Staff writers

SACRAMENTO — Granting terminally ill patients the right to end their lives with a doctor’s help, Gov. Jerry Brown on Monday signed the End of Life Option Act, a measure that triggered personal and passionate conflict across the state — and in the conscience of the governor himself.

Brown’s signature concludes a 23-year effort to pass a “right-to-die” law in a state of 39 million, more than quadrupling Americans’ access to life-ending drugs, with one in eight people living in states where it is now legal. California is the fifth state to take such a step, and its implementation of the new law — which will go into effect next year — will be closely watched throughout the nation.

In a signing message, Brown, a former Jesuit seminarian, expressed his extensive deliberations over the historic bill.

“In the end, I was left to reflect on what I would want in the face of my own death,” Brown wrote.

“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,” wrote Brown. “And I wouldn’t deny that right to others.”

Modeled after an Oregon law enacted in 1997, the legislation was inspired by Brittany Maynard, 29, a former Bay Area resident with brain cancer who left her home to seek aid in dying in Portland.

Before her death, Maynard shared her story with Brown for 35 minutes by phone, personally appealing to him to support the bill, which the Catholic Church opposed.

Brown said he carefully considered all viewpoints, including the “thoughtful opposition materials presented by a number of doctors, religious leaders and those who champion disability rights. I have considered the theological and religious perspectives that any deliberate shortening of one’s life is sinful,” he wrote.

“I have also read the letters of those who support the bill, including heartfelt pleas from Brittany Maynard’s family and Archbishop Desmond Tutu. In addition, I have discussed this matter with a Catholic Bishop, two of my own doctors and former classmates, and friends who take varied, contradictory and nuanced positions.”

Similar bills failed in the Legislature in 2005 and 2007. In 1992, voters rejected a proposal that would have granted physicians the right to give a lethal injection to a patient.

But a new Field Poll released Monday found two-thirds of California registered voters supported a proposal to give patients the right to obtain life-ending drugs, with support cutting across most religious and political party lines. Least likely to support the bill are political conservatives and born-again Christians.

California joins four other states where physician-assisted dying is legal: Oregon, Washington and Vermont, with courts also ruling in favor in Montana. In contrast, at least 11 states rejected such legislation this year.

“It is a brand new conversation in a lot of states,” said George Eighmey, of the Death With Dignity National Center in Portland, Oregon.

The organization estimated 1,000 Californians every year will seek physician-assisted dying, if the state’s residents opt for the practice at the same rate as Oregonians.

California’s experience will influence what happens in other states, because so much data will be generated in a state of 39 million people, predicted Eighmey, a former Oregon state legislator who was instrumental in getting that state’s legislation passed.

There are strict rules for patients seeking a prescription. Two doctors must diagnose a life span of less than six months. A written and two oral requests must be submitted by the patient at least 15 days apart.

And Californians must possess the mental capacity to make their own health care decisions, so the law does not apply to dementia patients. Other people may not make the request, so authority cannot be transferred to an agent handling medical decision-making in an advanced directive.

Assemblywoman Susan Eggman, D-Stockton, a former hospice worker who co-authored the Assembly legislation, said she learned that Brown had signed it when messages of congratulations began flooding her inbox while she was browsing the seafood counter at the grocery store near her home in Stockton.

“I felt tearful, I felt grateful, and I felt a real sense of humility for being part of something that will hopefully work well and also help us talk more about end of life care moving forward,” Eggman said.

Sen. Bill Monning, D-Carmel, sponsored the senate version of the bill along with Sen. Lois Wolk, D-Davis.

Sally Vance-Trembath, a religious studies lecturer at Santa Clara University, said she expected Brown’s support, saying “he came of age when the Catholic tradition was changing and adjusting to a more developmental understanding of the human person, with new situations in medicine able to prolong life and the emergence of biotechnology.”

But critic Tim Rosales, spokesman for the Californians Against Assisted Suicide Coalition, said opponents of the law aren’t giving up their fight. They vowed Monday to explore their options, including a referendum or legal action to repeal the law.

“As someone of wealth and access to the world’s best medical care and doctors, the governor’s background is very different than that of millions of Californians living in health care poverty without that same access — these are the people and families potentially hurt by giving doctors the power to prescribe lethal overdoses to patients.”

The Rev. Gerald Coleman, an adjunct professor in the graduate program of Pastoral Ministries at Santa Clara University, also was deeply disappointed by Brown’s decision.

Coleman had hoped the broad array of those who overwhelmingly opposed the bill would have persuaded Brown “that there are other ways of meeting the end of life issue” rather than suicide, he said, including the use of palliative and hospice care.

Maynard’s widower Dan Diaz said he felt relief — and deep gratitude.

“He echoed exactly what Brittany said — that the only person who should make that decision is the individual in that situation. Nobody should try to stand in the way.”

Contact Lisa M. Krieger at 650-492-4098. Follow her at Twitter.com/LisaMKrieger or Facebook.com/Lisa M. Krieger.