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Ask the Expert – End of Life Options and Medical Aid in Dying with Erika Ruiz

On Tuesday, March 28th she will review strategies for having important conversations with your doctor, options for end of life care, and how to access California’s End of Life Option Act at the Cancer Support Community Valley/Ventura/Santa Barbara. For those who can’t make it to the workshop, Erika Ruiz was kind enough to provide the following information for our readers.

End of Life Options and Medical Aid in Dying

by Erika RuizPic Conversation at End of Life.png

We live in a death denying culture, and fear often keeps us from having meaningful conversations with our doctors and loved ones about what we want and don’t want at the end of life. It’s sometimes not easy talking about end of life issues, but it is important to have end of life planning conversations early which leads to planning for a good death and consciously thinking through your priorities and options, and the options in California now include medical aid in dying.

Have you heard of California’s End of Life Option Act? This law is California’s medical aid in dying law, similar to Oregon’s Death with Dignity Act, and it went into effect on June 9, 2016. This law gives terminally ill adults the option to get a doctor’s prescription for medication they may decide to take to end unbearable suffering, by dying peacefully in their sleep.

California is one of seven jurisdictions in the United States that now authorizes medical aid in dying. Along with California, medical aid in dying is authorized in Oregon, Washington, Montana, Vermont, Colorado and Washington D.C.

In Oregon, where the law has been in place for 20 years, many people and their medical providers were confused about the law, and heartbreakingly, were waiting too late to start the process once their suffering or pain became unbearable, and so the aid-in-dying option was not available to them despite their eligibility and despite the amount of pain and suffering they were in.

Because people lack accurate information, they wait too long to initiate end of life conversations and decision-making processes with their doctors and loved ones. We want to learn from Oregon and make sure that all Californians have access to their full range of end of life options. This is why Compassion & Choices has launched the bilingual California Access Campaign. The Access Campaign focuses on educating the public and medical professionals about all end of life options, including medical aid in dying.

Who is eligible for medical aid in dying?

To be eligible under California’s law, an individual must be:

  • An adult
  • Terminally ill
  • Given a prognosis of six months or less to live
  • Mentally capable of making their own healthcare decisions
  • A resident of California
  • Acting voluntarily
  • Making an informed decision which includes being given information about all end of life options
  • Informed that s/he may choose to obtain the aid in dying medication, but not take it
  • Capable of self-administering and ingesting the aid in dying medication

How long does the process take to request and obtain the aid in dying medication?

The process can be a lengthy one (and may not be successful) if you do not have a supportive healthcare team. The average length of time is between 15 days to three months and requires at least two doctor visits.  Therefore, it is very important for individuals who may want to access the law to talk to their doctors early.

What cause of death is listed on the death certificates of individuals who accessed medical aid in dying?

The underlying illness should be listed as the cause of death. The law specifies that a death resulting from self-administering aid in dying medication is not suicide

Does accessing medical aid in dying affect a person’s will or insurance?

No, accessing medical aid in dying does not adversely affect a person’s will or insurance. The law specifically mandates that wills, insurance, contracts and annuities are not affected if a qualified individual shortens their dying process by ingesting aid in dying medication.

Note that no one but you can make this request to your doctor(s). The request cannot be made by a designee or third party (including relatives or anyone with power of attorney), and the request cannot be made via an advance healthcare directive.

Ask your doctor and medical providers now whether they will support your end of life choices, including medical aid in dying. This will encourage your medical providers to listen to your priorities and become prepared to provide you with the treatment you may want in the future. Compassion & Choices provides assistance to physicians through our Doc2Doc Program, which offers free, confidential telephone consultation with a seasoned medical director. Please feel free to give your physician the Doc2Doc phone number: 1-800-247-7421.

More information is available at: and

Compassion & Choices
3055 Wilshire Blvd, Suite 1010
Los Angeles, CA 90010

Erika Ruiz is the Central California Outreach Manager for Compassion & Choices, a national nonprofit organization working on improving care and expanding choice at the end of life. Her interest in advocating for and educating on end of life care options stems from her experience witnessing her father suffer a difficult death in an ICU. She started volunteering with Compassion & Choices during the legislation of the End of Life Option Act and now educates Californians (in English and Spanish) on their full range of end of life care options.

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