Physicians lack standing to sue over state assisted suicide law, court rules

Inland Empire physicians who successfully sued to block California's assisted suicide law lacked standing to challenge the legislation, a state appeals court ruled, leaving the constitutional question over the law to be answered another day.

Justices of the 4th District Court of Appeal said Tuesday the five physicians who sought to block the End of Life Option Act -- which allows terminally ill patients to get lethal drugs from their physicians if certain conditions are met -- did not adequately allege standing in their initial complaint.

Riverside County Superior Court Judge Daniel Ottolia in May struck down the law as unconstitutional, saying the California Legislature improperly passed the bill during a 2015 special session convened to address Affordable Care Act costs. The state Constitution places limits on the type of laws Sacramento can pass during special legislative sessions.

But the Court of Appeal justices, considering a mandamus petition filed by the state, said Tuesday Ottolia put the cart before the horse by letting the named plaintiffs proceed with the lawsuit.

Justice Manuel A. Ramirez, who authored the majority opinion, said the physicians hadn't articulated harm, noting they could choose not to help those who wished to die.

The decision does nothing to change the availability of assisted suicide services in California. The Riverside-based Division Two of the 4th District previously reinstated the law during the pendency of the appeal.

Tuesday's decision sends plaintiffs back to square one, punting on the issue of whether the law passes constitutional muster. Becerra v. Superior Court (Ahn), 2018 DJDAR 11217 (Cal. App. 4th Dist. Nov. 27, 2018).

But the decision does offer some clues as to what could be next. Ramirez offered examples of possible plaintiffs who might be able to challenge the law.

A district attorney who thinks the act is unconstitutional and seeks to prosecute physicians who aid in assisted suicide could sue, Ramirez said in his opinion. So too could a hospital that wishes to penalize health care providers under its watch who participate in the controversial procedure.

Justice Richard T. Fields concurred with Ramirez's opinion, but Justice Marsha G. Slough authored a partial dissent, saying there was no need to stop at the standing question.

"The majority's approach needlessly ties this case up in a procedural Gordian knot," Slough wrote, later articulating the passage of the assisted suicide bill was appropriate given the subject matter of the legislative session: health care.

Stephen G. Larson, a partner at Larson O'Brien LLP who represents the plaintiffs, said he was disappointed by the outcome but appreciated how detailed the decision was for an "important societal issue."

Ramirez's opinion provided a "road map" for how to proceed with the procedural challenge, Larson noted. Whether an amended complaint in the trial court or a petition to the California Supreme Court will come next isn't clear, he said.

"Bottom line, we haven't evaluated what we're going to do," he said in a phone interview.

The underlying lawsuit also includes a substantive challenge to the assisted suicide law on the basis of equal protection and due process, which Larson hopes the courts will eventually hear.

The state attorney general did not respond to a request for comment by press time.