For Attending Physicians
If you are a physician who is interested in learning more about how to support your patients who request medical-aid-in-dying, you have come to the right place. We offer you our gratitude and support as you explore this path for your patients. Below you will find the forms needed to comply with the law’s requirements. If you have any conflicting feelings or simply more questions, and wish to discuss these with another physician who has prescribed before, please call us at 760-636-8009. We have physicians on our Board of Directors and our Advisory Committee who are ready and willing to talk with you.
Definition of Attending Physician
According to the End of Life Option Act, “attending physician” means the physician who has primary responsibility for the health care of an individual and treatment of the individual’s terminal disease.
The Attending Physician will determine if the requesting patient is eligible to access the law, and the following points will help determine if the patient meets those qualifications.
Process
The Process for the Attending Physician:
- The Attending Physician must receive from the patient two oral requests a minimum of 48 hours apart, and a written request; two oral and one written. Telemedicine has been used for the second oral request; both should be recorded in medical record
- The Attending Physician will:
- refer the patient to a Consulting physician
- complete the Compliance form and checklist
- complete all documentation and send in required documentation
- counsel the requesting patient that they may rescind their decision at any time, even after receiving the medication
- counsel and confirm diagnosis and prognosis
- confirm patient understands result of taking aid in dying medication
- counsel the patient regarding all other possible treatments and end of life options available to them, including palliative care
- counsel patient to enroll in hospice care
- counsel patient to inform other family members, if possible
- counsel patient to have another support person available during the ingestion
- counsel patient to not ingest medication in open public space and to maintain medication in a safe place
- 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.
Timeline
Within 30 days of writing a prescription, the Attending Physician will:
- Ensure the Consulting Physician Compliance Form has been completed by the consulting physician
- Attending Physician Checklist & Compliance Form are completed.
- Ensure the forms are placed in the patient’s medical record.
- Submit copies of both the Attending and Consulting Compliance forms and the patient’s written request form to the CA Dept. of Health
Patient Eligibility
Eligibility Criteria Include:
- Is a California Resident
- Is 18 years of age
- Has a terminal illness and confirmed to have 6 months or less life expectancy
- Is making an informed decision
- Has decisional capacity to make an informed decision
- Is physically and mentally capable of ingesting aid in dying medication
- Has not demonstrated undue coercion and acted of own accord
- Has submitted and signed, the witnessed written request form
Do You Still Have Questions?
We know physicians who are ready and willing to talk with you.
Forms for Attending Physician
Attending Physician Forms Submission Instructions
Click to download document
Attending Physician's Checklist & Compliance Form
Click to download document
Attending Physician's Follow-up Form
Click to download document
Forms for Patients
aid-in-dying_request.pdf
Click to download document.
“We found your presentation very useful and informative for our situation. My husband was diagnosed with glioblastoma a few months ago. And we will pursue it with his doctors.” J. and S.
