End Of Life Option Act

1. Voluntary, as the patient genuinely wants to end his life and is able to clearly and persistently communicate this wish.

In California, the End of Life Option Act, is the law that permits adults who are terminally and also have the to capacity to make medical decisions, to be prescribed medication that aids in their death after meeting certain conditions (End of Life Option Act, 2017).In order to meet the conditions for this prescription, individuals must be at least 18 years of age, reside in the state of California, received a diagnosis that their disease is irreversible and are expected to have only six months left to live, are able to make medical decisions for themselves, be able to voluntarily request the prescription, and be able to self-administer the aid-in-dying medication by eating, drinking, or swallowing it (End of Life Option Act, 2017).

The criteria that must be met are stated in the End of Life Option Act The patient must be a resident, have been diagnosed with a terminal illness, 6 months or less to die and must be legally an adult. In the United States an adult is considered someone that is 18 years of age or older. According to California’s state law AB-15 End of Life Action Act, a patient must meet all of the criteria before the physician is able to administer the medication to end the patient’s suffering. These laws were passed under different circumstances but one of the main ones was the cases that kept arising in different parts of the country where patients were requesting to end their lives.

Secondly, the patient should be capable of making and communicating health care decisions for him or herself. Thirdly, the patient must be diagnosed with a terminal illness that will lead to death within six months.  Interested patients must also provide the request for termination in writing to the physician. In addition, physicians are expected to inform patients to alternative means of care including hospice care and other medications. Only after precautions evaluation, the laws then permit patients to make the ultimate life ending decision.

Within the more advanced stages the individual will commonly suffer from incontinence, limited mobility and limited communication usually the individual will not be able to use sentences just limited words. Other symptoms that worsen similar to those with a terminal illness are:

The importance of end of life issues and decisions are now being discussed at the time of admission to most acute care and long term acute care facilities. More attention is being placed on these specific decisions to ensure that the patient's

The Death with Dignity Act of Oregon, Washington, and Montana has harsh patient eligibility criteria that limit access to competent, legal residents of over age 18, with terminal illness that were given an estimated life expectancy of 6 months or less which is to be confirmed by two independent physicians. There is also a requirement for two oral requests with a 15-day waiting period in between, as well as a written request that must be witnessed. The prescriptions may be written by the physician not less than 48 hours after the receipt of the written request. Patients must be mentally and physically be able to

The Oregon Death with Dignity Act was put into effect on October 27, 1997. This act allowed physicians to prescribe to terminally ill patients a lethal dose of medication in order to hasten their death, even though euthanasia is prohibited in the United States. According to Katrina Hedberg, this act has been revised by Oregon legislature, but has still been brought to attention of the United States Supreme Court on raised questions of legality. In order to receive a prescription for the Death with Dignity Act, the patient must reside in Oregon, be a terminally ill adult, and should be expected to die within a six-month time frame. Along with these requirements, patients must be able to make their own healthcare decisions. Katrina Hedberg found that over the course of ten years, physicians had written 546 prescriptions and a total of 341 Oregon residents passed away after the lethal dose under this act. The medications that were prescribed during this time were secobarbital and pentobarbital, and most patients would pass away within an hour of taking pentobarbital. Many physicians have reported that patients who requested these prescriptions often had a loss of autonomy and a decrease in their ability to engage in activities that they enjoyed. The results showed that these factors had increased over the course of ten years. According to physicians, patient’s concerns of pain had also increased during this time. This is still very controversial, but findings have shown that

By giving a terminally ill patient the right to end their misery, it can be beneficial to the lives of others. A patient who ends their life by a physician-assisted death can save their remaining organs and the lives of others who are in need of a transplant. By doing this, the patient is given the opportunity to determine how they would like their organs to be donated and the warmth of knowing they are saving the lives of others. Even though their life may be ending, their life will be honored by the ones they saved.

