Dan King
Dan King · January 25, 2023

SACRAMENTO—Yesterday, the U.S. District Court for the Eastern District of California ruled that various regulations imposed on end-of-life doulas by the state of California violate their constitutional rights. The decision comes after two Sacramento-area doulas—Akhila Murphy and Donna Peizer, their nonprofit Full Circle of Living and Dying and Californians wanting to use their services—teamed up with the Institute for Justice (IJ) in 2020 to challenge the California Cemetery and Funeral Bureau’s monopoly on end-of-life care.  

Full Circle and its doulas help people make plans for their very last days, help plan for home funerals and assist in person at a home funeral. A home funeral involves the family caring for a deceased loved one at home, ceremonially washing and dressing the remains, and conducting the funeral itself. In 2019, the state of California told Full Circle to stop their activities because they were operating a funeral establishment without a license. The doulas, Full Circle and consumers brought suit arguing that these licensing restrictions violated their rights to free speech and to earn an honest living. The trial court agreed, holding that requiring doulas to build full-service funeral homes in order to operate violates their right to earn an honest living, and that preventing doulas from providing their clients with individualized end-of-life planning advice or from truthfully advertising their services violates their First Amendment rights.  

“The Court sided with the doulas on two of the hottest issues in constitutional law—the First Amendment right to give individualized advice and the due process right to earn an honest living without unreasonable regulation,” said IJ Senior Attorney Jeff Rowes. “This decision not only sets the doulas free. It will also serve as vital precedent for rights of every American to speak and work without pointless meddling by government licensing boards.” 

An end-of-life doula is not a funeral director, but rather a layperson who helps families host home funerals for loved ones who pass away. In addition, doulas often help plan for someone’s passing, provide emotional support to the family and are present for any needs in the days leading up to the home funeral. 

In 2019, Akhila and Donna were informed by the California Cemetery and Funeral Bureau that their non-profit organization (Full Circle of Living and Dying) was breaking the law. They were told that they were acting and advertising as a funeral establishment without a license. In order to come into compliance with the law, they were told they would need to build a funeral home with a room dedicated to storing or embalming bodies and pass a funeral director licensing exam. But doulas don’t store or embalm bodies, and most of the funeral director exam covers topics that are entirely irrelevant to the work doulas do.     

“The Bureau’s attack on Full Circle was never about protecting public safety, it was an unthinking and irrational application of laws for conventional funeral homes that have nothing to do with what end-of-life doulas do,” said IJ Attorney Ben Field. “We’re glad to see the court chip away at these policies that prevent people like Akhila and Donna from innovating new ways to approach death and from providing a valuable service.”   

“Today’s victory isn’t just about Full Circle of Living and Dying and putting end-of-life care and home funerals on the map,” said Akhila. “Our fight for our rights is also about protecting everyone who wants to speak, who wants to learn more about after-death care options and who wants to bring a valuable service to the public, whether as a nonprofit like us or through a small business.”

One issue remains unresolved by yesterday’s ruling. The court said that it could not decide whether it was constitutional or not to require the doulas to become licensed funeral directors. That issue will be resolved at a future trial.