrabacher doesn’t believe that global warming is caused by humans. But at least he recognizes a state right when he sees one.

NAPA LAND GRAB

We came back to work after the long holiday weekend to hear some good news. The Land Trust of Napa County just closed the deal on a land acquisition of 110 acres “rising from the western floor of Chiles Valley east of Angwin.”

It’s a pretty big deal, given that the land provides a connector to other lands and will ensure that wildlife corridors remain open. The land is next to the Los Posadas State Forest and wooded lands owned by Pacific Union College.

The property was donated to the land trust by the Okin family. In a statement, patriarch Bob Okin gushed over the natural beauty of the land as he explained why his family bought it in the first place.

“We were thrilled by its diversity, its roughness, its untouched, unspoiled beauty, and in certain places, the feeling it gave us of being on top of the world as we looked across multiple valleys to successive ridges of mountains. The overriding reason we bought the land was because we couldn’t bear to have it developed.”