Assisted dying law improves California’s end-of-life care
Physicians across California say that since the introduction of the End Of Life Option Act 2016 conversations that health workers are having with patients are leading to patients’ fears and needs around dying being addressed better than ever before. They say the law has improved medical care for sick patients, even those who don’t take choose an assisted death. Sometimes doctors end up adjusting patients’ medicines or treatments because patients hadn’t before expressed how much pain they were in. Some patients decide to go on hospice earlier than they would have otherwise.
“I think what this new law has done, it’s really a reminder we need to do a much better job with caring for people through the end of life,” said said Lori Dangberg, vice president of the Alliance of Catholic Health Care in California.
Doctors have sometimes struggled to talk about dying with patients. According to a 2015 Kaiser Family Foundation survey , 89% people believe doctors should discuss end-of-life care with patients, but only 17% had had such a conversation with their health care provider. But now, physicians say patients are curious about the law and asking about it, which provides them an opportunity to have these frank discussions. “Not everyone who’s talking about this is saying, ‘I want this medication.’ They’re saying, ‘I’m suffering’ or ‘I’m worried about suffering’ and that becomes the conversation starter … and it might not come up in any other way,” said Anne Coscarelli, clinical psychologist and director of Simms/Mann-UCLA Center for Integrative Oncology
The experience in California in the first year of operation of the End Of Life Option Act 2016, mirrors reports from Oregon, where the Death With Dignity Act 1997 lead to improvements in end-of-life care. Oregon is now the best state in which to die, according to a study ‘Lessons from Oregon in Embracing Complexity in End-of-Life Care’ published in the New England Journal of Medicine on 16 March 2017. This message was also given by Dr Leigh Dolin, past President of the Oregon Medical Association, who has recently met with NSW MPs to speak to them about the experience in Oregon over the last two decades – click for short videos of Dr Leigh Dolin 11 August 2017.
Meanwhile the first formal report on the operation of the Californian End Of Life Option Act 2016 has verified that the law is being used sparingly, with assisted deaths under the Act representing 0.06 percent of all deaths in the state. No issues were reported with the use of the law and the conclusion was made that California’s new assisted dying law is working as intended, providing peace of mind, comfort, and control at the end of life to dying Californians. Click for more details