More than 700 in California have opted to end their terminal suffering in 2021 using the End of Life Option Act (EOLA), according to a report released this month by the California Department of Public Health.
The End of Life Option Act allows qualifying adults diagnosed with a terminal disease to request aid-in-dying drugs from their attending physician. An annual report found that 772 terminally ill Californians obtained prescriptions for medical aid in dying, written by 277 unique physicians, an increase from 262 doctors who prescribed the medication in 2020.
“Terminally ill Californians are seeking information about their available end-of-life options, and more doctors feel empowered to talk about this compassionate medical practice,” says Kim Callinan, president & CEO of Compassion & Choices. “Our mission is to expand options and empower people to chart their own end-of-life journey alongside their loved ones and medical team. We are pleased to see that the majority of Californians utilizing this law are receiving hospice care at the time of their death.”
About 91.6 percent of patients that received the medication were enrolled in hospice when they died, and 66 percent were diagnosed with cancer. The report found that 486 patients took the medication in 2021, including 38 patients who obtained the medication prior to 2021.
According to Compassion & Choices, a nonprofit organization that works to expand and improve care options for the end of life, many terminally ill residents go through the 13-step process to obtain the medication and never ultimately use it.
"Patients share that it gives them a huge sense of relief to know that they have it available to them," the nonprofit wrote in a news release.
The state's EOLA went into effect on June 9, 2016, authorizing this practice. Perscriptions for 3,766 people have been written since the state's EOLA was signed into law. Of that number, 2,422 individuals went through with the process.
Senate passed Senate Bill 380, Improving the End of Life Act, on September 2021 in a 26-8 vote. The legislation, co-authored by Sen. Susan Talamantes Eggman (D-Stockton), and Assemblymember Jim Wood (D-Santa Rosa), was signed into law by Gov. Gavin Newsom on Oct. 5, 2021, and went into effect on Jan. 1, 2022.
The legislation included improvements, such as reducing the mandatory minimum 15-day waiting period between the two oral requests for aid-in-dying medication to 48 hours for all eligible patients.
Under the legislation, all healthcare systems and hospices to put their medical aid-in-dying policies on their websites and clarify that the first oral request must be documented in a patient’s medical record, regardless of whether the procedure is supported by the patient's physician.
“Too many terminally ill people were struggling to access the law and many died in exactly the way they didn't want,” Samantha Trad, National Director of Care Advocacy at Compassion & Choices says. “Removing these unnecessary barriers improved the law so that more dying Californians can have the option to peacefully end their suffering on their terms.”
SB 380 also requires healthcare facilities and hospices to publicly post their medical aid in dying policy online, allowing patients to make informed decisions about the location of their care. The bill also removed a redundant fourth medication request, clarifying documentation procedures for medical providers transferring care, and confirmed that medication can be self-administered within a healthcare facility.
Groups who support SB 380 argued that the bill removes regulatory roadblocks in the law while maintaining the core eligibility requirements. The Chief Executive Officer of Hospice of Santa Cruz County wrote in an argument of support “that while the number of patients choosing the EOLA at Hospice of Santa Cruz County remains small, I have witnessed the comfort and relief that patients receive from having this option. It is affirming to witness the dignity that patients feel by gaining some control at a time when they often feel like their bodies are failing them”.
Those in opposition to the legislation argued that assisted suicide does not constitute health care and is a dangerous risk to communities who are struggling to attain any option of basic care. The Disability Rights Education and Defense fund argued that the bill removes other protections for patients: requiring more medical professionals with more training to judge a patient’s prognosis and assess their decision-making capacity.
“It’s almost as if the law is set up to avoid finding problems. The annual statistical reports are very minimal for such an important public policy,” reads a letter of opposition by the Disability Rights Education and Defense in a Senate Floor Analysis.
Visit the California Department of Public Health to view the full 2021 California End of Life Option Act report.