For 20 years, advocates worked unsuccessfully to provide a legal option for terminally ill people in California with six months or less to live to request life-ending medication.

While advocates succeeded in Oregon, Vermont and Washington State, California voters and legislators rejected similar proposals. It was clear the issue did not fall along neat partisan lines in otherwise “blue” California.

Compassion & Choices had a mission to legalize medical aid-in-dying in California and partnered with Toni Broaddus, Goodwin Simon Strategic Research, Wild Swan Resources and Wonder: Strategies for Good to tackle this tough social issue.

Heartwired Insight and Strategy

Our research unearthed a deep conflict: while a majority of Californians did not want to see terminally ill people suffer needlessly, they had concerns about the unintended consequences of a law to allow medical aid-in-dying.

“Advocates had never succeeded in a state as racially and ethnically diverse as California,” Toni reflected. “Our messaging needed to ease the moral concerns of Christian legislators and our Catholic governor. We needed to understand how to talk to people of faith and people of color.”

Focus groups showed that Christian voters raised moral objections when they felt messaging suggested they should choose medical aid-in-dying if diagnosed with a terminal illness.

Revised messaging and heartfelt stories delivered by Christian messengers helped calm their concerns. Stories emphasized shared values — such as honoring and respecting the decision of a terminally ill person and their family, even if we might make a different decision — helped voters manage their concerns with the policy.


In 2015, Governor Brown signed legislation making California the largest state in the nation to allow the option for medical aid-in-dying.Gov. Brown’s signing letter approving the legislation powerfully reflected the messaging framework developed by the research and strategy team. 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.”

Our research and strategy has helped Compassion & Choices pass similar policies in Colorado, Washington, DC, and Hawaii.