Physician Assisted Suicide has become an enormous debate across the world. It was originally thought to be entirely cruel and immoral, but, as time has passed and medical ethics have been considered, it has slowly gained acceptance. Physician Assisted Suicide (PAS) is a legitimate option for those suffering from painful terminal illnesses. It allows the patient who is suffering to have a choice in the matter of their life, which is valuable when someone is in such a vulnerable place. Legally, the topic has not done extremely well in the past, but in recent years people have acknowledged that legally there is nothing wrong being done. There are laws and regulations that are followed while performing PAS, making it nearly impossible to take advantage of it. Slowly PAS has gained acceptance, from different states, and from general people worldwide. Physician Assisted Suicide is a valid option for terminal patients and should not be criminalized or considered cruel.

The DWDA contained strict regulations and guidelines governing the usage of PAS. Some of it's main points were as follows. The patient must be able to make a fully informed and voluntary decision based on a terminal diagnosis of less than six months of life by two separate physicians. The patient had to submit two oral and one written request with a waiting period of 15 days between both oral requests and a 48-hour period between the final written request and disbursement of the requested medication. The DWDA did not allow for either mercy killing or active euthanasia, in which the physician performs the act of administering the fatal drug or drugs. The medicines prescribed were either pentobarbital, secobarbital or a combo of amobarbital and secobarbital. It also punishes anyone found to be coercing the patient to use this option.

Since 1993, Compassion in Dying, which is a nonprofit charitable organization, has provided information, consultation, and emotional support to patients that were terminally ill and wanted to consider assisted dying by self-administration of medication as one of their end of life options. The team for this organization includes nurses, psychologists, physicians, and clergy as was as laypeople from the community who help patients, their families, and their physicians examine the choices available to achieve peaceful and humane deaths (Lee). To be eligible to use this Act a person must be a resident of Oregon, 18 years or older, capable of making and communication health care decisions for him or herself, mentally competent, and diagnosed with a terminal illness that will lead to death within six months. This article uses data from the files of Compassion in Dying, and they describe 34 individuals who approached Compassion wanting to use the Death with Dignity Act and who died during the first year of the Act’s implantation. A downfall to this Act that has caused some problems is delays in processing a

With an increasing aging population and growing numbers of individuals with chronic conditions, it is important for individuals to prepare for end-of-life care. An Advance Directive is a defined as a “legal document that provides data to critical care staff about patients’ wishes, especially when critical illness decreases decision-making ability” (McAdam, Stotts, Padilla, and Puntillo, 2005). An Advance Directive also allows for better communication between the patient and doctor, and preserves the autonomy of patients. It may also alleviate one’s family from any possible burden of uncertainty of one’s wishes. It provides guidance, which may avert arguments with family members concerning treatment choices (Cedars Sinai, 2015). The Patient

The current health situation should be explained in a non-technical way so the patient (if possible) family, and or valid surrogate can understand every aspect. The physician should also help them understand when there is no hope for recovery. Most often the organs are no longer functioning, or there is little to no brain activity; at this point suffering potentially outweighs the probability of recovery. Medical teams most often realize that the focus should be on comfort, rather than extending a dying life. This decision comes with a great deal of uncertainty, and will always be hard, no matter what age of the patient, or the circumstances. Kathryn Kosh, MD explains that, “Ready access to advanced modern technology has changed death from an event to a process… Defying death requires payment [in the form of] pain and discomfort or in an unacceptable decline in the quality of life.” Often times physicians will not prescribe treatment in the first place knowing that this option will not benefit the patient, prolong suffering; and will likely end in termination anyway. Therefore, allowing the nature of the illness or injury to take its own course of action. Another point of interest regarding this topic is that medical teams realize in most cases, that providing an ethical and dignified death can be just as rewarding as administering aggressive measures to save a

It is also clear that while making these decisions, the decisions ought to be made based on informed consent (Werth and Crow 195). Sometime, the patient may be experiencing dementia, clinical depression or delirium for which they may be affecting the patient’s decision making capabilities (Werth and Crow 197, 198). If such a person is allowed to make their right-to-die decision, this may be done without the patient having comprehensive information before consent and thus should not be encouraged (Werth and Crow 198).