California amends end-of-life option law

The California End of Life Options Act went into effect on June 9, 2016.1 On February 11, 2021, Governor Gavin Newsom proposed, enacted and signed an amendment into law on October 6, 2021, with the provisions taking effect on January 1, 2022.2

The provisions are as follows:

  • Exemption from final certification form
  • Extension of the cancellation clause by law until January 1, 2031
  • Prevent health care entities or providers from engaging in deceptive, erroneous, or misleading practices relating to the willingness of providers to qualify a patient or provide a prescription for dying medicines
  • Reducing the waiting period for patients requesting expired medications from 15 days to 48 hours between the first and second oral requests.
  • Require a healthcare entity to publish its policy on assisting in the dying on its website
  • Require providers to disclose their reasons for why they support or not support the patient’s request for end-of-life services, document the patient’s request and notify the provider of the refusal in the medical record, and transfer medical records upon request

Assisted suicide has been a topic of debate for more years than most people realize. A number of parties have argued the pros and cons of this issue, but 40 countries have yet to enact a bill on the subject. Legislators and lobbyists are bringing this topic up to the legislatures, and such laws are being passed slowly. There is no federal law on euthanasia, so each state has the opportunity to assess the ethical and moral issues surrounding end-of-life procedures.

Legislation that addresses this problem was first introduced in 1906 in Ohio. However, the bill has not been enacted. Several years later, Reverend Charles Potter co-founded the American Euthanasia Society in New York. By 1947, 37% of individuals who responded to a Gallup poll said they supported physician-assisted dying, while 54% said they opposed it.3

The concept of a legally protected right to die prompted Oxford University Law Professor Glanville Williams for publication Sanctity of life and criminal law in 1958.3 The work suggested that the mentally competent and the terminally ill should be allowed to choose euthanasia as an option related to the individual’s well-being.

Between the mid-1950s and the mid-1980s, more books were published calling on individuals to take end-of-life measures. Some publications even provided specific details about how to help with the death of a loved one. In 1957, Lael Wertenbaker published Death of a Man, which described in detail how she helped her husband end his life.

In the 1960s, several important steps were taken. Lawyer Lewis Kuttner wrote the first living will
In 1969, politician and physician Walter W. Sackett Jr. introduced an unsuccessful right-to-die bill in 1967.3 In addition, a proposal has been made to redefine death, including brain, heart, and lung death. This was slowly accepted after professors from Harvard Medical School suggested this important change.3

The Patient Rights Act, developed by the American Hospital Association in 1973, recognized the right to refuse treatment as part of informed consent.1 That year, the first American hospice opened in New Haven, Connecticut,3 The Euthanasia Society changed its name to the Right to Die Society.

In 1974, the health care community was surprised by the results of a Gallup poll. The results showed that 53% of Americans would prefer a physician-assisted death and 34% oppose it.3

Because religion has long been a significant factor in arguments against euthanasia, many people were shocked when a deeply religious couple attempted suicide in 1975 without health care providers.

He chose Henry B. Van Dusen, 77, and his wife Elizabeth, 80, end their lives so that they no longer suffer from disability conditions. The couple, who are leaders in a Christian Christian movement, wrote a note saying, “We still feel this is the best and the right way to go.”3 In 1976, the highly publicized Karen Ann Quinlan case became a legal milestone when the New Jersey Supreme Court granted her parents’ wish to separate her from a ventilator. Since physician-assisted death was not yet legal in New Jersey, Quinlan lived for more than 8 years in a vegetative state.3

Ten states, New Mexico most recently in 2021, have enacted assisted-death laws. This raises ethical and moral issues for pharmacists regarding whether they should participate in physician-assisted dying or even process insurance claims. Recently, a patient diagnosed with cancer saw her insurance company refuse her treatment but offered to cover her right-to-die medication for $68,000 for $1.20.4 These bills could mean major changes for pharmacists and other health care providers.

About the authors

Rebecca V he is Doctor filter at the University of Kentucky College of Pharmacy in Lexington.

Joseph L. Fink III, JD, DSC (Hon), BSPharm, FAPhA, Professor Emeritus of Pharmacy Law and Policy and former Professor of the Kentucky Pharmacists Association, Professor of Leadership at the University of Kentucky School of Pharmacy at Lexington.


1. Medina J. Who Might Die? Patients and doctors in California grapple with assisted suicide. The New York Times. June 9, 2016. Accessed August 31, 2022. – Share & ReferingSource = articleShare

2. Governor Newsom highlights notable new laws that will take effect January 1, 2022. Press release. Governor Gavin Newsom’s office. December 29, 2021. Accessed May 10, 2022. 2022 /

3. Humphrey D. Chronology of Right to Die events during the twentieth century through the millennium. Organization for Research and Guidance in Euthanasia. Updated January 2, 2019. Accessed August 31, 2022.

4. Judge rules California assisted suicide law unconstitutional. Life Legal Defense Foundation. May 15, 2018. Accessed May 10, 2022.

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