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06
Jun 2016

Covering California’s End-of-Life Law’s Strict Rules

Early in 2012, our family had the difficult time of watching an insidious bile duct cancer strangle my dad’s life by inflicting incredible pain and suffering upon him. Many days, I sat across the room, watching my dad in his reclining chair attempting to cope with another trying day, huddled under layers of blankets, unable to tolerate most noises or food. On a 1-to-10 pain scale, there appeared to be too many moments my tough-as-nails dad (who never even took aspirin) was at 11 on the charts.

Hospice care was taking over the at-home process, yet I saw very little that was hospitable or noble in my father’s incredible suffering. In many respects, it seemed cruel for a human to suffer one final indignity of letting a disease dictate his final days. There had to be a better way to treat a dying person’s final weeks or days than what our family witnessed.

California’s new law, effective June 9, 2016, now allows life-ending drugs for the terminally ill. However, it should be noted that the Left Coast state has the strictest requirements of any of the five states that legally allow such lethal prescriptions.

Doctors are starting to voice to the public their uneasiness and nervousness with prescribing lethal doses of drugs for terminal patients. This California “Right to Die” law in our country’s most populated state took many years to pass. Physicians and opponents of the law still have grave concerns that the new legal prescription will inevitably lead to hasty decisions, misdiagnosis and disappearing support from health plans for palliative care (pain-relief care), when a cheaper and quicker alternative is available to the dying patient and his/her family.

However, there are specific requirements for a doctor to obtain a prescription for lethal drugs for the terminal patient under the new state law. These requirements for California residents to know and understand include:

  1. Patients must be at least 18 and be diagnosed with only six months or less to live by a physician.
  1. Two doctors must sign off on the diagnosis and deem the patient mentally competent.
  1. The terminally ill patient must be able to make an oral request for the prescription to their primary care doctor twice and 15 days apart.
  1. The terminally ill person must also make a written request.
  1. Under the law, the terminally ill person must be able to administer the drugs themselves without help from a physician or family member.
  1. The law does not require private insurance companies to cover the cost. The drugs will be covered under California’s Medicaid program, known as Medi-Cal.
  1. Federal programs such as Medicare and the Veterans Administration will not cover the lethal prescriptions because the practice is not allowed under federal law.

The ethical debate will wage on, but the law is here and will become a bit more understood as physicians and the public start to implement the alternative care change.

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