On June 9, End of Life Option Act becomes an option in California in all settings of care.  What will your facility do when it receives a request for this option?  I predict that most of our facilities will be receiving such requests in the coming months.  How will your facility manage those requests?

Fortunately, the larger settings of care are developing tools and resources for us to consider so that we can develop appropriate, standardized, impartial, and systematic responses to these requests that represent the interests of our patients, families, staff, management, and ownership.  

In Sonoma County, the major hospital systems have developed resources and tools.  Sutter has made a few resources available (see attachments at the end of this article).  I’m looking forward to viewing the PowerPoint presentation by Dr. Steve Lai, a former CALTCM Board Of Directors member.  I also appreciate Sutter’s efforts to poll the medical staff for their level of participation in this new law locally as well as regionally.

As a Medical Director I expect to receive requests.  I personally feel most comfortable at this time not participating in the activities allowed by this Act, but I am willing to discuss the Act, ask about their reasons for considering this option to make sure we address those reasons, and then have an awareness of the local or regional option for those who choose to become providers for this option.

One of my facilities has developed a policy of opting out of participating in this option.  If that’s the case, what facilities locally or regionally will be participating, and will they be open to referrals from non-participating facilities?  It sure would be nice for large organizations like CAHF or LeadingAge California to take a poll of member facilities to identify facilities who will be participating and will be open to consider referrals of patients who want to avail themselves of the Act.

In other states where physician-assisted dying is legal, only a tiny fraction (under 1%) of the actual deaths by this method have occurred in long-term care settings (e.g., nursing homes and assisted living).  Nonetheless, this is a very diverse state and public acceptance of this option is rapidly increasing (the Oregon experience). Now is the time to prepare for the requests which will surely come.  

If you are aware of other resources on this evolving area of medical care in our state, please email them to us at [email protected].

Attachments:

Facts for Physicians 

Facts for Patients

Patient Checklist

FAQ 1

FAQ 2

EOL Option Act: How to respond