Kill the Bill, Not the Ill

Original Article

Sacramento, California

It was every liberal’s dream of diverse, grass-roots political activism: more than a hundred people demonstrating angrily in front of the California state capitol against pending legislation that threatened people who are poor, who are disabled, and who are vulnerable. Disability-rights activists in wheel-chairs marched in solidarity with white medical professionals, alongside African-American clergy and advocates for the poor, next to Latino migrant farm workers and Catholics praying the rosary.

Some liberals, however, were displeased by this show of diversity. For Democratic assembly-women Dion Aroner of Berkeley and Sheila Kuehl of Santa Monica, for example, the protest was only the latest frustration. Aroner is the author of AB 1592, a bill to legalize physician-assisted suicide, and Kuehl is a leading supporter. Conventional wisdom had held that the bill would move swiftly and easily through the committee process and onto the assembly floor for quick approval. But the grass-roots coalition that had sprung up to oppose it had slowed the bill’s progress to a crawl.

In contrast with the monochrome proponents of assisted suicide — all “white, well-off, well, and worried,” as disability-rights activist Diane Coleman puts it — the opponents “look like America.” For hours, they demonstrated on the sidewalk, walking in a circle and chanting robustly:

Kill the bill, not the ill!
We won’t take your deadly pill!
This is what we’re going to do:
Kill AB 1592!

One in four in this state are poor,
Medical care has closed its doors:
All of us want to stay alive!
We don’t want your suicide!

One, two, three four,
Death-squad medicine will kill the poor:
Five, six, seven, eight,
Stop 1592 before it’s too late!

California has always been the prize most avidly sought by assisted-suicide advocates. The first modern attempt to legalize euthanasia in this country was mounted in California in 1988, when proponents gathered signatures for an initiative. That effort fell short, but the proponents were able to place Proposition 161 on the ballot for the November 1992 election. Although the early polls put it ahead with more than 70 percent support, California voters nixed the euthanasia and assisted-suicide measure by 54 percent to 46 percent. Now, with rich philanthropists such as George Soros and foundations like the Gerbode Foundation of San Francisco behind the effort, and with the governor’s mansion and legislature in Democratic hands, advocates sensed the time was ripe to strike and win.

First stop for AB 1592 was the Judiciary Committee, chaired by Sheila Kuehl. The committee was weighted heavily in favor of passage, with nine Democrats, five Republicans, and the newly elected Green party assemblywoman from Oakland, Audie Bock, whose first big vote would be about 1592.

On the day the measure was heard, April 20, 1999, more than 50 opponents crowded the committee room, alongside fewer than 10 supporters. One would have thought that a proposal as momentous as permitting doctors to facilitate the intentional deaths of their patients would require a deep exploration of the pros and cons. Kuehl didn’t see matters this way. She permitted only brief testimony from two witnesses on each side. Supporters pushed the “choice” button. Opponents brought up objections often overlooked in media accounts of the assisted-suicide debate. For example, an assisted suicide costs only $ 35, while proper treatment for the same patient might cost $ 35,000. In the era of managed care, the financial force of gravity is obvious. The threat assisted suicide poses to disabled people was also stressed. Professor Paul Longmore, a nationally recognized disability-rights activist who teaches history at San Francisco State University, testified that “fear of disability underlies assisted suicide,” noting that “a dozen major disability-rights organizations strongly oppose it.”

What were liberals to do? They despise HMOs and vilify them often. Yet, opponents label AB 1592 the “HMO Profit Protection Act.” Liberals claim to care deeply about protecting people with disabilities, but the disability-rights community was out in force protesting the bill.

An initial vote was taken: ayes 7, noes 8. It looked like AB 1592 was history. But wait. Kuehl and Aroner closed in on the weak link in the opposition chain, Audie Bock, who had voted “no” on account of her worries about HMO abuses. Shaken by the intensity of Aroner’s and Kuehl’s pressure, Bock called her mother to ask how she should vote. Casting what became known derisively as “the mommy vote,” the Green party member turned yellow: Bock switched her vote to “yes” on the basis of her mother’s support of assisted suicide and Aroner’s blithe assurance that her HMO concerns would be addressed in amendments.

Disappointed opponents wasted little time grousing about Bock’s weakness. They set to work lobbying members of the Appropriations Committee, chaired by the powerful San Francisco Democrat Carole Migden, who is closely allied with Aroner and Kuehl. The hearing in Appropriations was held on May 19. As at the Judiciary Committee hearing, opponents filled the committee room; this time more than 100 strong, they overflowed into an upstairs balcony. Once again, testimony was restricted to two brief presentations from each side. Opponents loudly applauded major points made in opposition. Kuehl groused to Migden that she had not allowed opponents to applaud when she had chaired the Judiciary Committee hearing. Then an African American stepped forward, angrily declaring, “I demand to be heard! I demand to be heard! This bill will harm my community!”

