More than 700 terminally ill Californians used the End of Life Option Act to die peacefully in 2021, according to a newly released report by the California Department of Public Health. This law allows terminally ill, mentally capable adults the option to request a medication they may decide to take to peacefully end their terminal suffering. The majority of these patients (91.6 percent) were enrolled in hospice when they died, and 66 percent of them were diagnosed with some form of cancer.
“Terminally ill Californians are seeking information about their available end-of-life options, and more doctors feel empowered to talk about this compassionate medical practice,” said Kim Callinan, president and CEO of Compassion and Choices. “Our mission is to expand options and empower people to chart their own end-of-life journey alongside their loved ones and medical team. We are pleased to see that the majority of Californians utilizing this law are receiving hospice care at the time of their death.”
The annual report states that 772 terminally ill Californians obtained prescriptions for medical aid in dying, written by 277 physicians (an increase from 262 doctors who prescribed the medication in 2020). A total of 486 patients (63 percent of those with prescriptions) took the medication in 2021 (this includes 38 who obtained the medication prior to 2021). Many terminally ill residents go through the 13 step process to obtain the medication and never ultimately use it; patients share that it gives them a huge sense of relief to know that they have it available to them.
Since the End of Life Option Act has been in effect (June 9, 2016 through December 31, 2021) prescriptions have been written for a total of 3,766 people; 2,422 individuals (64.3 percent) total have died peacefully after ingesting the medication. We do not know how many people have been unable to access the law, but we do know that 75 percent of Californians, and the majority of every demographic, want the option of medical aid in dying, according to a comprehensive survey by the California Health Care Foundation.
Other findings in the annual report include:
- The majority of patients who utilized the law were white (85 percent), and 52 percent were male.
- The median age at the time of death was 76.
- There was a small increase in Hispanic residents who used the law in 2021 (5.1 percent compared to 3.4 percent in 2020).
- Neurological illnesses such as Amyotrophic lateral sclerosis and Parkinson’s disease accounted for the second largest underlying cause of death (13.2 percent).
- 93 percent of those who ingested the medication did so in the comfort of their own home.
It should be noted that this data does not reflect some very recent changes. Senate Bill 380, improving the End of Life Option Act, was signed by Governor Newsom on Oct. 5, 2021 and put into effect Jan. 1, 2022. SB 380 improves access for eligible, terminally ill Californians. One of the largest changes is the reduction of the waiting period between requests, down from 15 days (as mentioned in this report) to 48 hours. This update addressed the excruciating pain and death by approximately 30 percent of eligible people, noted in a 2017 study released by Kaiser Permanente of Southern California.
SB 380 also ensured transparency by requiring healthcare facilities and hospices to publicly post their medical aid in dying policy online, allowing patients to make informed decisions about the location of their care. It also removed a redundant fourth medication request, clarified documentation procedure for medical providers transferring care, and confirmed that medication can be self-administered within a healthcare facility.
“Too many terminally ill people were struggling to access the law and many died in exactly the way they didn’t want,” Samantha Trad, National Director of Care Advocacy at Compassion and Choices said. “Removing these unnecessary barriers improved the law, so that more dying Californians can have the option to peacefully end their suffering on their terms.”
California is one of 10 states — including Colorado, Hawaii, Maine, Montana, New Jersey, New Mexico, Oregon, Vermont, and Washington — as well as the District of Columbia, that have authorized medical aid in dying. Collectively, these 11 jurisdictions represent more than one out of five U.S. residents (22 percent) and have decades of combined experience using this end-of-life care option, starting with Oregon in 1997.