California Cancer Patients Get a Bill of Rights, but Has No Teeth

M. Alexander Otto, MMS, PA

August 31, 2021

Both houses of the California State Legislature have unanimously approved a Cancer Patients' Bill of Rights resolution, but it has no force of law.

The measure outlines six rights for patients, including the right to fully understand their diagnosis and to be treated in a timely fashion with the latest advances, as well as the right to access clinical trials.

The resolution was sponsored by City of Hope, a National Cancer Institute (NCI) cancer center in Durante, California. It was introduced into the state senate by Susan Rubio (D), a state senator representing nearby Baldwin Park.

"The unanimous passage of the Cancer Patients' Bill of Rights resolution is the first real step forward in gaining awareness and momentum in California toward giving patients the best cancer care available," Sen. Rubio said in an email to Medscape Medical News.

The idea is to address the well-known problems regarding equal access to care and disparities in outcomes, particularly in underserved communities. It's "a strong statement of principles affirmed by the California legislature and will help build awareness and momentum for expanded access to specialty cancer care for all," a City of Hope spokesperson said.

However, it lacks the force of law, according to a state legislative aide. "I hope it's not window dressing," said Joseph Jacobson, MD, a medical oncologist at the Dana Farber Cancer Institute, Boston, Massachusetts. He was the lead author of a 2020 proposal for a cancer patients' bill of rights that covered much of the same territory. The proposal was published last year in JCO Oncology Practice. "We thought we were defining the floor of care," but "it fell on deaf ears," he said.

There was no real response from Sen. Rubio, City of Hope, and a state physician and lawyers' group when asked what impact the California measure will have on physicians and patients. City of Hope said no one was available for an interview.

As for implementation, the resolution directs the secretary of the senate to transmit copies "for appropriate distribution." Sen. Rubio's office said that "she will continue to discuss ways to move forward with the City of Hope."

In the final approved resolution, the right to "timely access to cancer subspecialists" was changed to the right to "contracting" subspecialists. The right "to direct access to" NCI cancer centers was changed to the "right to contracting" NCI centers.

When asked about those and similar changes, Sen. Rubio said only that "it is normal procedure for the two chambers to give feedback and make amendments."

Jacobson said the new bill of rights "touched the right touchstones," but "what they've done is not sufficient because there is no force of law and it's not proscriptive. I'm not sure it's going to accomplish anything.

"I would love for all patients with a new cancer diagnosis to have access to high-quality care independent of their economic status. If the governor signed a bill that somehow made those services available to [everyone], that would be terrific," he said.

M. Alexander Otto is a physician assistant with a master's degree in medical science. He is an award-winning medical journalist who worked for several major news outlets before joining Medscape. He is an MIT Knight Science Journalism fellow. Email: aotto@mdedge.com.

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