California Editorial Rdp

Published 10-25-2018

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Oct. 24

Los Angeles Times on California's cruel rule barring 2,400 vets from accessing aid in dying:

Not long after California enacted a law allowing terminally ill people to obtain life-ending prescriptions, the state Department of Veterans Affairs (known as CalVet) adopted an emergency regulation making it clear that residents of its eight veterans homes would not be allowed to take advantage of the new law's provisions.

The emergency regulation prohibits CalVet staff from providing aid-in-dying drugs or assistance to residents of the agency's homes, and specifies that any resident who wants to take an aid-in-dying drug, even if it is provided by an outside doctor, must first be "discharged" from the residential facility where they live.

It is cruel and unfair to deny these 2,400 old and disabled veterans the same right afforded other Californians under the 2016 End of Life Option Act. But CalVet officials claimed the harsh regulation was necessary to keep the agency from losing millions in federal funding under the 1997 Assisted Suicide Funding Restriction Act, which prohibits federal funds from being used "to pay for items and services (including assistance) the purpose of which is to cause (or assist in causing) the suicide, euthanasia, or mercy killing of any individual."

The veterans homes located in Los Angeles and other California cities provide a place to live as well as medical and rehabilitative care to former active-duty military members and their spouses who are over 55 or disabled. Veterans homes are also open to homeless vets in need of care. Though primarily funded by the state's taxpayers, the U.S. Department of Veterans Affairs pays for nearly $68 million of the homes' $350-million budget.

The federal prohibition makes it clear that doctors in veterans homes should not provide life-ending prescriptions, and though we disagree with that rule, the government has the right to make it; no hospital, doctor or health care employer is under any obligation to participate in the right-to-die program. But nothing in the text of the federal law indicates that it is necessary to evict sick people from their homes if they wish to obtain an outside physician's prescription for the life-ending drugs and ingest them on their own.

Indeed, other states that have legalized so-called medical aid-in-dying have interpreted the federal prohibitions in various ways. Like California, Colorado and Vermont require residents of veteran homes to leave the facilities if

The federal prohibition makes it clear that doctors in veterans homes should not provide life-ending prescriptions, and though we disagree with that rule, the government has the right to make it; no hospital, doctor or health care employer is under any obligation to participate in the right-to-die program. But nothing in the text of the federal law indicates that it is necessary to evict sick people from their homes if they wish to obtain an outside physician's prescription for the life-ending drugs and ingest them on their own.

Indeed, other states that have legalized so-called medical aid-in-dying have interpreted the federal prohibitions in various ways. Like California, Colorado and Vermont require residents of veteran homes to leave the facilities if they wish to end their lives. But Washington and Oregon allow veterans home residents to stay while they get the lethal prescriptions from outside doctors and even when they take them, though staff is not allowed to assist in any way. Oregon's Death with Dignity Act has been on the books for more than 20 years, and there have been no challenges under the federal prohibition.

Earlier this month, two veterans groups along with two residents of a veterans home in Yountville sued CalVet, claiming its restriction is punitive. Dying people may not have the strength or means to relocate to a new nursing home or hospice. Many veterans who move into veterans homes choose to do so because of subsidies for those with limited financial means, and most of them remain in the homes for the rest of their lives.

The groups argued that CalVet could use accounting barriers to comply with the federal prohibition.

California's End of Life Option Act passed in large part because of the moving story of 29-year-old Brittany Maynard, who was diagnosed with an aggressive and terminal brain cancer. After weighing her end-of-life options, Maynard and her family decided to leave the Bay Area and move to Oregon so that she could access that state's aid-in-dying law. When California lawmakers finally made it legal for physicians to prescribe life-ending drugs the following year, it was with the promise that no dying Californian would be forced to choose between leaving home and suffering in their final days. But CalVet has broken that promise for the men and women living in veterans homes.

CalVet can and should find a way to comply with federal rules without forcing residents of its veterans homes to leave in order to seek aid in dying, as Oregon and Washington have done. Not just to avoid the time and cost of a lawsuit, but because it is the compassionate and correct thing to do.

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Oct. 23

Appeal-Democrat on PG&E's lack of communication in explosion:

The California Public Utilities Commission last week announced it was fining the Pacific Gas & Electric Company $1 million for an explosion that destr

Earlier this month, two veterans groups along with two residents of a veterans home in Yountville sued CalVet, claiming its restriction is punitive. Dying people may not have the strength or means to relocate to a new nursing home or hospice. Many veterans who move into veterans homes choose to do so because of subsidies for those with limited financial means, and most of them remain in the homes for the rest of their lives.

The groups argued that CalVet could use accounting barriers to comply with the federal prohibition.

California's End of Life Option Act passed in large part because of the moving story of 29-year-old Brittany Maynard, who was diagnosed with an aggressive and terminal brain cancer. After weighing her end-of-life options, Maynard and her family decided to leave the Bay Area and move to Oregon so that she could access that state's aid-in-dying law. When California lawmakers finally made it legal for physicians to prescribe life-ending drugs the following year, it was with the promise that no dying Californian would be forced to choose between leaving home and suffering in their final days. But CalVet has broken that promise for the men and women living in veterans homes.

