Californians who are terminally ill and have less than six months left to live will be able to ask their doctors to help them die beginning June 9, but many doctors in the state are confused about the new law, a new report finds.
Health organizations, doctors and families lack information about The End of Life Option Act and how it will be implemented, according to the brief released Thursday by the UCLA Center for Health Policy Research.
“The combined effort of legislators, doctors and the public is needed to ease the final days of what should be the focus of our attention, the critically ill patient,” Cindy Cain, faculty associate at the Center and author of the report, said in a release.
Researchers found that doctors are unclear about how to implement the new law, which allows them to prescribe a lethal dose of medication to patients who qualify.
Physicians have questions about how to properly prescribe the medication, what the law permits and whether they are legally liable if there are complications. Some doctors also wonder if they can opt out of participating in the new law and refer patients who qualify elsewhere.
California is the fifth state in the country to allow assisted death. Oregon was the first state to legalize it, in 1994. Since then, Washington, Montana and Vermont have followed suit.
Still, the number of people who die each year from taking a doctor-prescribed dose of lethal medication is low, the study found. In 2014, 105 people died this way in Oregon, a rate of 31 physician-assisted deaths per 10,000 total deaths in the state, according to Oregon Health Authority statistics cited in the report.
More people request a prescription than actually use it, the study found. In Oregon in 2014, 155 people were prescribed the medication. That same year, in Washington, 126 of the 176 people who received a prescription took the lethal dose.
“Having a choice in the matter may itself provide comfort to a terminally ill person,” Cain said. “Having that prescription in hand might give them a feeling of control, whether they ultimately use it or not.”
During legislative discussions, disability rights advocates raised concerns over the new law. Lawmakers tried to include safeguards to prevent the possibility that a patient will be coerced into hastening death or have impaired thinking while making the decision.
In order to receive the prescription, the attending doctor must confirm that the patient has six months or fewer to live, is mentally stable and is informed of other options. The patient must also orally request aid in dying twice and provide a written request with signatures from witnesses. In addition, a consulting doctor must certify the patient’s diagnosis and prognosis, and confirm the request for aid in dying.
The report recommends that the state collect more complete data on dying and those who use the new law, including what conditions they have and whether they are disabled. Health organizations should also offer educational programs to providers and patients to help them understand assisted death, Cain said.