INFORMATION ON END-OF-LIFE ISSUES: Guidelines and Resources June 1, 2016 General Death and Dying, Marin Medicine The California Medical Association has published new legal guidance intended to help physicians and patients understand requirements of the End of Life Option Act. The document, #3459 in CMA’s extensive On-Call Health Law Library, is in question-and-answer format. It is available as a free download to CMA members and to nonmembers who register with cmanet.org. Below are the questions addressed in the 15-page guide. Click here to download the End of Life Option Act itself. A PDF of the questions as published in this issue of Marin Medicine, along with a list of Resources for Physicians and Patients, is available for download. The Resources listed in the PDF can also be found on CMA's website here. When does the End of Life Option Act become effective? Who can make an aid-in-dying request under the Act? How does a patient make an aid-in-dying request? Are there documentation and witness requirements for oral and written requests? Are there additional documentation requirements? Are particular forms required by the Act? Can an interpreter be used? Who is a “health care provider” under the End of Life Option Act? Can any physician receive a request for an aid-in-dying drug? What are the obligations of the attending physician who receives a request? What is required for an initial determination that a patient is “qualified” to request an aid-in-dying drug? Can a terminally ill patient with a mental disorder be “qualified” to request an aid-in-dying drug? Does a patient’s request for an aid-in-dying drug mean the patient needs someone else to make decisions for them? Are there specific requirements to ensure that the patient is making an informed decision? Is a referral to a consulting physician required for every patient? Does the Act contain safeguards against coercion and undue influence? Will the patient be counseled about taking an aid-in-dying drug? What are the final steps before an aid-in-dying drug can be prescribed? How does a qualified patient obtain the aid-in-dying drug? Who can be a consulting physician and what are their responsibilities? Is a mental health specialist assessment required for every patient who requests an aid-in-dying drug? Who can serve as a mental health specialist under the Act and what are their responsibilities? Can a patient change his or her mind to use an aid-in-dying drug? Does the patient have any additional obligations once the aid-in-dying prescription is written? Does the Act specify what aid-in-dying drug can be prescribed? What should be stated as the official cause of death on the death certificate? What are the attending physician’s reporting requirements? What are the aid-in-dying data collection and publication requirements? What happens to unused or excess aid-in-dying drugs? Are physicians required to participate in the End of Life Option Act? Are there legal protections if a physician chooses not to participate? Can medical staff members, employees, and others be prohibited from participating? What is considered “participation” in activities authorized by the Act? Does the Act require notice of a prohibiting employer or health care provider’s policy prohibiting participation in activities under the Act? Are there limits on a prohibiting employer or health care provider’s ability to prohibit participation in activities under the Act? Can a physician be disciplined for violation of a prohibiting employer or health care provider’s policy prohibiting participation in the Act? Can a physician be reported to the medical board solely for violation of a policy prohibiting participation under the Act? Are there protections and immunities for physicians who choose to participate? What is considered criminal conduct under the Act? How does the Act impact insurance policies and contracts? Contact CMA with questions about the Health Law Library or how to access documents: 800-786-4262. << DEATH CERTIFICATES: Certification of Death: Whose Responsibility? OUT OF THE OFFICE: Tale of a Suicide: A Life-Ending ‘Option’ We All Deplore >>