Hi there, Bridget Mackay here, and I’m an attorney in Petaluma. I work in the area of estate planning and elder law. You are joining me for my final part in a four-part series on the End of Life Options Act, which California is implementing on June 9th of this year. The final series, we’re going to talk about what protections are in this law. The authors of the law assert that the system includes enough steps and safeguards to prevent abuse such as inheritors trying to expedite the death of an elderly relative. They point to the example of Oregon, where assisted death has been legal for nearly 20 years with no recorded cases of misuse. In the law, physicians must inform the patient that he or she may rescind the request for an aid in dying drug at anytime and in any manner so at any point, the patient can stop this process from happening.

Furthermore, as you’ve learned from our earlier video blogs, the request for a prescription cannot be made on behalf of a patient through an agent under a power of attorney, or an agent under an advanced healthcare directive, or a conservator, or any other person. The request for the prescription needs to be made by the patient themselves, and the law does make it a felony to forge requests for a prescription, coerce someone into requesting the life-ending medication, or administer it without their consent. Those are all huge violations of the act, and whoever does it is exposed to a felony criminal charge.

Also, at any moment, a patient can also withdraw their request, and health insurance carriers are not allowed to provide any information about assisted-death options unless someone asks for it. It’s really a law that’s based on everything coming from the patient, all the decision making, even administering the drug. Furthermore, California Medical Association has come onboard and issued guidelines to physicians on writing prescriptions of lethal doses of drugs for terminally ill patients. There is some comfort in knowing that physicians throughout the state are getting some guidance through the California Medical Association, although the new law does leave some questions unanswered for physicians including what the physician writes on the death certificate, and the law is silent as to what the cause of death should be identified on the death certificate.

It does say, taking an aid in dying drug shall not constitute suicide. If suicide is not the reason of death on the death certificate, a lot of discussion among physicians would be the underlying diagnosis that led this patient to a decision to end their life early because of a terminally ill diagnosis. The discussion is that what is on the death certificate will be whatever that terminally ill diagnosis was. The guide also says physicians can list the cause of death as they feel what is most accurate, including the underlying terminal illness, like I said, or just write, “pursuant to the End of Life Options Act.” This is all something that’s going to be figured out as we implement the law, and there have been people who have done it and precedence. All of you who maybe are just tuning in now, please look at earlier video blogs, where I discuss the basics of the act, who does it cover and how, the second is on the requirements to get a prescription, and the third is how the prescription is administered. Thank you.

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