California Health and Safety Code 443.5 – (a) Before prescribing an aid-in-dying drug, the attending …
(a) Before prescribing an aid-in-dying drug, the attending physician shall do all of the following:
(1) Make the initial determination of all of the following:
Terms Used In California Health and Safety Code 443.5
- Adult: means an individual 18 years of age or older. See California Health and Safety Code 443.1
- Aid-in-dying drug: means a drug determined and prescribed by a physician for a qualified individual, which the qualified individual may choose to self-administer to bring about their death due to a terminal disease. See California Health and Safety Code 443.1
- Attending physician: means the physician who has primary responsibility for the health care of an individual and treatment of the individual's terminal disease. See California Health and Safety Code 443.1
- Attending physician checklist and compliance form: means a form, as described in Section 443. See California Health and Safety Code 443.1
- Capacity to make medical decisions: means that, in the opinion of an individual's attending physician, consulting physician, psychiatrist, or psychologist, pursuant to §. See California Health and Safety Code 443.1
- Consulting physician: means a physician who is independent from the attending physician and who is qualified by specialty or experience to make a professional diagnosis and prognosis regarding an individual's terminal disease. See California Health and Safety Code 443.1
- Department: means the State Department of Public Health. See California Health and Safety Code 443.1
- Informed decision: means a decision by an individual with a terminal disease to request and obtain a prescription for a drug that the individual may self-administer to end the individual's life, that is based on an understanding and acknowledgment of the relevant facts, and that is made after being fully informed by the attending physician of all of the following:
California Health and Safety Code 443.1
- Mental health specialist: means a psychiatrist or a licensed psychologist. See California Health and Safety Code 443.1
- Mental health specialist assessment: means one or more consultations between an individual and a mental health specialist for the purpose of determining that the individual has the capacity to make medical decisions and is not suffering from impaired judgment due to a mental disorder. See California Health and Safety Code 443.1
- Person: means any person, firm, association, organization, partnership, business trust, corporation, limited liability company, or company. See California Health and Safety Code 19
- Physician: means a doctor of medicine or osteopathy currently licensed to practice medicine in this state. See California Health and Safety Code 443.1
- Public place: means any street, alley, park, public building, any place of business or assembly open to or frequented by the public, and any other place that is open to the public view, or to which the public has access. See California Health and Safety Code 443.1
- Qualified individual: means an adult who has the capacity to make medical decisions, is a resident of California, and has satisfied the requirements of this part in order to obtain a prescription for a drug to end their life. See California Health and Safety Code 443.1
- State: means the State of California, unless applied to the different parts of the United States. See California Health and Safety Code 23
- Terminal disease: means an incurable and irreversible disease that has been medically confirmed and will, within reasonable medical judgment, result in death within six months. See California Health and Safety Code 443.1
(A) (i) Whether the requesting adult has the capacity to make medical decisions.
(ii) If there are indications of a mental disorder, the physician shall refer the individual for a mental health specialist assessment.
(iii) If a mental health specialist assessment referral is made, no aid-in-dying drugs shall be prescribed until the mental health specialist determines that the individual has the capacity to make medical decisions and is not suffering from impaired judgment due to a mental disorder.
(B) Whether the requesting adult has a terminal disease.
(C) Whether the requesting adult has voluntarily made the request for an aid-in-dying drug pursuant to Sections 443.2 and 443.3.
(D) Whether the requesting adult is a qualified individual pursuant to subdivision (q) of Section 443.1.
(2) Confirm that the individual is making an informed decision by discussing with them all of the following:
(A) Their medical diagnosis and prognosis.
(B) The potential risks associated with ingesting the requested aid-in-dying drug.
(C) The probable result of ingesting the aid-in-dying drug.
(D) The possibility that they may choose to obtain the aid-in-dying drug but not take it.
(E) The feasible alternatives or additional treatment options, including, but not limited to, comfort care, hospice care, palliative care, and pain control.
(3) Refer the individual to a consulting physician for medical confirmation of the diagnosis and prognosis, and for a determination that the individual has the capacity to make medical decisions and has complied with the provisions of this part.
(4) Confirm that the qualified individual’s request does not arise from coercion or undue influence by another person by discussing with the qualified individual, outside of the presence of any other persons, except for an interpreter as required pursuant to this part, whether or not the qualified individual is feeling coerced or unduly influenced by another person.
(5) Counsel the qualified individual about the importance of all of the following:
(A) Having another person present when they ingest the aid-in-dying drug prescribed pursuant to this part.
(B) Not ingesting the aid-in-dying drug in a public place.
(C) Notifying the next of kin of their request for an aid-in-dying drug. A qualified individual who declines or is unable to notify next of kin shall not have their request denied for that reason.
(D) Participating in a hospice program.
(E) Maintaining the aid-in-dying drug in a safe and secure location until the time that the qualified individual will ingest it.
(6) Inform the individual that they may withdraw or rescind the request for an aid-in-dying drug at any time and in any manner.
(7) Offer the individual an opportunity to withdraw or rescind the request for an aid-in-dying drug before prescribing the aid-in-dying drug.
(8) Verify, immediately before writing the prescription for an aid-in-dying drug, that the qualified individual is making an informed decision.
(9) Confirm that all requirements are met and all appropriate steps are carried out in accordance with this part before writing a prescription for an aid-in-dying drug.
(10) Fulfill the record documentation required under Sections 443.8 and 443.19.
(11) Complete the attending physician checklist and compliance form, as described in Section 443.22, include it and the consulting physician compliance form in the individual’s medical record, and submit both forms to the State Department of Public Health.
(b) If the conditions set forth in subdivision (a) are satisfied, the attending physician may deliver the aid-in-dying drug in any of the following ways:
(1) Dispensing the aid-in-dying drug directly, including ancillary medication intended to minimize the qualified individual’s discomfort, if the attending physician meets all of the following criteria:
(A) Is authorized to dispense medicine under California law.
(B) Has a current United States Drug Enforcement Administration (USDEA) certificate.
(C) Complies with any applicable administrative rule or regulation.
(2) With the qualified individual’s written consent, contacting a pharmacist, informing the pharmacist of the prescriptions, and delivering the written prescriptions personally, by mail, or electronically to the pharmacist, who may dispense the drug to the qualified individual, the attending physician, or a person expressly designated by the qualified individual and with the designation delivered to the pharmacist in writing or verbally.
(c) Delivery of the dispensed drug to the qualified individual, the attending physician, or a person expressly designated by the qualified individual may be made by personal delivery, or, with a signature required on delivery, by United Parcel Service, United States Postal Service, FedEx, or by messenger service.
(Amended by Stats. 2021, Ch. 542, Sec. 4. (SB 380) Effective January 1, 2022. Repealed as of January 1, 2031, pursuant to Section 443.215.)