Addressing the End of Life Options Act

Posted by Mark Clark on Tue May 17, 2016 in Advocacy

In the May 12, 2016 edition of the SF Chronicle, Dr. Molly Bourne, Chief Medical Officer at Hospice by the Bay, discussed California’s new End of Life Options Act, which will go into effect on June 9, 2016. Here is the complete text:

molly-bourne-preparing-for-death-fbWhat you need to know about state’s End of Life Option Act

By Molly Bourne
May 12, 2016

On June 9, the End of Life Option Act goes into effect for California. With it in place, terminally ill patients will have the option to take a medication that hastens death, thus deciding where, when and how they die.

This law illustrates our human desire for control over our final days. As chief medical officer at Hospice by the Bay, I am committed to patient choice and believe control is possible, regardless of whether you support the new legislation.

The law itself is modeled after similar ones in states such as Oregon and Washington. Its many safeguards ensure autonomy and safety. Two physicians must attest to the requesting individual’s six-month prognosis and decision-making capacity. There is a two-week waiting period before the medication can be obtained. Upon taking the drug, patients must confirm in their own writing that they took it themselves, uncoerced. Other states with similar laws and safeguards show no evidence of misuse or abuse of the aid-in-dying medication.

People who participate in the act are likely to be enrolled in hospice care. In Oregon, 92 percent of people who took advantage of their “right to die” elected the hospice benefit. Interestingly, most people who request the medication do not end up taking it. They simply want the option, illustrating that the sense of control is more important than the actual act. The California law recommends a patient take advantage of hospice services upon request of the medication.

Let’s not forget, though, that there is a large group of terminally ill patients who do not get this choice. These are people who suffer from dementia, strokes, brain tumors, kidney failure, Parkinson’s disease and other illnesses that impair their ability to make decisions or swallow medication, leaving them ineligible for the End of Life Option Act. A look at our current patients suggests that more than two-thirds will not be able to participate in the new law should they want to.

We all want a magic pill — a quick fix. Nobody wants to talk about losing mental or physical function. Mostly, we do not want to acknowledge that we will die. We would rather discuss this law than plan our final days. But given the odds and knowing how much we all like control, I recommend a little forethought and a few conversations. If you support the End of Life Option Act and are one of the few eligible in the end, more power to you. But just in case, turn to the person next to you and tell them what you want in the end.

Tell your family and friends your wishes and philosophy; tell them how you feel about taking medications, what you think about dying in a hospital versus home; tell them what music to play when you are dying, who will take your dog; fill out your advanced directives so you get what you want and your loved ones know what to do; make a bucket list and check it off; learn everything you can about palliative and hospice care.

Where to begin?

Tools for starting the conversation about end-of-life planning:

  1. Make a list of what is most important to you, your values.
  2. Use your list to complete an advance health care directive.
  3. Share your directive with trusted family, friends, physicians

Find more about Advance Care Planning at

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