California law provides individuals the ability to ensure that their health care wishes are known and considered if they become unable to make these decisions themselves.
The California Medical Association (CMA) encourages Californians to think and talk with loved ones about their wishes for end-of-life medical care before a serious illness or injury occurs. CMA has developed a number of guidelines, forms, and other resources to assist providers, patients, and loved ones with making important end-of-life decisions.
California’s End Of Life Option Act
On October 5, 2015, California became the fifth state in the nation to allow physicians to prescribe terminally ill patients medication to end their lives. ABX2-15, the "End of Life Option Act," permits terminally ill adult patients with capacity to make medical decisions to be prescribed an aid-in-dying medication if certain conditions are met. The following document discusses the requirements under the End of Life Option Act, which went into effect June 9, 2016:
Advance Health Care Directive
In California, advance directives are the legally recognized format for “living wills.” An advance directive enables individuals to make sure that their health care wishes are known in advance and considered if for any reason they are unable to speak for themselves. Advance directives also allow patients to appoint a health care "agent" who will have legal authority to make health care decisions in the event that the patient is incapacitated, or immediately upon appointment if the patient expressly grants such authority.
See below for more information about advance directives, or to purchase CMA's Advance Health Care Directive Toolkit, available in English and Spanish:
Physician Orders for Life-Sustaining Treatment
Physician Orders for Life Sustaining Treatment (POLST) is a legally recognized document, similar to the widely used “do not resuscitate” (DNR) orders. The POLST form, used for patients with a serious illness or whose life expectancy is a year or less, outlines a plan of care reflecting the patient’s wishes concerning medical treatment and interventions at life’s end. The POLST form complements an advance directive by turning a patient’s treatment preferences into actionable medical orders.
See below for more information about POLST, or to purchase CMA's POLST toolkit, available in English and Spanish:
Do Not Resuscitate (DNR) Form
The Pre-Hospital DNR form, developed by the California Emergency Medical Services in conjunction with the California Medical Association, instructs EMS personnel to forgo resuscitation attempts in the event of a patient's cardiopulmonary arrest. Below you will find CMA resources that include additional details about DNR requests and purchasing information for the DNR form in English and Spanish.
Other Resources
CMA's Health Law Library
Updated annually, CMA's online health law library contains nearly 5000 pages of valuable information for physicians and their staff. The CMA Center for Legal Affairs has developed several On-Call documents on important end-of-life issues in the medical practice. Access to the library is FREE to members. Nonmembers can purchase documents for $2 per page.
Additional Resources
For more information about end-of-life medical decisions, visit the Coalition for Compassionate Care of California (CCCC) website.
CCCC also provides end-of-life resources for health care providers including decision guides, palliative care tools and resources for physicians.