California Department of Public Health End of Life Option Act Forms and Information Click Here
WHEN DID IT GO INTO EFFECT?
The California End of Life Option Act went into effect on June 9th, 2016, authorizing the compassionate option of medical aid in dying for terminally ill adults who wish to end their life peacefully with doctor prescribed medication. California Senate Bill 380, improving the End of Life Act (and removing the previous sunset provision), was signed by Governor Newsom on October 5, 2021. The bill went into effect on January 1, 2022.
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 2 voluntary requests, two oral (at least 48 hours 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 be able to swallow the medication yourself. Injection is not 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 need time to look for another doctor.
The American Clinicians Academy on Medial Aid in Dying (ACAMAID) offers a patient-to-doctor referral system, which can be a useful resource for you and your doctor. ACAMAID
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, improved the California End of Life Option Act so that more eligible Californians are able to access the law. Key improvements:
- Shortened the waiting period to 48 hours.
- Improved transparency of healthcare facility policies by requiring them to post their medical aid in dying policies on their websites.
- Removed the redundant fourth request for medical aid in dying (referred to as the final attestation).
- Clarified that medical providers should document and date requests for medical aid in dying, which can be referenced should a patient choose to transfer care.
- Clarified that medical aid in dying medication may be self-administered within a healthcare facility.More information: https://www.hemlocksocietysandiego.org/california-sb-380-signed-into-law/
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.