Recently, there’s been a dramatic increase in the number of states considering death with dignity laws. Sometimes called “assisted suicide” or “right to die” initiatives, these laws make it possible for terminally ill patients to use prescribed medication to end their lives peacefully rather than suffering a painful and protracted death.
The catalyst for greater national attention to this issue was 29-year-old Brittany Maynard, a woman diagnosed with terminal brain cancer who moved from California to Oregon to end her life in 2014. Maynard chose Oregon because California had not yet passed its aid-in-dying law, and Oregon is one of just a few other states to allow terminally ill patients to legally end their lives.
In 2015, during a special session on health care, the California legislature passed a death with dignity bill called the California End of Life Option Act. Signed into law by Governor Jerry Brown in October 2015, the act took effect on June 9, 2016. It allows terminally ill patients to request aid in dying in certain clearly defined situations. In 2018, the latest year for which statistics are available, 452 people received prescriptions under the act and 337 used them to die. (For additional statistics, see the California End of Life Option Act 2018 Data Report published by the California Department of Public Health.)
This article first clarifies some confusing language related to death with dignity laws and then sets out the basics of California’s law.
“Death with dignity” is one of the most commonly accepted phrases describing the process by which a terminally ill person ingests prescribed medication to hasten death. Many people still think of this process as “assisted suicide” or “physician assisted suicide.” However, proponents of death with dignity argue that the term “suicide” doesn’t apply to terminally ill people who would prefer to live but, facing certain death within months, choose a more gentle way of dying. In fact, California’s law states that terminating one’s life under the law is not suicide. (See Cal. Health & Safety Code § 443.18.)
Increasingly, health organizations are turning away from the term “suicide” to describe a terminally ill patient’s choice to reduce the suffering of an inevitable death. The phrase “aid in dying” is becoming a more accepted way to refer to this process. California’s End of Life Option Act uses the phrase “aid in dying”—for example, under the law, the prescribed life-ending medication is called “aid-in-dying medication.”
You may also see the phrase “right to die” used in place of “death with dignity.” However, “right to die” is more accurately used in the context of directing one’s own medical care—that is, refusing life-sustaining treatment such as a respirator or feeding tubes when permanently unconscious or close to death. You can provide your own health care directions by completing a California advance health care directive. (See the end of this article for more information.)
To request a prescription for life-ending medication in California, a patient must be:
A patient who meets the requirements above will be prescribed aid-in-dying medication only if:
To use the medication, the patient must be able to ingest it on their own. A doctor or other person who administers the lethal medication may face criminal charges.
In addition, no other person—such as a health care agent, attorney-in-fact, or conservator—may make a request for aid-in-dying medication on behalf of the patient.
You can read the full text of California’s End of Life Option Act on California’s Legislative Information website.
To find out more about the history and current status of death with dignity laws in the United States, visit the website of the Death With Dignity National Center.
For information about appointing a health care agent and making known your own wishes for medical care at the end of life, see the Living Wills & Medical Powers of Attorney section of Nolo.com.
Updated July 22, 2019