Howard Cohen, CMD, HMDC

California’s state law allowing terminally ill individuals to request medication from their physician to end their life.

    From decades of practicing medicine, I have never lost the belief that every patient/person deserves the ultimate right to choose or not to choose a medical treatment offered to them. My experience has been extremely rewarding and varied.

    I was sponsored by the U.S. army to attend medical school followed by my gratified repayment as a practicing general medicine physician which included obstetrics, delivering lots of babies, at an army hospital in Hawaii. Once completing my repayment to the army, and no longer a “soldier”, I subsequently specialized in Emergency Medicine allowing me to assist in all levels of patient care, from minor illness and injury to extremely serious and grave conditions. Emergency medicine also taught me that patients with serious conditions, on occasion, requested to stop all aggressive medical treatment and to allow them to go home to die on their own terms in order to remain in control of their choice for care and dignity. This was enlightening to my medical experience…assisting patients to make a final choice of HOW AND WHERE they wish to leave at the end of their life. This experience eventually led me to my current practice in Hospice Care.

    I realized that my medical experience has transitioned over the entire circle of life. From initially delivering babies to assisting patients with serious medical and physical conditions to currently assisting patients at the end of their life, per their choice, with dignity and comfort with hospice care.

    My experience with terminally ill individuals has been educational on all levels, not typically expected in general medical care. It has led me to participate in assisting patients with a terminal illness to choose to die legally under the California state law. These same requests to other physicians across our nation have led ten states, plus Washington, DC, to pass laws allowing individuals who have a medical condition with a life expectancy of six months or less, the ability to receive a legal prescription from their attending physician for medications to end their life.

    The California law is named the END-OF-LIFE OPTION ACT (EOLOA). The law is strict and states that only the individual who is diagnosed with a terminal life condition and who is of clear mind can make the request of their physician for the prescription. The law also requires that the request be made twice, currently 15 days apart, before it can be prescribed. The individual must have the full ability (mentally and physically) to ingest the medication on their own without any assistance. Additionally, in order to confirm the patient’s ability to make the request and meet all requirements, the California law requires a second physician (referred to as a consultant) to agree that the patient has a terminal illness of prognosis of six months or less and can make this decision on their own with a clear mind. Both physicians must complete the required documentation per the requirements of the EOLOA of California law prior to obtaining the orders for the EOLOA medications. And lastly and of great understanding, once the individual has received the medication, it is important to know that they do not have to take the medication. It is and will always be the patient’s choice to ingest the medication. They will always remain in control of their destiny as to how and when they choose to leave. This is their decision and only theirs to make, allowing them to remain in complete control of their life, at all times, despite the disease process, even at the end of life.

    My direct observation of patients opting for the EOLOA of California never appeared fearful but instead, appeared at peace. Almost every one of them commented upon how grateful they were to have lived a life that they were proud of and were ready to leave with no guilt upon their decision to participate with this option. They were always supported by their loved ones and made amazing plans on where and when they would choose to participate in the EOLOA. At the end of their life, it was amazing how they were now providing comfort care to those they loved just as they had been receiving from them. To me, that appeared to be a complete 180-degree turnaround as to who was caring for who and was, for me, quite inspirational.

               Find Family Hospice Care in the Wellness Village. Members since July 22, 2015. Family Hospice Care believes and promotes that each of us has the right to die comfortably in our home while receiving the necessary care to maintain dignity. 

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Updated: August 16, 2017