Cindy Cain, an assistant professor in residence at the UCLA Fielding School of Public Health, is the author of a policy brief on the End of Life Option Act for the UCLA Center for Health Policy Research, where she is a faculty associate. The new California law, taking effect on June 9, allows a terminally ill patient with six months left to live to take a lethal dose of medication to hasten death. This brief interview was originally published in “Three Questions for the Expert.”
How are Californians being made aware that their terminally ill loved ones have the option to use a physician-prescribed medication to hasten death starting in June?
I think most Californians do not know that this option will be available starting in June. However, many Californians will remember stories about Brittany Maynard, a young woman dying from brain cancer who moved to Oregon to take advantage of the Death with Dignity Act. These kinds of mass media conversations may have increased awareness of the debates surrounding aid in dying.
Now that the law is going into effect, we need more intentional public campaigns to raise awareness about what the law permits, what it does not permit and how one can get more information.
Is the burden on the terminally ill patient and his or her family to ask a physician about end-of-life options?
The burden is on the patient to bring up aid in dying as an option at the end of life. If a patient asks their attending physician for a comprehensive list of end-of-life options, the physician may tell them about aid in dying as one of those options. However, because the law permits physicians to opt out of participating in aid in dying, physicians do not have to give information about aid in dying if they are opposed to it on moral or ethical grounds.
This means that patients who want this information may have to change physicians if their current physician is opposed. Ultimately, patients will have to be much more proactive to receive information on this option, compared to other options at end of life.
Three states have enacted or allowed aid in dying in the last six years. Is it a signal of a national trend?
There is a growing national interest in talking about end-of-life issues and quality of life. Several states are now considering legal actions that would make aid in dying possible. As more people learn about California's End of Life Option Act, I expect that there will be more public interest in having this option.
