What Does the ‘End of Life Option Act’ Mean for Palliative Care?

By Redwing Keyssar, RN, Director of Seniors At Home’s Palliative Care Program

There is much conversation about the End of Life Option Act, which went into effect on June 9 in California. This new law authorizes an adult who meets certain qualifications, and who is determined to be suffering from a terminal disease, to request a prescribed drug that will end his or her life.

End of Life Option Act

First of all, it is important to note that this is not for everyone. In fact, the law is very specific about who is eligible and who is not, how “aid in dying” is obtained, what the responsibility of doctors or healthcare systems are to assist patients, and how patients are protected by the law. This fact sheet is great resource for more information.

For the general public and the healthcare community alike, the passing of this law has sparked controversy. Some in opposition believe it condones suicide; there are others who feel that the law enables people to die with dignity.  For many of us in the field of Palliative Care, it raises issues that are more complex.

What Does the End of Life Option Act Mean for Palliative Care?

In Palliative Care, our hope and our intention in working with people with chronic, serious, and terminal illness is to provide appropriate and timely pain and symptom management throughout the entire course of an illness—and also at the end of life.

Suffering, as we know, is not just about the physical plane; anyone who has undergone long and arduous treatment for a disease that will never be “cured” knows that the emotional and psychological factors of a diminished quality of life are overwhelming. So in order to truly reduce suffering in the case of terminal illness, human beings—not diseases—must be tended to with expertise and with the basic ingredients of love, compassion, and understanding of their values from the outset. When this is the case, a person can have more control over their own treatment plan, truly understand their options, and in terminal illness, make informed choices about their own death. This is what Palliative Care strives to accomplish.

The End of Life Option Act is somewhat of a misnomer because really, there is no “option” for the end of life—it will come, one day, for each and every one of us whether we want it or not. The law is actually designed to offer terminally ill people, who have intractable pain, a choice to consider when all other treatments have failed to reduce their suffering. Hopefully, before a person makes that choice, all other options will have been explored including a palliative care consultation, excellent pain and symptom management, in-depth emotional and psychological support, and counseling.

Unfortunately, holistic palliative care that can help reduce suffering throughout the course of an illness is not yet available to most people who need it. JFCS’ Seniors At Home is pioneering a model of community-based palliative care and we are making great strides, but there is still a long way to go before it becomes the way our nation cares for everyone.

Will the Law Change Anything for Palliative Care?

We live in a culture where most people want control over their lives, their healthcare, and their plans for how they want to do things. Now, the public has voiced the desire to also have control over one’s own dying process.

In Oregon, where this type of law has been present for many years, the biggest impact has been the  step forward in our cultural conversations, both publicly and privately,  about death and dying—conversations we should always be having, but until recently have avoided far too often. If the End of Life Option Act in California serves to increase conversation about death, dying, our mortality and what is important about life and living, then it will indeed help make changes that the field of Palliative Care has hoped to achieve.

If someone you know is having difficulty navigating the territory of serious illness and would like a Palliative Care consultation, please encourage them to call our team at 415-449-3777.