There are currently 10 states and Washington DC that permit medical aid in dying – all have slightly different requirements – and this is just focusing on California. In California, it’s called the End of Life Option Act (EOLA).

To qualify:

• Over 18 years of age

• California resident (no specific time frame)

• Terminal illness with a prognosis of 6 months or less to live

• Capacity to make the decision

• Strength to self-administer the medication (orally, by feeding tube, or rectally)

There are 3 phases: 1) the request; 2) the prescription; 3) the administration.

The most important thing is that the patient must be the person to bring this up verbally. This is not an option that a physician will present to a patient. The patient must know this option exists and request information about it. Requesting information about EOLA does NOT require the patient to use EOLA! It’s just a query. In fact, even if the patient goes through all the steps of EOLA and has the prescription in hand, they still do NOT need to use it. It’s an option, not a requirement.

EOLA is an opt-in program. Most hospitals have physicians and palliative care teams to talk through the process; but not all physicians are going to participate.

The Request

Once the patient makes a request, there are 3 appointments: a) prescribing physician who interviews the patient to make sure this is what they want, they’re acting under their own free will, they have capacity, and they have 6 months or less to live; b) consulting physician who more or less confirms the same information; c) prescribing physician (again) at least 48 hours after the first request. There’s a combination of oral and written requests and paperwork to be completed, including that the patient must have two people sign a written witness request — and one of the two people must not be an heir/beneficiary of the patient.

The Prescription

The prescribing physician calls in the prescription to the pharmacy. Some pharmacies can turn it around the same day/within hours; some pharmacies require several business days. This is a question worth asking.

The Administration

The medication is self-administered — in a private location (a home, a hospice facility) — orally (swallowing), by feeding tube, or by rectal tube administration. Although a medical professional is not required to be present, it is usually recommended, especially if the patient requires rectal administration. If the medication is being administered via feeding tube or by rectum, there’s a syringe-type tube that is connected to a tube. The patient must press the syringe themselves. If swallowing, the patient must lift the cup to swallow themselves.

Generally, the medication puts the patient to sleep and then the body dies over a period of time (around 2 hours or less, typically).

A death certificate for the patient states the underlying cause of death, not that the person utilized medical aid in dying medications.

There are a lot of other intricacies that have to take place, but this is sort of the general overview. If you have any questions, please do reach out to me or your medical professional.