Lancaster Palmdale Hospice Care
Death With Dignity
Death with dignity is a concept that emphasizes the importance of allowing individuals to have control over their own end-of-life decisions. It recognizes the right of individuals to choose how they want to die, especially when faced with terminal illness or unbearable suffering.
Autonomy in Dying
At its core, death with dignity promotes the idea that every person should have the autonomy to decide when and how to end their life, provided they are of sound mind and have considered all options. This can be achieved through various means, such as physician-assisted dying or the use of advance directives.
Advocates for death with dignity argue that it is a compassionate and humane approach to end-of-life care. It allows individuals to avoid unnecessary pain and suffering, maintain their dignity, and have a sense of control over their own destiny. It also acknowledges that death is a natural part of life and that individuals should have the freedom to choose when they are ready to face it.
California End Of Life Option Act
The California End of Life Option Act went into effect on June 9, 2016. Revisions to the law were approved and are effective 1/1/2022.
Read a recent LA Times article called One last trip: “Gabriella Walsh’s decision to die — and celebrate life — on her own terms” featuring Gabriela’s story. Gabriela was one of our Patients.
This law grants terminally ill adults who are California residents the ability to request medication from their physician to terminate their own lives. Those who choose to end their lives in this manner, and who carefully follow the steps outlined by the legislature, will not be considered to have committed suicide. Instead, they will be regarded as having succumbed to their underlying terminal illness. Physicians who prescribe the aid-in-dying medication and adhere to all legal procedures will not face legal liability or professional sanctions. Both patients and physicians can voluntarily participate in this end-of-life option.
Who can use this option?
To receive the aid-in-dying medication, a person must:
- Be 18 years or older
- Be a resident of California
- Have a terminal disease that is expected to result in death within six months
- Can make medical decisions and not have impaired judgment for medical decisions because of a mental disorder
- Can self-administer the medication (orally, anally, or through an existing feeding tube)
What changes does SB 380 make to the End of Life Option Act (ELO)?
SB 380 modifies the End of Life Option Act process for patients by decreasing the required waiting period and specifying when the waiting period commences.
- The waiting period between the first and second oral requests decreases from 15 days to 48 hours.
- When a patient requests ELO from a physician, the waiting period commences regardless of the doctor’s participation or the completion of the full exam/assessment on that day.
How does this change impact patients?
The reduced waiting period benefits patients by expediting the process. It’s crucial to keep in mind that the patient’s first and second oral requests do not encompass the entire process.
Resources
Bill Text-
SB 380 End of Life Option Act 2022
California Medical Association-
CMA On-Call: California End of Life Option Act
California Department of Public Health-
How long does the entire ELO process take at Lancaster Palmdale Hospice Care.
The complete process typically takes three weeks on average. Our physicians conduct a thorough review before prescribing aid-in-dying medication to any patient. There is a 48-hour waiting period between the first and second oral requests. After the second oral request, the process initiates, which encompasses:
- The process involves a minimum of three physician appointments, a physician’s review of the medical record, and consultation with specialists when necessary.
- The patient must complete the written request form with two witness signatures and submit it before the prescription can be written.
- Once the prescription is written, an additional 7 business days are necessary for dispensing, delivery, and pharmacy consultation.
At Lancaster Palmdale Hospice Care, our physicians wholeheartedly review each patient’s terminal illness and prognosis, engage in a goals-of-care conversation to ensure all the patient’s clinical and emotional needs are addressed, and seek input from medical specialists and mental health clinicians when necessary.
How soon will I get the medication after the prescription is written?
On average, the prescription filling and delivery process takes 7 business days. Prescriptions cannot be filled or delivered on weekends or holidays. We deliver the ELO medication to the patient via courier and schedule a consultation appointment with a pharmacist (usually on the same day).
If the waiting period is 48 hours, why can’t the medication be obtained in 48 hours?
The waiting period between the patient’s first and second oral requests must be at least 48 hours. The law does not establish a timeframe for completing the remaining requirements. Kaiser Permanente is dedicated to honoring patients’ wishes and expediting the process. Simultaneously, we are equally committed to ensuring that patients meet the legal criteria and undergo a thorough evaluation, so their prescribing physician can confidently confirm that the process aligns with California law.
Can I take the medication at Lancaster Palmdale Hospice Care?
Lancaster Palmdale Hospice Care does not allow ingestion of ELO medications in any of its facilities.
Death With Dignity
Opponents of death with dignity raise concerns about the potential for abuse and the ethical implications of intentionally ending a person’s life. They argue that it may undermine the sanctity of life and the role of healthcare professionals in preserving and protecting it. These concerns highlight the need for strict legal and ethical guidelines to ensure that death with dignity is only provided to those who genuinely meet the criteria and are making informed decisions.
Overall, death with dignity is a complex and sensitive topic that touches on fundamental questions about life, autonomy, and compassion. It prompts society to grapple with difficult ethical and moral considerations. As discussions continue, it is important to approach the topic with empathy, respect differing viewpoints, and strive to find a balance that upholds the values and rights of all individuals involved.