CALIFORNIA END OF LIFE OPTION ACT

When executing an advanced healthcare directive, individuals are often concerned that their appointed agent can authorize physician assisted suicide on their behalf. This is a common misconception when in fact a prescription for drugs to aid-in-dying is only available to a very small group of individuals after thorough discussion and approval by physicians. This article seeks to briefly explain the recently enacted California End of Life Option Act. 
Brittany Maynard was a 28 year old Anaheim resident diagnosed with terminal brain cancer. Instead of living the end of her life in hospice and, in her opinion, putting her family through a nightmare, she chose to move to Oregon to exercise her right to die under the Oregon Death with Dignity Act. 

Brittany Maynard’s public story helped facilitate the passing of California’s own legislation, the California End of Life Option Act (“Act”). The Act permits terminally ill adults to be prescribed an aid-in-dying medication. The law was signed by Governor Brown in October 2015 and went into effect on June 9, 2016. California is the fifth state to enact a “death with dignity” law. 
Purposely, the Act makes obtaining medication difficult. An individual who wishes to end their life through the Act must have capacity to make medical decisions, be over 18 years old, be a resident of California, and have the physical and mental ability to self-administer the aid-in-dying drug. The last requirement might rule out individuals with certain debilitating physical conditions like ALS. 

The individual must orally request the aid-in-dying drug two times from their attending physician, a minimum of 15 days apart. The individual must also make one written request that states he is of sound mind, is not being coerced, and is acting voluntarily. That written request must be witnessed by two individuals, only one of whom may be related to the individual or a beneficiary of his estate. 

Two physicians must also be involved in the request. The attending physician must make a determination that the individual has capacity to make medical decisions, that the individual has a terminal illness, and that the individual is making the decision voluntarily. The attending physician must also refer the individual to a consulting physician for confirmation of the determinations. Finally, the attending physician must inform the individual that he may withdraw the request at any time, offer the individual the opportunity to withdraw the request, verify immediately before writing the prescription that the individual is making an informed decisions, and confirm that all requirements have been met and carried out. 

If the individual has any mental health issues, a mental health specialist must also examine the individual and determine that the individual has mental capacity to make medical decisions, is acting voluntarily, and is making an informed decision. 

The law has been in effect for six month but statistics are not yet available as to the amount of individuals who have utilized the Act.