BILL ANALYSIS �
AB 2139
Page 1
ASSEMBLY THIRD READING
AB 2139 (Eggman)
As Amended May 12, 2014
Majority vote
HEALTH 13-5
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|Ayes:|Pan, Ammiano, Gordon, | | |
| |Bonilla, Bonta, Chesbro, | | |
| |Gomez, Gonzalez, Roger | | |
| |Hern�ndez, Lowenthal, | | |
| |Nazarian, Ridley-Thomas, | | |
| |Wieckowski | | |
| | | | |
|-----+--------------------------+-----+--------------------------|
|Nays:|Maienschein, Ch�vez, | | |
| |Nestande, Patterson, | | |
| |Wagner | | |
| | | | |
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SUMMARY : Requires health care providers to notify patients with
terminal illnesses of their right under current law to
comprehensive information and counseling regarding legal
end-of-life options. Specifically, this bill :
1)Requires a health care provider, when he or she makes a
terminal diagnosis, to notify the patient of his or her right,
or when applicable, the right of another person who is
authorized to make health care decisions for the patient, to
receive comprehensive information and counseling regarding
legal end-of-life options. Allows this notification to be
provided at the time of diagnosis or at a subsequent visit in
which treatment options are discussed. Provides that this
notification is not required if the patient has already
received it.
2)Expands current law that gives patients the right to receive
comprehensive information and counseling to also allow another
person who is authorized to make health care decisions for the
patient to receive this information and counseling.
EXISTING LAW :
AB 2139
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1) Requires a health care provider, when he or she makes a
diagnosis that a patient has a terminal illness, to provide
the patient comprehensive information and counseling
regarding legal end-of-life options, upon request.
Requires the provider, if he or she does not wish to comply
with a patient's request, to refer the patient to another
provider who will. Defines "health care provider," for
these purposes, as an attending physician and surgeon or a
nurse practitioner or physician assistant, as specified.
2) Requires comprehensive information about end-of-life
options to include: a) hospice care at home or in a health
care setting; b) a prognosis with and without the
continuation of disease-targeted treatment; c) the
patient's right to refusal of or withdrawal from
life-sustaining treatment; d) the patient's right to
continue to pursue disease-targeted treatment, with or
without concurrent palliative care; e) the patient's right
to comprehensive pain and symptom management at the end of
life; and f) the patient's right to give individual health
care instructions under current law, including advance
health care directives.
FISCAL EFFECT : None
COMMENTS : The author states that the need for this bill arises
from the discrepancy between the care that most Californians
prefer at the end of life and that which they are receiving.
The author cites three reports from 2012 and 2013 prepared by
the California HealthCare Foundation (CHCF) that raise serious
concerns with the care Californians receive at the end of life.
One report provides evidence that most Californians would prefer
to die at home, avoid pain, and be comfortable as they approach
the end of life. However, an additional study finds great
disparity in end-of-life care in California across regions and
institutions, with California, compared to the nation as a
whole, trending toward providing more inpatient care and more
intensive care in the last six months of life. Similarly, in a
third study specific to cancer care, CHCF finds that, compared
to the country as a whole, California's patients with advanced
cancer are more likely to die in the hospital, spend time in an
intensive care unit, and receive aggressive life-saving measures
in the final weeks of life. Finally, while 80% of Californians
indicate they would definitely or probably would like to talk
with a doctor about end-of-life care, only about 7% have had
AB 2139
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these important conversations.
The author writes that these concerns have persisted despite the
passage of AB 2747 (Berg), Chapter 683, Statutes of 2008, which
gives patients with a terminal diagnosis the right to be
informed, upon request, about their legal end-of-life care
options. The author indicates this bill would ensure that
patients with a terminal illness are notified about this right.
Supporters of this bill write that people with terminal
illnesses are often unprepared for end-of-life decision making
and consequently receive treatment that is not consistent with
their wishes. Supporters argue that this bill will ensure that
patients are offered an opportunity for patients to have a
conversation with their physicians about the course of a
terminal disease and the full range of expected treatment
options.
The California Medical Association (CMA), in opposition to a
prior version of this bill, asserts that end-of-life issues
should definitely be discussed, but they should be discussed
upon the patient's request, as required by current law, or when
the physician deems it appropriate. CMA writes that, by
requiring the physician to give a patient information about
end-of-life options upon diagnosis, this bill could disrupt the
physician-patient relationship.
Analysis Prepared by : Ben Russell / HEALTH / (916) 319-2097
FN: 0003352