BILL ANALYSIS �
AB 2139
Page 1
CONCURRENCE IN SENATE AMENDMENTS
AB 2139 (Eggman)
As Amended August 18, 2014
Majority vote
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|ASSEMBLY: |46-28|(May 29, 2014) |SENATE: |29-7 |(August 21, |
| | | | | |2014) |
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Original Committee Reference: HEALTH
SUMMARY : Requires a health care provider, when making a
diagnosis that a patient has a terminal illness, to notify the
patient of his or her right to comprehensive information and
counseling regarding legal end-of-life options. Extends the
right to request information to a person authorized to make
health care decisions for the patient and specifies that the
information may be provided at the time of diagnosis or at a
subsequent visit with the health care provider.
The Senate amendments clarify that the provisions of this bill
are not intended to interfere with the clinical judgment of a
health care provider in recommending the course of treatment.
EXISTING LAW :
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
AB 2139
Page 2
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.
AS PASSED BY THE ASSEMBLY , this bill required 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.
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 like to talk with a
doctor about end-of-life care, only about 7% have had 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, including the Alzheimer's Foundation of
America, the American Cancer Society Cancer Action Network and
the California Hospice and Palliative Care Association, among
others, write that people with terminal illnesses are often
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unprepared for end-of-life decision making and consequently
receive treatment that is not consistent with their wishes. The
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 Right to Life Committee opposed the April 2,
2014, version of this bill because they believe it does not
create a more informed and supportive environment, but makes a
vulnerable patient more anxious and even feeling unwanted or
unworthy to continue living.
Analysis Prepared by : Lara Flynn / HEALTH / (916) 319-2097
FN: 0005069