In 1976, the first state advance directive law was passed in California just months after
the Quinlan decision (Glick, 1992a). However, this law was first proposed and defeated in 1974,
and this proposal in California was not the first proposal of ADL legislation. The first advance
directive law proposal was made in 1967 in Florida and was not passed until 1984 (Glick,
1992a). Case studies on both California and Florida suggest why it took one state 17 years to
adopt a law that only took two years in another. In California, a skilled policy entrepreneur was
able to create a consensus which garnered the political support needed for adoption, but in
Florida a lesser-skilled policy entrepreneur could not foster a consensus and lacked the support
for adoption (Glick, 1992a).
According to Glick (1994) and Hoefler and Kamoie (1994)- both highly acclaimed
authors in the topic of state advance directive law-the utilization of policy entrepreneurs is a
powerful way of implementing groundbreaking policy in spite of highly vocal and powerful
opposition. In both California and Florida, interest groups raged against the proposed ADL
(Glick, 1992a) and were successful in inhibiting policy efforts. The legislators that crafted ADL
proposals in California and Florida took contrary strategies to address interest group opposition,
one strategy successful while the other was not (Glick, 1992a).
In California, Barry Keene was elected as a freshman Democrat in the 1972 state Senate,
and his background as an attorney prepared him to aggressively defend his proposal (Glick,
1992a). Keene pursued a favor from the Speaker to appoint him and four like-minded senators to
the Committee on Health, where his advance directive bill would land (Glick, 1992a). The bill
failed due to opposition from the California Pro-Life Council and California Catholic Conference
but Keene spent the next two years winning opponents to his side, although these groups
remained opposed (Glick, 1992a). The more vocal CPLC called the bill "the first step on the

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