Frequently Asked Questions Regarding California’s End of Life Option (EOLOA) Law
(Right-to-Die Law, Physician or Medical Aid in Dying, Assisted Dying or Death with Dignity)
COVID & END OF LIFE OPTION ACT
Some people mistakenly believe that the CA End of Life Option Act can help them should they develop a severe case of Covid-19. The reality is that by the time you’re terminal from coronavirus, you’re probably unconscious, and you don’t have capacity to make medical decisions, so you cannot meet the legal requirements for California’s medical aid in dying law.
WHEN DID IT GO INTO EFFECT?
June 9, 2016. It is currently in effect and can be used, despite lawsuits by opponents. Unlike Oregon’s law, which is permanent, California’s law will sunset on January 1, 2026, if not renewed.
WHO QUALIFIES UNDER THE LAW?
The requirements of the law are:
- You must be 18 years of age or older.
- You must be able to make and communicate health care decisions.
- You must be a California resident, verified with a California Driver License or California Identification Card, voter registration or tax return.
- You must have a terminal illness—a disease that will, determined by reasonable medical judgment, produce death within six months.
- You must make 3 voluntary requests, two oral (at least 15 days apart) and one written, which must be signed by two witnesses. The first request can be made via telephone, but be sure that the request is entered into your medical record and signed by the attending physician.
- You must sign a “final attestation” form before ingesting the drug, stating that you are fully informed of the consequences and alternatives. You can change your mind at any time and decide to NOT take the drug.
- You must be able to swallow the medication yourself. Injection is not permitted. Administration via PEG tube or rectally is permitted.
You will not qualify under the act if you are not of clear mind and are not capable of making the request, orally and in writing.
WILL I LOSE MY LIFE INSURANCE BENEFITS IF I TAKE ADVANTAGE OF THIS LAW?
No. By law, the death certificate will indicate that you died from the underlying illness.
HOW MANY DOCTORS ARE REQUIRED?
Two; an “attending physician,” who writes the prescription, and a “consulting physician,” who confirms the diagnosis, prognosis and the patient’s capability to make an informed decision. A doctor does not have to be present at death.
HOW WILL I FIND A DOCTOR?
Our first recommendation would be to talk to your own doctor. Do this early, while you are healthy, in case your doctor is unalterably opposed to participating. If that happens you will have time to look for another doctor.
This article on the Death With Dignity website gives excellent advice about approaching doctors. Don’t expect an enthusiastic YES from your doctor, but be wary if s/he is rude, changes the subject. If your doctor says, “NEVER,” you need to find a willing one.
We know that the following systems will NOT participate in this law:
- Veterans Administration
- Catholic healthcare systems
- All California Tenet Hospital Systems, including Desert Regional, JFK in the Coachella Valley and Hi-Desert Medical Center in Joshua Tree
- Eisenhower Medical Center
Kaiser healthcare systems have specialists to help you navigate the law. Some hospices are now participating.
Even if a healthcare system does not object to participating in the law, individuals within the system have the option to not participate.
SB 380, taking effect January 1, 2022, improves the California End of Life Option Act so that more eligible Californians are able to access the law. Key improvements include:
- Shorten the waiting period to 48 hours.
- Improve transparency of healthcare facility policies by requiring them to post their medical aid in dying policies on their websites.
- Remove the redundant fourth request for medical aid in dying (referred to as the final attestation).
- Clarify that medical providers should document and date requests for medical aid in dying, which can be referenced should a patient choose to transfer care.
- Clarify that medical aid in dying medication may be self-administered within a healthcare facility.
If you interested in considering the possibility of using this law, ASK your provider. It is almost universal that no medical system will present this option to you as a possibility.
SHOULD I STILL PLAN TO KEEP HOSPICE IN MIND IF I USE THE LAW?
Yes. It is possible that good hospice care will make it unnecessary to end your life yourself. Brittany Maynard chose not to have hospice because her symptoms, which could not be relieved, were causing her suffering. Be sure to find out, before enrolling in any hospice, what its policy is on the End of Life Option Act; whether their physicians will prescribe and whether they will allow their staff to be present at ingestion.
IF I QUALIFY, DO I JUST TAKE A PILL?
The physician can prescribe any medication s/he wants for this purpose. The preferred drug, Seconal, (the one that required emptying 100 capsules) has become unavailable. A mixture of drugs are now used. The solution is bitter. You must drink it quickly to prevent falling asleep before you have ingested the proper dose. Other drugs may be added to prevent nausea and vomiting. The cost for these drugs can vary from $450 to $3500. They are not covered by Medicare, but Medi-Cal and some private insurances will cover a portion of the cost.
For individual help with California’s End of Life Option Act, contact End of Life Choices California 760.636.8009. They provide free, individual volunteers to help you with any aspect of using California’s End of Life Option Act.