Physician-assisted suicide is a hot topic across the nation, with debates heating up after recent legislations in other states have made the practice legal. End-of-life issues are emotional by nature and can lead to many complicated questions.
California’s End of Life Option Act
California is one of only five states in the U.S. to approve physician-assisted suicide legislation and pass it into law. The other four states that legalized this action are Montana, Oregon, Vermont, and Washington. California’s End of Life Option Act authorizes any adult (over the age of 18) who meets certain qualifications and is a resident of California to request an aid-in-dying drug with the purpose of ending his or her life.
To qualify for the End of Life Option, adults must suffer from a medically confirmed terminal illness and have six months or less of expected time to live. For the bill’s purposes, “terminal disease” means an irreversible and incurable disease that will result in death within six months. Adults must request the drug twice orally to physicians, at least 15 days apart, and once in a written request. The person must have the mental capacity to make his or her own informed medical decisions and must self-administer the drug without help.
The bill prohibits any provisions in contracts or wills to be conditioned on or affected by a person making the request for the drug. It provides immunity from civil and criminal liability to anyone present while another person self-administers the drug, as long as the person did not assist with ingestion. The act passed on October 5, 2015, and took effect on June 9, 2016, as California’s physician-assisted dying law, ABX2-15, the End of Life Option Act.
Oregon’s Death With Dignity Act vs. California’s End of Life Option Act
Following Oregon’s lead, California lawmakers introduced the End of Life Option Act in January 2015 based on the Oregon Death With Dignity Act. California’s Act has modifications to comply with California statute, such as that the attending physician must discuss the request for end of life alone with no one else in the room. There is no waiting period between the written request and the prescription being filled.
Oregon’s act is permanent unless legislators or voters repeal it, but California’s will expire ten years from now (in 2026) if lawmakers do not renew it. In these ten years, California legislation hopes to demonstrate the benefits of the act for the state’s terminally ill patients, including end-of-life care improvements, such as providing patients with a sense of control and better communication regarding end-of-life care issues.
What Is the Protocol for the End of Life Option?
Once a person with the capacity to make medical decisions asks for the aid-in-dying drug twice orally and once in writing, the attending physician will certify the diagnosis of terminal illness. He or she will also certify the patient’s mental competence to make and communicate decisions regarding health care. The bill requires physicians to inform the patient of other alternatives, including hospice and pain management options. The physician must ask the patient if he or she wants to withdraw the request, notify next of kin, or have someone present while taking the drug.
Once the patient makes the final written request, there is no delay in writing the prescription of the drug. The physician must inform patients that they do not have to take the drug even after filling the prescription. If the patient still wants to go through with the End of Life Option, the attending physician will give the aid-in-dying drug to the patient.