California Aid in Dying Law

Having been passed by the Legislature in September 2015 and signed by the Governor in October 2015, California’s End of Life Options Act (AB 15) became law effective June 9, 2016.  It was slightly amended in October 2021 (SB 380).

In short, the End of Life Options Act has three main elements:

1. The law grants patients who satisfy specified criteria the legal right to request, receive, and self-ingest aid-in-dying drugs, i.e., medications whose sole purpose is to bring about the patient’s death.

2. The law details a rigorous process that includes steps to be followed by the patient, at least two physicians (the patient’s attending physician and an independent consulting physician, both of which are specifically defined for this law), and, possibly, a mental health specialist. The process also requires a variety of documentation including forms (to be completed by the patient and the physicians) which are to be submitted (by the attending physician) to the California Department of Public Health.

3. The law allows healthcare providers, for reasons of conscience, morality, or ethics, not to participate in any or all of the following five specified activities associated with the above-mentioned process:

a. serving as an attending physicians as defined for the law;
b. serving as a consulting physician as defined for the law;
c. serving as a mental health specialist as defined for the law;
d. prescribing, dispensing, and delivering aid-in-dying medication;
e. being present when a patient ingests aid-in-dying medication.

At Cedars-Sinai, the relationship between patients and their healthcare providers sets the stage for respectful and quality patient care.  This holds true for all patients and at every stage of life. 

For patients facing end of life, the range of available options often runs, on the one hand, from relevant disease-targeted treatment to, on the other hand, focus on palliative and comfort care only, including hospice.  What’s best for any individual patient is a decision the patient and their physician decide together. 

Accordingly, for a patient who may be interested in treatment under the End of Life Options Act, it is the policy of Cedars-Sinai to direct them to their primary physician.  That physician, knowing and working with the patient, can then best address questions about eligibility and steps associated with the End of Life Options Act should it turn out to be fitting.

Given the complexities associated with each of the three main elements of the End of Life Options Act (as briefly outlined above), both patients and healthcare providers may have many questions. There are a number of resources available via the Internet for answering such questions, including:

• California Department of Public Health
• California Medical Association
• Coalition for Compassionate Care of California

Also, in terms of the step-by-step process that must be followed, below are the forms that must be utilized if engaging in the specified process detailed by the Law (these forms are legally required without exception if an aid-in-dying drug is to be prescribed).

• Patient Request Form  
• Attending MD Checklist & Compliance Form  
• Consulting MD Compliance Form  
• Attending MD Follow-Up Form