On June 9th, 2016, California’s End of Life Option Act will take effect. The law permits a qualifying individual with a terminal disease to receive a prescription for an “aid-in-dying drug.”
Assisted suicide received national attention when Brittany Maynard, a 29-year-old California resident with a terminal diagnosis of brain cancer, moved to Oregon to access its “Death With Dignity” law. California now joins five other states with similar laws. The law includes a “sunset clause” which will remove the law from the books if not extended by January 1, 2026.
The law permits a competent adult with a terminal disease to receive a prescribed “aid-in-dying” drug, (most commonly, secobarbital), if all of the following are met:
1. California resident at least 18 year old.
2. Diagnosed by his or her attending physician as having less than six (6) months to live.
3. Initial diagnosis confirmed by a consulting physician who is independent from the attending physician and qualified to confirm the attending physician’s diagnosis, including an assessment of whether the patient has the capacity to make medical decisions, is acting voluntarily, and has made an informed decision regarding aid-in-dying medication.
4. The request for the prescription must come solely and directly from the individual diagnosed with the terminal disease. No request can be made by an agent under an advance health care directive, a conservator, or any other legally recognized health care decision maker.
5. The patient must make 2 oral requests, a minimum of 15 days apart, and a written request to his or her attending physician. The attending physician shall directly receive all three requests. The written request must be witnessed by 2 individuals, one of whom must not be related to the patient. The witnesses must attest to the individual’s freedom of choice and sound mind in making the request.
6. The patient must have the physical and mental ability to self-administer the aid-in-dying drug. No one is permitted to administer the drug on behalf of the patient.
7. The physician must confirm that the qualified individual’s request does not arise from coercion or undue influence. The physician must counsel the patient extensively as to each of the following:
– The request may be withdrawn at any time and in any manner.
– Having another person present when he or she ingests the aid-in-dying drug.
– Not ingesting the aid-in-dying drug in a public place.
– Notifying the next of kin of the request.
– Participating in a hospice program.
– Maintaining the aid-in-dying drug in a safe and secure location until taken.
The physician must give the individual an opportunity to withdraw or rescind the request immediately before prescribing the aid-in-dying drug.
The state of California is readying the required physician forms, which should be available online in June. Hospital systems are training doctors, pharmacists and other health care professionals in how to assist patients who want a prescription.
The program is voluntary for doctors, medical groups and hospitals. Those opposed to assisted suicide, such as Catholic hospitals, are not expected to participate. However, some of California’s biggest medical facilities, including Kaiser Permanente, Sutter Health and UCLA, are expected to comply with the law at the facilities, while respecting the right of individual doctors to opt out.