When the End of Life Option Act was signed into law in 2016, it became possible for terminally ill, mentally capable adults with six months or less to live, to end their lives peacefully by taking a prescribed medication.
Four years later, the law has worked exactly as its supporters had hoped. According to the California Department of Public Health, as of December 2020, 1,985 people – mostly cancer patients – received their requested medications, and 65 percent used them. There has never been a single incident of coercion or abuse reported.
It has become increasingly clear, however, that the process of accessing this relief is extraordinarily burdensome. It includes a 15-day waiting period between two verbal requests for the medication, the need for two doctors to certify that the patient is within six months of dying, a psychiatrist or a psychologist confirming the patient is of sound mind, and a “final attestation” that must be completed in writing by the patient 48 hours before self – administration of the medication.
Too often it can take weeks, if not months, to complete all of these steps – a challenge for anyone in good health, let alone someone who is terminally ill. A 2018 study by Kaiser Permanente of Southern California concluded that an estimated one-third of patients died before they could complete the process, many of them in unbearable pain.
There are other barriers. Healthcare facilities which refuse to participate in the program decline to timely transfer patients who request it, while imposing gag orders that foreclose referrals to willing doctors or facilities. Then there is a shortage of psychiatrists and psychologists, particularly in rural areas, who can attest to patients’ sound mental capacity, a problem that could be ameliorated by allowing other licensed mental health professionals to do so.
In 2019, Oregon – which has had the law on its books since 1977 – recognized that patients sometimes won’t survive such a lengthy application process, so it waived the 15-day waiting period while keeping the other safeguards in place. Washington and New Mexico are also considering this change.
California’s legislators have recognized the problems. Senate Bill 380 would lower the barriers while preserving the necessary safeguards. Critically, SB 380 would also prevent the End of Life Option Act from expiring in December 2025, which will otherwise occur. (None of the other jurisdictions with such a law in place have sunset clauses.)
Now is the time to take action. Contact state senators John Laird, D-Santa Cruz, and Anna Caballero, D-Salinas, to express support of SB 380 (firstname.lastname@example.org and email@example.com). The Senate Judiciary Committee (on which both Caballero and Laird serve) is the next committee to hear the bill.
On March 25, Laird became a co-author of SB 380, signaling his support. And the Senate Health Committee voted 8-1 to support the bill, a positive start.
Let’s keep an improved End of Life Option Act here for good.