End of Life Act

Last year on June 9th, California Governor Jerry Brown gave terminally ill patients in California with less than six months to live the ability to request a doctor’s prescription to end their life. In order to attain such a request, the End of Life Act requires that adults 18 years and older must (1) make three requests of their primary doctor for an aid-in-dying prescription: twice verbally, 15 days apart, and once in writing; (2) be mentally and physically able to request the lethal dose; and (3) take it themselves, without anyone’s help or coercion. Specific requirements vary between states, but for each state, doctors are not required to comply by issuing a prescription and cannot be held liable for refusing a patient’s request. Since the passage of the End of Life Option Act, more than 100 people have taken their lives.

California is one of 5 states that provide patients the legal protection to choose doctor-assisted death. Doctors are trained to abide by the ethical code of patient autonomy, beneficence, nonmaleficence, and justice, but what happens in conflicting cases where people who are terminally ill seek the means to end their despair? In hospital beds lie many individuals who are afflicted with debilitating conditions that leave them incapable of functioning. They are in excruciating emotional and physical pain; meanwhile, their family sit beside them witnessing their agony. Supporters of acts such as the End of Life Act argue that doctors have an obligation to relieve the suffering of fellow human beings and to respect their dignity. They emphasize the importance of autonomy and beneficence at the expense of nonmaleficence. On the other hand, opponents argue against such acts given the availability of hospice and palliative care that can reduce pain and suffering for terminally ill patients. They advocate society’s moral duty to protect and preserve all life. They take on a nonmaleficence approach and ask the question, “Once we accept that only life of a certain quality is worth living, where will we stop”?

In passage of the End of Life Act, additional questions were brought forth: What medication will be prescribed? Will there be a supportive environment available for the patient? Will there be a supportive environment available for the family?

The ethical dilemma of assisted suicide is very powerful and brings about the importance of discussing quality versus quantity of life. Regardless of the laws set in place, one thing is for certain: quantity of life does not guarantee quality of life and quality of life does not guarantee quantity of life. In states, such as Washington, Oregon, and now California, doctors play a central role in this dilemma. With immense responsibility, it is important, now more than ever, to openly discuss such difficult topics and find ways to address these issues that most benefit the patient.

 

References
  1. http://www.npr.org/sections/thetwo-way/2015/10/05/446115171/california-governor-signs-physician-assisted-suicide-bill-into-law
  2. http://www.ibtimes.com/californias-right-end-life-invoked-111-terminally-ill-patients-6-months-report-says-2558545
  3. http://www.sacbee.com/news/local/health-and-medicine/article75967042.html
  4. https://www.scu.edu/ethics/focus-areas/bioethics/resources/assisted-suicide-a-right-or-a-wrong/
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Nancy Lopez was born and raised in Los Angeles, California. She graduated from the University of California, Irvine, with a degree in biological sciences with a minor in medical anthropology. She received a Master's in global medicine from the University of Southern California. She has a special interest in rural and public health. In her free time, she enjoys dancing, hiking, snowboarding when the sunny Arizona weather is permitting, and spending time traveling.