CalVet can and should find a way to comply with federal rules without forcing residents of its veterans homes to leave in order to seek aid in dying, as Oregon and Washington have done. Not just to avoid the time and cost of a lawsuit, but because it is the compassionate and correct thing to do.

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Oct. 23

Appeal-Democrat on PG&E's lack of communication in explosion:

The California Public Utilities Commission last week announced it was fining the Pacific Gas & Electric Company $1 million for an explosion that destroyed a Yuba City home and injured two people (it was a miracle they weren't killed).

In that manner, the CPUC deals with a utility company's practices relating to infrastructure. We wish the commission would also exhort the speedy relay of pertinent information to neighborhoods and communities where accidents occur.

The CPUC said it found that there was a faulty installation of a pipeline that contributed to the explosion. The homeowner was blown out of the home, in that explosion, but walked back in to carry out his girlfriend who had been in the shower stall at the time.

Not long after the explosion PG&E replaced a mile's worth of pipe along Bogue Road and South George Washington Boulevard.

Our beef with the utility, to begin with, was a lack of communication. We wanted to know, whether it was the utility company's fault or not, that there weren't other similar situations and that that particular neighborhood was now safe. It was apparent after a couple months that it wasn't just PG&E, but the commission as well ...

"Hey! Are we all safe here?" we would call and ask. "No comment at this time," they'd say.

It seemed evident there was a problem with the gas line ... they replaced it soon after the explosion. But there was no communication from the utility about the safety of the situation. The company was evidently fearful of inadvertently claiming liability by explaining they'd mitigated danger by replacing faulty pipeline.

Customers went more than a year without an explanation about the explosion that blew a home in their neighborhood apart and without specific assurances that the neighborhood was now safe.

PG&E is not to blame for the litigious society we now live in. But it just seems some sort of communication could have been delivered somehow.

As of now, we still don't have it straight from the horse's mouth that the sort of mislaid pipe at fault in that catastrophe has been changed out everywhere it occurs. Only that they "continue to work to have the safest delivery system in the country."

Not much in that message ... but, then, they've still got legal issues to deal with.

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Oct. 20

The Press Democrat on California's anti-smoking efforts saving lives:

The decadeslong effort by California to discourage tobacco use is paying amazing dividends in lives saved. A recent study published in the journal Cancer Prevention Research found that lung cancer rates in California are 28 percent lower than the national average - a gap that widens every year.

A voter initiative passed in 1988 established a comprehensive statewide tobacco control program that has been extraordinarily successful in discouraging young people from ever picking up smoking, reducing the number of cigarettes consumed by those who do smoke and encouraging smokers to quit.

John P. Pierce, a professor emeritus of cancer prevention at UC San Diego's School of Medicine and Moores Cancer Center and the lead author of the study, said the tobacco control program clearly worked.

"What we saw is that among people under 35 years old, the combination of a 39 percent lower initiation rate, 30 percent lower consumption of cigarettes among those who did smoke, and a 24 percent higher early quit rate meant that young Californians now have much less exposure to cigarette smoking than those of similar age in the rest of the country," Pierce said.

According to the U.S. Centers for Disease Control and Prevention, only Utah has a lower smoking rate than California.

In 1985, lung cancer was killing Californians older than 35 at a rate of 108 per 100,000. By 2013, that rate had declined to 62.6. Those statistics translate to tens of thousands of lives saved over the years.

This is undeniably good news - and strong evidence that other states should use California's approach as a model. But California shouldn't rest on its laurels. Thankfully, it appears the Tobacco Control Program is making every effort to build on its successes.

The agency has targeted flavored e-cigarettes that can help ease teens into tobacco use and launched a campaign this summer to convince older social smokers that they're at high risk of becoming regular smokers.

Finding new ways of encouraging adult smokers to quit is important. "Quitting smoking at any age will improve a person's quality of life," said Pierce. "But quitting before the age of 35 could help smokers avoid nearly all the negative health effects of smoking. Quitting by age 50 could reduce a person's risk of disease by almost half."

The California Tobacco Control Program is an undeniable success. The longest-running statewide program in the nation has helped convince teens that starting to smoke is a bad idea. It's helped adult smokers find the means to overcome their addiction to nicotine.

More important, perhaps, has been the effort to reduce the social acceptability of tobacco use, especially in places where it leads to secondhand exposure of nonsmokers. The program has run thought-provoking statewide campaigns to counter Big Tobacco's massive marketing efforts.

Tobacco is the No. 1 cause of premature deaths in the United States. Though Big Tobacco has taken quite a beating in recent years, it is still working hard to hook new generations of customers.

California was a pioneer in tobacco prevention programs - and that early effort has saved many, many lives. This successful strategy should continue full bore, and other states should do their best to emulate it.

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