The eyes of the liberals on the committee widened and their jaws dropped. An uncomfortable silence fell. This kind of thing is only supposed to happen to conservatives.

Migden allowed the man to testify along with the other witnesses, then announced quickly that the bill was “in suspense.” The vote would not be held for another week.

If the bill’s supporters expected the opponents to go away, they were in for a big surprise. During the ensuring week, advocates for the poor mounted a vigil. They scoured the capitol hallways looking for legislators to pigeonhole. Meanwhile, professional lobbyists hired by other members of the anti-1592 coalition, such as the California Hospice Association, kept up the pressure. Informal counts of the committee showed AB 1592 losing 11-10.

The vote was scheduled for May 26. Once again, opponents filled the committee room. Lacking the votes to get 1592 out of committee, the chair delayed the vote until the next day. But this time, no advance schedule would be posted announcing the committee meeting. AB 1592 would be heard in the Appropriations Committee “off the floor” — that is, on very short notice after the day’s full assembly session. Opponents were forced to attend the entire session just to learn when and where the committee would meet.

When this was finally announced, about 35 opponents filled a small hallway adjacent to the committee room. No vote was held. Then, at about 3:20 P.M., Carole Migden accompanied by 1592 opponent George Runner, a Republican, came out to speak to the opponents. Penny Montemayor, a member of the Coalition of Concerned Medical Professionals, was there. According to Montemayor, Migden said, “There will be no vote on AB 1592 today. You can all go home. It might be tomorrow.” Relying on Migden’s word, opponents left the building.

They shouldn’t have been so trusting. Migden was not telling the truth. Shortly after the opponents departed, Migden called AB 1592 before the committee for a vote. Runner says he was “surprised that the measure was taken up in light of the fact that the Chair [Migden had] told opponents that we would not be taking up the bill.” He objected, to no avail.

The measure still should have lost. However, the California assembly is profoundly undemocratic. Unbeknownst to most Californians, special rules created by former speaker Willie Brown permit the speaker of the assembly to mix and match committee members almost at will to secure desired results on different bills. Thus, a committee that meets on Tuesday to vote on one set of bills may not consist of the same members when the committee meets on Wednesday to take up different proposals. This ability to play political musical chairs gives the speaker tremendous power. If he wants a bill to pass through the committees, it passes through the committees.

Assembly speaker Antonio Villaraigosa has not announced his actual position on assisted suicide or AB 1592. However, it is known that as a matter of political comity, he promised Aroner that her pet proposal would reach the assembly floor. In order to accomplish this, at the last minute he was forced to substitute two “yes” votes in the Appropriations Committee for two of the previously announced “no” votes. With opponents misled and the committee membership manipulated undemocratically, AB 1592 passed out of the Appropriations Committee by a vote of 11-9 and limped onto the assembly floor.

That night, Aroner crowed disingenuously to the Oakland Tribune that the Appropriations and Judiciary Committees votes in favor of 1592 had demonstrated the “strength” of her measure. But even she had to acknowledge that any chance of moving it through the assembly and into the senate was gone. Realizing she did not have the 40 votes needed to pass the measure, Aroner put her bill on the inactive list. It cannot be brought up again until January.

So now the fight is on for the hearts and minds of the California assembly. It is democracy versus political maneuvering, grass roots versus establishment politicians, constituency activism versus capitol horse-trading. Bad news for Aroner: The grass roots are angry. They did not appreciate Bock’s being pressured to change her vote. They are even angrier at being lied to about the pending Appropriations Committee vote. They are especially bitter about the switch of committee members that made a sham of their participation.

Proponents of AB 1592 claimed they wanted an open, democratic debate on one of the most controversial issues facing the country. But they didn’t act like it. What they actually sought was to push assisted suicide quickly through the assembly before anyone knew what was happening. Instead, they underestimated the power of bad public policy and underhanded political tactics to unify and motivate strange political bedfellows. Now, the opponents’ determination is palpable:

Thirty-five dollars is all it costs,
To write us off as a total loss:
For thirty-five bucks the state could pay
For the poor and sick to go away:
Thirty-five dollars — that’s so cold
For suicide when you get old.

Wesley J. Smith

Chair and Senior Fellow, Center on Human Exceptionalism
Wesley J. Smith is Chair and Senior Fellow at the Discovery Institute’s Center on Human Exceptionalism. Wesley is a contributor to National Review and is the author of 14 books, in recent years focusing on human dignity, liberty, and equality. Wesley has been recognized as one of America’s premier public intellectuals on bioethics by National Journal and has been honored by the Human Life Foundation as a “Great Defender of Life” for his work against suicide and euthanasia. Wesley’s most recent book is Culture of Death: The Age of “Do Harm” Medicine, a warning about the dangers to patients of the modern bioethics movement.