Making Aid in Dying a Legal Option for Terminally Ill People and Their Families in California
For more than 20 years, advocates had worked unsuccessfully to pass a law allowing the option of medical aid in dying in California.
In 2014, Compassion & Choices approached Goodwin Simon Strategic Research, Wild Swan Resources and Wonder: Strategies for Good to lead public opinion research and to develop a successful messaging and storytelling strategy in California.
Previous unsuccessful efforts made it clear that the issue did not fall along neat partisan lines in otherwise “blue California.” Voters and legislators had both previously rejected efforts to allow this option for terminally ill people.
Our research showed that people’s lived experiences – including their experiences with doctors who had somehow “gotten it wrong” when it came to a terminal diagnosis, as well as watching their own loved ones die, made many Californians uncomfortable with this type of legislation.
Our role: Using Public Opinion Research, Psychological Analysis & Storytelling Strategies to Understand and Shape Attitudes
Goodwin Simon, Wild Swan, and Wonder worked in partnership with Compassion & Choices in Dying to develop the research methodology and messaging strategy. To begin, Wonder led a media audit to determine how the issue had been framed in California and other states as well as social listening research to understand how ordinary Californians talked about the issue.
Wild Swan developed a psychological analysis of the media audit and social listening research led by Wonder. Wonder also led a pop culture analysis to better understand how stories about aid in dying have been told over the past 20 years in television shows, documentaries and feature films. Together, we created and tested message and story strategies in various qualitative research methods led by Goodwin Simon among African-American, Asian/Pacific Islander, Latino, and Anglo voters in California.
Goodwin Simon developed an analysis of the qualitative research, which included a psychological and narrative analysis by Wild Swan and Wonder. The analysis helped us to better understand the competing needs, concerns, values, and other conflicts that would prevent voters from being supportive and the messages and stories they needed to hear to manage those heartfelt conflicts.
Goodwin Simon, in partnership with Wild Swan, also developed a statewide survey that tested legislative language among California voters. Based on our research, we created a message and storytelling guide that guided Compassion & Choices in their public communications and legislative advocacy.
Complementing their grassroots advocacy work, we worked with Compassion & Choices to feature the stories of California families struggling with the terminal illness of a loved one and how the law would give those families peace of mind even if they didn’t use the option. Compassion & Choices tapped their network to find families willing to share their stories.
Those emotionally powerful stories helped to generate empathy among reluctant audiences – even those who would never consider the option if they were terminally ill. The stories featured diverse characters including Catholics, Latinos, and Republicans.
In an op-ed in the Sacramento Bee, civil rights icon Dolores Huerta recounted the prolonged, agonizing death of her mother from breast cancer. In her appeal to legislators, she wrote:
“For those caring legislators who could never imagine considering this option for themselves if they were terminally ill – because it may conflict with their values and beliefs – this vote must be especially tough. My lifelong work as an advocate for social justice has taught me that these difficult moments require our utmost compassion, the wisdom to imagine walking in another person’s shoes and the ability to respect the wishes of others. Those of us who have cared for a loved one and witnessed a lengthy and painful dying process are urging legislators to act now.”
Our messaging strategy also emphasized the many safeguards included in the legislation to assure concerned Californians that the law would work as intended.
Change Created: After More Than 20 Years, Advocates Succeeded in Making Medical Aid-in-Dying a Legal Option for Terminally Ill Californians and Their Families
On October 5, 2015, Gov. Brown signed legislation making California the largest state in the nation to allow the option for medical aid in dying – more than 20 years after voters rejected a similar proposal at the ballot box.
In his letter approving the legislation, Gov. Brown reflected the messaging framework we developed that had proven most powerful in persuading reluctant audiences – honoring and respecting the decision of a terminally ill person. He wrote:
“In the end, I was left to reflect on what I would want in the face of my own death. I do not know what I would do if I were dying in prolonged and excruciating pain. I am certain, however, that it would be a comfort to be able to consider the options afforded by this bill. And I wouldn’t deny that right to others.”
Advocates are now looking to take the momentum from the victory in California to advance aid-in-dying policies in other states.