Majority of EOLOA Applicants Choose Death

A new study shows that three quarters of terminally ill adults in California qualified to receive End of Life Option Act (EOLOA) drugs ingest them and die.

In a new research letter, investigators at Kaiser Permanente School of Medicine (Pasadena, CA, USA) and Kaiser Permanente Southern California (Pasadena, USA) described how Kaiser Permanente dealt with the first year of implementation of EOLOA, providing outcomes and characteristics of 379 individuals who initiated the EOLOA process. The most common reasons cited for pursuing EOLOA were not wanting to suffer and no longer being able to participate in activities that made life enjoyable.

Of the 379 patients initiated an inquiry through June 30, 2017, 176 were deemed eligible, with 55% of the patients suffering impairment in activities of daily living and receiving palliative care, or were staying at a hospice at the time of their inquiry. Most of the patients suffered from cancer, and in the previous 12 months had received care mainly from specialists. In all, 74% of the patients who received the EOLOA drugs ingested them and died within a median of nine days after receiving the prescription. The study research letter was published on December 26, 2017, in JAMA Internal Medicine.

“The California End of Life Option Act, which took effect on June 9, 2016, allows qualified adults diagnosed with a terminal disease to request aid-in-dying drugs from their physician,” concluded lead author Huong Nguyen, PhD, and colleagues. “Patients' end-of-life concerns appear difficult to palliate, with the most common cited reasons for pursuing EOLOA being existential suffering, inability to enjoy life, and loss of autonomy.”

California is the fifth state in the United States to enact an aid-in-dying law. To be eligible, an individual must be an adult, a California resident, have a diagnosis from a primary physician of an incurable and irreversible disease which will, within reasonable medical judgment, result in death within six months. Petitioners must be confirmed to be able to make medical decisions for themselves, voluntarily request the aid-in-dying drug without influence from others, and be able to self-administer the drug. Requests must be made solely and directly by the patient to the attending physician, and cannot be made through a power of attorney, health care agent, or any other legally recognized health care decision maker.

Related Links:
Kaiser Permanente School of Medicine
Kaiser Permanente Southern California