Articles Tagged with end of life option act

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Tomcloseup-300x300When I started writing about California’s End of Life Option Act in this blog, I never imagined that an old friend, from a job that I had in the late 1980’s and early 1990’s, would be one of the people in California to make use of it.

But in late March, Tom Negrino, terminally ill with cancer, made a plan to take drugs that would put him to sleep, then allow him to pass away. The End of Life Option Act allows patients, like Tom, with less than six months to live, to choose to take their own lives, provided that two doctors determine that the person is mentally competent to make medical decisions, is able to swallow medication themselves, and requests the aid-in-dying drug both verbally and in writing.

In a story in the Healdsburg tribune, on March 7, 2017, Dori Smith, Tom’s wife, said that Tom was exhausted after a multi year struggle with kidney cancer and was ready to rest. She said, “He’s fought and he’s fought, all of his life. He’s the eldest son in an Italian family; he’s always been strong. His biggest grief now is that he can’t read or write.” If you’d like to read what Tom had to say about dying, you can read his post here.

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shutterstock_265887227On October 5, 2015, Governor Brown signed the End of Life Option Act into law. The law requires that two doctors determine that a patient has six months or less to live before the lethal drugs can be prescribed. Patients also must be mentally competent to make medical decisions and be able to swallow the medication themselves and must affirm in writing, 48 hours before taking the medication, that they will do so.

But the law, when passed, wasn’t to become effective until 91 days after the adjournment of a special legislative session on health care, and no one knew exactly when that was going to happen. Now we do.  That session ended on March 10, 2016, which means that the law will be effective as of June 9, 2016.

Since this is a new law and a new policy for the state, it is going to take time for both the public and doctors to fully understand how the process is going to work and what the legal requirements are for compliance.

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shutterstock_265887227In October, California became one of five states to permit medical aid in dying with the passage of the End of Life Option Act. The bill is modeled after one passed in Oregon in 1997.

Governor Brown signed the bill, with a signing statement that said, in part, “I do not know what I would do if I were dying in prolonged and excruciating pain. I am certain, however, that it would be a comfort to be able to consider the options afforded by this bill. And I wouldn’t deny that right to others.”

The bill allows doctors to prescribe lethal drugs to terminally ill patients who are expected to live six months or less. A patient must make two oral requests, at least 15 days apart, and one written request, signed in front of two witnesses. The signer must have the capacity to understand what they are requesting, the request must be voluntary, and a physician has to discuss feasible alternatives that would also be available to the patient.

In addition, a patient must self-administer the drug (in other words, no one else can administer the drug) and no one can request such drugs on another’s behalf (in other words, no one can act for a patient to make such a request through a power of attorney, an advance health care directive, or as a conservator, health care agent, surrogate, or any other legally recognized health care decisionmaker.) A patient can rescind such a request at any time.

The bill provides a form for the request for lethal drugs that reads in part:

REQUEST FOR AN AID-IN-DYING DRUG TO END MY LIFE IN A HUMANE AND DIGNIFIED MANNER I, ………………………………………………, am an adult of sound mind and a resident of the State of California.
I am suffering from ……………., which my attending physician has determined is in its terminal phase and which has been medically confirmed.
I have been fully informed of my diagnosis and prognosis, the nature of the aid-in-dying drug to be prescribed and potential associated risks, the expected result, and the feasible alternatives or additional treatment options, including comfort care, hospice care, palliative care, and pain control.
I request that my attending physician prescribe an aid-in-dying drug that will end my life in a humane and dignified manner if I choose to take it, and I authorize my attending physician to contact any pharmacist about my request.

The Bill takes effect 90 days after the Legislature adjourns its special session on health care, which will be sometime in 2016. To read more about the End of Life Option Act, here’s a good summary from the LA Times.