By Loulena Miles, Attorney at Miles & Torres Associates
End of life decisions are never easy, and people feel many different ways about the right to physician-assisted suicide. California is now the fifth state to allow physicians to assist people who have made a decision to end their life, but only under certain narrow conditions.
What is it?
California’s Governor Jerry Brown signed the End of Life Option Act into law last fall and it took effect on June 9, 2016. This law allows mentally competent individuals who are terminally ill (and are expected to die in the next six months) to take medication that will end their life at a time and private place of their choice.
Who does it apply to?
The law only applies to adult, terminally ill, California residents with no more than six months to live. A patient must be deemed terminally ill and mentally competent by two physicians to receive a prescription. To make a formal request for the medication, the patient must tell his or her doctor on two separate occasions, at least 15 days apart, that they want the lethal medicine. The patient must also submit a request to the doctor in writing. All licensed medical doctors in California can prescribe the medication, but they are not required to offer this option.
Who doesn’t it apply to?
This law does not apply to people who have a significant mental illness, including advanced Alzheimer’s and dementia. It also does not apply to people who are terminally ill and are in constant pain, but who have more than six months to live. Moreover this law will not provide an option for people who are unable to see multiple doctors and make multiple requests. The medication costs could be prohibitive, costing anywhere from $500 to $4000. The State of California will pay for the medication for those who qualify for Medi-Cal coverage but no federal funds can be used to pay for the medication. Some large health providers including Kaiser have opted to allow their doctors to prescribe the medication. Catholic affiliated medical providers, the Veterans Health Administration and Medicare have opted out of prescribing the medication.
How does it affect estate planning?
Generally, when a person does estate planning, they have to answer questions about what level of care they would want if they no longer had the mental capacity to make decisions for themselves. In California, those decisions are documented in what is called an Advance Health Directive. In that document, a person can name an agent to make decisions in the event that he or she loses mental capacity. The End of Life Option Act does not allow a person to choose physician assisted suicide in advance or name an agent to authorize this decision for them. But an advance health directive does allow a person to designate what other types of medical interventions they would want if they were terminally ill. For instance, many people choose not to have feeding tubes to keep them alive artificially if they are not able to eat or swallow, and they have no mental capacity to make that decision for themselves. Estate planning can help you navigate these difficult decisions in advance so that your friends and family are better prepared to make decisions for you if the time comes.
Miles & Torres Associates provides estate planning services to help you navigate these difficult decisions and feel confident that your wishes will be carried out. Call us for a free consultation at 415-496-9396.