(Last Updated 1/27/2020) Description of and commentary on the California End of Life Option Act, plus updates on status of the 2016 law.
(Original post) On June 6, 2016 the California End of Life Option Act became law. Living in Sacramento, and working as a lobbyist representing rural counties, I followed the progress of the bill through the Legislature from afar. I did, however, have the opportunity to hear both supporters and the opposition present their positions on the bill. I felt that good points were made on both sides of this difficult issue.
Regardless of your position on the California End of Life Option Act – as it is now the law in California I personally wanted to become familiar with its specific provisions.
Note: The California End of Life Option Act sunsets on January 1, 2026 unless that date is extended. This means that the California State Legislature will have to proactively pass legislation to extend the law or remove the sunset date prior to 2026, and the Governor will have to sign the legislation into law.
SacramentoRevealed.com – All Things Sacramento (from a personal perspective)
After reviewing the California End of Life Option Act I have decided that I am personally very glad to have this option available. You never know what cards life will deal you.
California End of Life Option Act Basics:
- Permits a competent, qualified individual who is an adult resident of California with a terminal disease to receive a prescription for an aid-in-dying drug if certain conditions are met, and a physician is willing.
- Requires compliance with various specific conditions crafted to ensure that an individual has time to consider and reconsider his or her decision.
- Requires the individual to have the physical and mental ability to self-administer the aid-in-dying drug.
The law also:
- Specifies that a death resulting from self-administering an aid-in-dying drug is not suicide
- Provides that insurance coverage (health, life, accident) or an annuity policy shall not be impacted other than that of a natural death from the underlying illness.
- Puts in place civil and criminal protections for those present when the individual self-administers and ingests the aid-in-drying drug.
California End of Life Option Act 2016 Data Report
The California End of Life Option Act (EOLA) requires the California Department of Public Health (CDPH) to provide annual reports under strict privacy requirements. The first report, issued in late June 2017, presents data received between June 9, 2016 (the date the law became effective) and December December 31, 2016. Subsequent annual reports will cover 12 months of data.
During this time period 258 individuals started the end-of-life option process by making two verbal requests to their physicians at least 15 days apart. Other statistics contained in the report:
- 191 individuals received prescriptions under EOLA.
- 111 of these individuals (or 58.1%) died following their ingestion of the prescribed aid-in-dying drug(s). Of the 111 individuals, 87.4% were 60 years of age or older, 96.4% had health insurance, and 83.8 % were receiving hospice or palliative care.
- 21 individuals (or 11%) died without ingestion of the prescribed aid-in-dying drug(s).
- The outcome of the remaining 59 individuals (or 30.9%) is currently undetermined as there has been no outcome reported during the time period covered by the report.
Characteristics of Individuals
Of the 111 individuals who died pursuant to EOLA during 2016:
- 12.6 % were under 60 years of age
- 75.6 % were 60-89 years of age
- 11.7 % were 90 years of age and older
- 89.5 % were white
- 54.1 % were female
- 83.8 % were receiving hospice and/or palliative care
- 72.1 had at least some level of college education
The majority (58.6%) of underlying illnesses was identified as cancer, with neuromuscular disorders such as ALS (Amyotrophic Lateral Sclerosis) and Parkinson’s accounting for the second largest grouping – totaling 18.0%.
Since the EOLA took effect there have been reports about the difficulty of those dying making use of the EOLA – to their distress and the distress of their loved ones. Let’s hope that this situation is resolved in the near future.
(UPDATED 1/27/2020) This month the Riverside Superior Court ruled in a tentative ruling that the Legislature did not violate the state constitution by passing the medical aid-in-dying law during a special session on health care, and that the physician plaintiffs do not have legal standing to bring the case (Ahn vs. Hestrin, Case RIC1607135).
Among other conclusions reached by the court was that “The Legislature acted within its authority when it enacted the End of Life Option Act…”
The court said, however, that the plaintiffs could amend their complaint to try to justify third-party standing if they can find patients who share their common value of opposing medical aid in dying and “may be subject to undue influence from family members and others” to use this option. So, continue to stay tuned!
(UPDATED 12/1/18) Broken link deleted.
(UPDATED 6/25/18) The California Department of Public Health recently released the California End of Life Option Act 2017 Data Report. This is the first full year of data reported.
According to the report, for the year (January 1 – December 31, 2017), 577 individuals received aid-in-dying drugs under the Act, and 374 people died following ingestion of the prescribed drugs. Of the 374 individuals, 90.4 percent were more than 60 years of age, 95.2 percent were insured and 83.4 percent were receiving hospice and/or palliative care.
(UPDATED 6/17/2018) Last month a Riverside County Superior Court judge declared the California End of Life Option Act unconstitutional – stating that it had been adopted illegally as it passed during a special session of the California State Legislature called to address health-related issues. The California Attorney General asked the appeals court to stay the ruling, and the Fourth District Court of Appeals in Riverside County issued an immediate stay. The law is now back into effect, but opponents may well file objections to the appeals court decision. Stay tuned!
Comments on the California End of Life Option Act?
Are you personally aware of difficulty in accessing the EOLA process? How would you “fix” the existing process?
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