Some doctors in California felt uncomfortable last year when a new law began allowing terminally ill patients to request lethal medicines, saying their careers had been dedicated to saving lives, not ending them.
Many healthcare systems designed protocols for screening people who say they’re interested in physician-assisted death, including some that were meant to dissuade patients from taking up the option.
But physicians across the state say the conversations that health workers are having with patients are leading to patients’ fears and needs around dying being addressed better than ever before. They say the law has improved medical care for sick patients, even those who don’t take advantage of it.
“One doctor said we should be able to order the End of Life Option Act without the drugs,” said Dr. Neil Wenger, director of the UCLA Health Ethics Center. “It really has created a new standard for how we ought to be helping people at the end of life.” . . . [Full text]
Judy Dale died of cancer in her San Francisco home in September, in agony, after being denied the pain-relieving medication she might have received under the state’s aid-in-dying law that had taken effect three months earlier.
A lawsuit by her children will determine whether UCSF Medical Center, where Dale first went for treatment, was responsible for her suffering by allegedly concealing its oncologists’ decision not to provide life-ending drugs to patients who ask for them. More broadly, their suit illuminates the inner workings of a law that confers new rights on terminally ill patients, but few obligations on their health care providers.
The law allows a medically competent adult who has six months or less to live to ask a doctor to prescribe lethal medication. The patient, not the doctor, must be the one to administer the drug. Two doctors must agree on the terminal diagnosis, and the patient must make two requests, at least 15 days apart, before receiving the medication.
But doctors and hospitals are not required to take part in the process or to refer the patient to someone who will grant the request. Hospitals can prohibit their physicians from prescribing life-ending medication, something that medical centers affiliated with the Catholic Church and some secular hospitals have done. And a doctor who has decided not to prescribe the drugs is not required to disclose that fact until the patient asks for them. . . [Full text]