January 18, 2020

The New California Assisted Suicide Law

“To die: to sleep;
No more; and by a sleep to say we end
The heart-ache and the thousand natural shocks
That flesh is heir to, 'tis a consummation
Devoutly to be wish'd.”
— Hamlet, Shakespeare

The California End of Life Options Act became effective in June. Before we can understand what the new law permits and how it might change the care of dying patients, we have to understand a little about end of life care prior to this development.

Suffering and dying is not a recent problem. Much has been thought and written about the alleviation of suffering and the medical care of dying patients. This is a well established topic in medical ethics that has been largely reflected in the relevant laws in many states.

So let’s imagine that we are quite ill, and that the pain and debility caused by our illness make us believe that death is preferable to our current state. Prior to the new law, what options were available to us?

One option is refusal of some medical care. This option is based on the general ethical principle of autonomy, which states that an informed patient who is able to make decisions may refuse any care, including life-saving care. So in our example, we may refuse life-saving antibiotics in the event of an overwhelming infection. We may choose not to be hospitalized the next time we are critically ill. We may decide ahead of time that if our breathing or heart were to stop, we would forego artificial respiration or CPR. This general approach allows patients to declare that they are unwilling to undergo some interventions even if these are necessary to prolong their lives.

In practical terms this is done through a conversation between a patient and her physician. These decisions can be formalized in various ways for communication with other doctors and other facilities. A standard way to document these decisions is the “>Cedars-Sinai Health System and of “But when you talk about destruction
Don't you know that you can count me out”
— Revolution, The Beatles

Learn more:

“>CA Aid-in-Dying Law (Cedars Sinai-Health System)