End of Life Option Act: Resources & Materials

The End of Life Option Act at UCLA

People come to UCLA for innovative treatments for advanced disease. The more advanced the illness, the greater the importance of ensuring that patients’ goals guide the treatments they receive. This ensures that the most intensive treatments aim to achieve an outcome the patient desires, and it also means nimble re-orientation toward comfort-oriented treatment if the prognosis worsens and focus sets on a different set of goals. This requires in-depth, deliberate conversations between patients and their physicians. These conversations must include the possibility of aiming for comfort, palliative care and the value of hospice. For patients receiving intensive treatments for advanced illness, as well as for those focusing on comfort, UCLA aims to enhance the experience of patients and families toward the end of life. This means exploring meaning, coming together and making the most of this final phase.

For some patients, having a terminal condition means wanting to take control. At times, symptoms or suffering might become overwhelming. UCLA Health aims to ensure that symptom management and supportive care are always a priority, although we realize that in rare cases medicine’s ability to control suffering might be overmatched. Under these unusual circumstances, the End of Life Option Act permits a willing physician to respond to an eligible patient’s request with a prescription for an aid-in-dying medication.

At UCLA, our process also includes a clinical consultant who works to fulfill the patient’s request while at the same time ensuring that UCLA is providing the best possible treatment and affording the patient maximal support for the best experience at the end of life.

If you are a UCLA patient, ask your physician about your treatment options. Your UCLA physician is dedicated to making sure that your treatment matches your goals. If you have questions, you also can call the Simms/Mann–UCLA Center for Integrative Oncology at 310-794-6644 or you may call UCLA Care Coordination at 310-267-9702 and indicate your interest in the End of Life Option Act.

Below you will find detailed information on required End of Life Option Act forms, step-by-step guidelines for patients and healthcare providers, and general background information on the Act itself. For a broad overview of the Act and its implementation at UCLA, please visit: Introduction to California End of Life Option Act page.

In this section: General Materials | State Documents | UCLA Patient Materials

General Materials

• AB-15 End of life
  Text of the End of Life Option Act

• CMA On-Call: California End of Life Option Act
  Guidance and information regarding the End of Life Option Act from the California Medical Association

• California Hospital Association: End of Life Option Act
  Guidance from the California Hospital Association

• Implementing Aid in Dying in California: Experiences from Other States Indicates the Need for Strong Implementation Guidance”
  A comparative analysis of statewide aid-in-dying laws by UCLA Center for Health Policy Research

• HS 1490: The California End of Life Option Act
  UCLA Health policy on implementation of the California End of Life Option Act

State Documents

Documents may also be found on the Medical Board of California website.

• Request for an Aid-in-Dying Drug to End My Life in a Humane and Dignified Manner form
  Official form for patient to request aid-in-dying drug from one’s attending physician

• Final Attestation for an Aid-in-Dying Drug to End My Life in a Humane and Dignified Manner form
  Official form for patient to attest plan to ingest the aid-in-dying drug within 48 hours

• Attending Physician Checklist and Compliance form
  Official form for attending physician to ensure compliance in prescribing the aid-in-dying drug

• Consulting Physician Compliance form
  Official form for consulting physician to ensure compliance in prescribing the aid-in-dying drug

• Attending Physician Follow-Up form
  Official form that attending physician completes after the patient’s death

• Request for an Aid-in-Dying Interpreter Declaration form
  Official form for interpreter to sign after helping patient complete the aid-in-dying drug request

UCLA Patient Materials

Introductory, explanatory and guiding materials were developed by the clinical consultants team under the direction of Anne Coscarelli, PhD, of the Simms/Mann–UCLA Center for Integrative Oncology.

• Introduction to the End of Life Option Act
  Context and introduction to how the End of Life Option Act is implemented at UCLA Health

• California End of Life Option Act: Information for Our UCLA Patients
  An introduction to the End of Life Option Act for the person contemplating participation and the role of the clinical consultant

• Aid-in-dying Options: Finding One’s Way to Clarity
  Assistance in thinking about end-of-life care choices and its implications when thinking about end of life or aid-in-dying as one option

• End of Life Resource List
  Resources, ranging from transportation to hospice, for the patient or family facing end of life care

• California End of Life Option Act: Information, Suggestions and Options for Patients
  An introduction and step-by-step guide to the End of Life Option Act for patients

• Preparing for Death: Guidelines for Your Family, Loved Ones or Caregivers
  Practical information and guidance for loved ones and caregivers about being with a dying person

• Preparing for Your Own Death: Instructions and Essential Information
  Personal preparation for the experience of dying

• Preparing for Your Own Death: Personal Checklist
  Important things to do or discuss when preparing for end of life that may benefit patient and family

• Safe Drug Drop-Off Locations
  Safe Drug Drop-Off program’s sheriff station locations in the Los Angeles Area

• Written Legacies: A Valuable Gift for Those You Love
  Guidance on creating a written legacy, a valuable resource that may comfort and guide children and others you care about in the future