241 Cal. App. 4th 1118
Cal. Ct. App.2015Background
- Plaintiffs (three terminally ill patients and a hospice/palliative physician) sued California public prosecutors seeking a declaration that Penal Code §401 does not apply to physicians who prescribe lethal doses for patient self-administration and an injunction against prosecutions.
- §401 (since 1873) makes it a felony for “every person who deliberately aids, or advises, or encourages another to commit suicide.” Plaintiffs argued prescribing is not "direct" aid and legislative history shows it was not intended to reach furnishing means.
- Defendants (Attorney General and district attorneys) demurred; trial court sustained demurrers without leave to amend and entered judgment for defendants. Plaintiffs appealed.
- During the appeal the Legislature enacted the End of Life Option Act (Assembly Bill 15) authorizing physician-assisted dying with safeguards; parties agreed the appeal was not moot because AB15’s effective date and referendum challenge left uncertainty and it might not help plaintiffs.
- The Court of Appeal independently reviewed statutory interpretation and an "as-applied" state constitutional privacy challenge and affirmed the judgment, holding §401 covers prescribing lethal drugs and that plaintiffs’ privacy claim fails; it emphasized that policy and safeguards are legislative matters.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether Penal Code §401 applies to physicians who prescribe lethal drugs for patient self-administration | Donorovich-Odonnell: prescribing is not “direct” participation because physician does not directly perform final act; furnishing means is indirect and may depend on pharmacist/patient | §401’s broad language (“every person” who “aids”) includes physicians; courts require active/intentional participation and furnishing means qualifies | Held: §401 covers prescribing a lethal dose — writing a prescription is active, intentional participation (furnishing the means) |
| Whether §401 is latently ambiguous given Field Code/Code Commission history and thus should be read not to reach furnishing means | Plaintiffs: legislative history (Field Code distinctions) shows drafters did not intend to criminalize furnishing means; Code Commission omitted a separate provision for means purposefully | Defendants: plain text controls; historical silence and consistent judicial construction show §401 was intended to reach furnishing means; subsequent statutes and legislative efforts (and AB15) show Legislature treated §401 as criminalizing aid | Held: No latent ambiguity; plain meaning controls and judicial/legislative history supports that §401 proscribes furnishing means; rule of lenity inapplicable |
| Whether applying §401 to physician prescribing violates California constitutional autonomy/privacy rights (as-applied challenge) | Plaintiffs: terminally ill competent patients have a privacy/autonomy interest in assistance to die; state must show compelling interest to prohibit physicians assisting | Defendants: no fundamental right to third-party assistance in suicide; state has compelling interests (preserving life, protecting vulnerable, medical ethics); federal cases permit regulation; policy for safeguards belongs to Legislature | Held: As-applied privacy claim fails; no established fundamental privacy right to physician-assisted suicide and state interests justify §401 application; issue for Legislature (AB15 demonstrates legislative route) |
| Whether court should condition a favorable ruling on compliance with AB15-similar safeguards | Plaintiffs: propose conditioning judicial relief on voluntary compliance with AB15 safeguards to avoid abuse | Defendants: not addressed at length; court concerned about policing compliance and broad effects on all physicians | Held: Rejected as inappropriate — court will not impose or monitor voluntary statutory-like safeguards; such detailed regime is for the Legislature |
Key Cases Cited
- In re Ryan N., 92 Cal. App. 4th 1359 (Cal. Ct. App.) (interpreting §401: conviction requires specific intent and active/direct participation such as furnishing means)
- People v. Matlock, 51 Cal. 2d 682 (Cal. 1959) (§401 contemplates participation in events leading to suicide; furnishing means is implicated)
- In re Joseph G., 34 Cal. 3d 429 (Cal. 1983) (driver who caused co-suicider’s death supplied instrumentality; conduct fell within assisted-suicide statute)
- Donaldson v. Lungren, 2 Cal. App. 4th 1614 (Cal. Ct. App.) (no constitutional right to third-party immunity for assisting death; issue for legislature)
- Washington v. Glucksberg, 521 U.S. 702 (U.S. 1997) (federal due process: no fundamental right to physician-assisted suicide; states may prohibit)
- Vacco v. Quill, 521 U.S. 793 (U.S. 1997) (equal protection: distinction between refusing treatment and assisted suicide is rational and permissible)