California has joined a dubious list of American states that have now embraced physician-subscribed suicide on its most vulnerable citizens—the terminally ill. Beginning last Thursday, the Golden State became the fifth to allow the practice of prescribing death-inducing medication as a form of medical treatment. According to the End of Life Option Act , patients must have been determined to have six months or less to live and also be able to administer the fatal dose themselves. The law went into effect despite valiant bi-partisan opposition to the measure. Several high-profile Democrats joined their conservative counterparts in arguing about the dangers of the proposed bill, blocking it in committee. Not to be deterred, the Legislature’s Democratic leadership—bent on their anti-life agenda—ignored the pleas in their own party, using a tactical approach to resurrect the measure. Once party leaders bypassed their reluctant caucus colleagues, the measure sailed to passage and was signed into law by Gov. Jerry Brown, despite his own misgivings on their backdoor approach. An attempt to overturn the law at the ballot failed to garner enough signatures to qualify for the ballot, paving the way for its implementation.

Although the progressive legislature has succeeded in creating the law, their biggest hurdle may be the medical community itself, as a major provision in the act allows hospitals and physicians to opt out from prescribing the fatal drugs. Although most faith-based hospitals are expected to ban the practice at its facilities, at least one secular facility is also considering opting out of the Act. According to the Los Angeles Times, Huntington Memorial Hospital in Pasadena has asked an ad-hoc committee to review the issue, although doctors are being allowed to prescribe the suicide pills while the policy is under review.

At UCLA, Dr. Neil Wenger, director of the university’s Health Ethics Center, told the L.A. Times that he’s developing the campus’ policy but said he will likely not participate because of his personal oath to save lives. “We have always, up till now, been able to say we will never hasten a death,” Wenger told the newspaper. “Suddenly, that bright line is not so bright.”

A new web page has been created to track possible abuses to the law in California and beyond.