California was the most recent state to adopt the End of Life Option Act, codified at Health & Safety Code section 443. It basically allows a competent patient who has been diagnosed with a terminal illness to seek and obtain a prescription for drug to be self administered.  The law is effective on June 9, 2016. Aid-in-dying legislation has passed in Oregon, Washington, Vermont, and Montana.   Doctors in those states are allowed permitted to prescribe drugs to  terminal patients that will end their lives.  The patients must meet certain requirements and undergo a set process to receive the medication. California’s procedures, like the other state’s, seek to protect terminal patients from rash decisions or over-anxious relatives.  While patients may designate agents to make all sorts of health care decisions on the patient’s behalf, an agent is not able to request aid-in-dying drugs on behalf of a patient, and therefore these drugs cannot be requested through an advanced healthcare directive. The  Act allows doctors, medical groups and hospitals to opt out of the law.    Most, if not all, religious hospitals are expected to reject the law.  Physicians are not required to prescribe life ending drugs to patients.  The California Medical Association dropped it’s opposition to the bill.  According to news reports, the state of California will pay for the costs of the drugs to be utilized. According to the Act, the “aid-in-dying drug” means a “drug determined and prescribed by a physician for a qualified individual, which the qualified individual may choose to self-administer to bring about his or her death due to a terminal disease.”  The Act does not describe what the appropriate drug might be. To summarized the requirements, in order for a person to seek aid-in-dying drugs, they must meet the following criteria:  

• The patient must be at least 18 years old
• They must have capacity to make medical decisions
• Diagnosed with a terminal illness by an attending AND consulting physician
• The individual must voluntarily express the wish to receive the aid-in-dying drug
• They must request the drug twice orally—such requests should be made 15 days apart
• Must request by written request which is signed/dated and witnessed by two adults
• Must be California resident (and provide proof of such residency)
• Must have physical and mental ability to self-administer the drug
• The decision must be confirmed that it is not due to coercion or undue influence
• The attending physician must offer the qualified individual to withdraw or rescind the request

Upon filling the aid-in-dying prescription, the patient must complete a “Final Attestation for an Aid-in-Dying drug to End My Life in a Humane and Dignified Manner” form 48 hours prior to self-administering the drug. Developments in the law should be closely monitored as it is likely that that state regulators may develop more detailed and specific standards when facing a terminal patient seeking end of life drugs. By Matt Kinley, Esq, LL.M.  Mr. Kinley represents health care clients in Southern California.  If you have any questions, please contact  Matt at  mkinely@tldlaw.com.