Early lessons from California right‑to‑die law
Friday, June 30, 2017
Just over a year after California enacted the End of Life Option Act, preliminary reports released by the Department of Public Health show 111 Californians took a lethal prescription to end their life in the first six months of the new law.
Modeled closely after the Oregon law that was enacted almost two decades ago, California became the fifth state to allow patients with less than six months to live to request medication to assist in ending their lives. Currently, doctor-assisted death is legal in Montana, Vermont, Washington state and Washington, D.C.
As one of the country's most diverse and populous state, many have been awaiting the data to help quell concerns and questions about the new law. Unlike Oregon's homogenous population, California's diversity provides a better picture of who would be seeking end-of-life care.
Although broad conclusions cannot be made from just six months of data, it certainly shows a preview of who may be seeking such care in other diversely populated states, such as New York or Florida.
Characteristics of the individuals from the California report:
- 191 individuals were provided prescriptions by 173 physicians
- 111 ingested the drugs and died
- 21 did not take the drugs and subsequently died due to the underlying disease
- 59 had undetermined outcomes
- 75.6 percent were 60-89 years of age
- 89.5 percent were white
- 54.1 percent were female
- 72.1 percent had at least some college education
In order for patients to participate, they must be 18 years or older, have a diagnosis from their physician that will likely result in death within six months, be able to make medical decisions for themselves, voluntarily request the prescription and be able to self-administer the medication.
Despite such provisions to insure no one takes advantage of these vulnerable patients, critics of the law fear that by decriminalizing suicide, this opens the door to hasty care decisions and or possible misdiagnosis. However, supporters see the choice of dying as the logical evolution of the healthcare system that continues to extend life with little regard for painless deaths. Many physicians feel they are assisting their patients in protecting their personal autonomy.
Currently, participation by physicians is completely voluntary in the state of California, and they are not allowed to offer this choice. The patient must initiate the conversation.
Although the data is only preliminary, it certainly sheds some early light on who would be potential participants of such options in other states. But more importantly, keeps the conversation going regarding personal beliefs and care at the end of life.
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