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Talking to your Doctor about MAID

When your plans include California’s End of Life Option Act

 

Medical aid in dying is a legal end-of-life option in 11 US states and jurisdictions, including California. Aid in dying has been available to Californians since 2016 via the California End of Life Option Act (ELOA).

Talking to your doctor

Medical aid in dying is a sensitive and personal topic. While I am not currently facing a terminal condition, I take comfort in knowing medical aid in dying would be available if I needed it in the future. Some of you may be in a similar situation. However, others of you may be nearing the end of life with a life expectancy of less than six months.  

If you qualify for the ELOA, these are crucial first steps:

Be specific when talking with your doctor.  

While prescribing aid in dying is legal in California, not all doctors choose to participate. So it’s necessary to confirm whether your doctor supports medical aid in dying. A direct and concise question like: “Will you prescribe medical aid in dying for me using California’s End of Life Option Act?” makes your request unambiguous. You may also choose to first acknowledge all that your doctor has done to extend your life, using a statement like: “I appreciate all the support you’ve given me; yet I’ve made peace with understanding my death is nearing and need to ask one more thing of you . . .” 

Ensure your request is documented in your medical record.

Communicating your request to receive aid in dying is a key requirement of the ELOA. So even if your doctor declines to prescribe such aid, following up with an ask that your request be written down and noted is recommended. (A recent court challenge to the ELOA removed the requirement for doctors to document the request.) If your doctor declines and does not offer a referral, you may reach out to End of Life Choices California and a volunteer can direct you to nearby providers known to support aid in dying. When your doctor accepts your request, and documents it, there’s often an opportunity for a heartfelt conversation about what this means for you. 

For those of you who would want access to medical aid in dying if needed in the future, firstly, ensure you have completed an Advance Directive. In addition, talking with your doctor to express your wishes remains key. 

These are important first steps: 

* Schedule a doctor’s appointment specifically for an end-of-life planning discussion.

Physicians often get behind schedule and can seem rushed. Thus getting an appointment just for an end-of-life planning discussion is a good strategy. When scheduling, you can specify your planned topic, or simply make it a general check-in. (If you use Medicare, your doctor will be reimbursed specifically for an end-of-life planning discussion.) 

* Avoid generalities and use specific language.

Relaying your awareness and understanding of California’s ELOA is a great way to start the conversation. Then staying focused with a direct question like: “If I ever had a terminal diagnosis and was eligible for medical aid in dying, and I asked you to prescribe the medication for me, would you do so?” will bring clarity. 

Being direct about a sensitive and personal topic like aid in dying can be intimidating. But the more clearly you express yourself, the more likely your doctor is to really “hear you” and understand not only your request, but also your priorities and values. 

Refer to this material on our website for additional information about the ELOA and medical aid in dying or call and ask for a volunteer to assist you.       

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Becky Oliver is a volunteer with EOLCCA.  Her professional life has been spent as part of Silicon Valley’s tech industry.  Outside of work, her personal passions include contributing to end-of-life causes, with a specific interest in the nature of care for the aging and those nearing end of life.  

EOLCCA supports a strong team of experienced volunteers throughout the state, ready to help anyone, anywhere in California with information and support regarding all end-of-life planning and choices, including aid in dying through the California End of Life Option Act.  Please find comprehensive information on our user-friendly website at www.endoflifechoicesca.org. To support our work, please visit www.endoflifechoicesca.org/ways-to-help/.  Thank you.

 

On COVID-19, Flexibility and Compassion

We share this thoughtful blog by EOLCCA Board member Fran Johns, a prolific thinker and writer. While much has changed in the mere 11 days since she wrote this piece, we wanted to share her calming perspective as we go about the hard work of isolating ourselves physically from our normal way of living.  This is also a gentle reminder to all, that EOLCCA volunteers stand ready and available to continue responding to terminally ill individuals and their families seeking information and support to determine their own end of life choices even as this pandemic has altered so much in our daily lives.  Many of those whom we can continue to help during this pandemic are suffering from unrelated end stage cancer and neurodegenerative diagnoses with a 6 months prognosis and need our help now. 

We can be reached at 760-636-8009 or email info@endoflifechoicesca.org. We are here for you.

 

I don’t know about your neighborhood, but Covid-19 is making life interesting here in the San Francisco Bay Area. Difficult for many, devastating for some, and interesting for the rest of us. As of this writing (I recommend the CDC site for accurate data on other areas, other updates) we have sped past the first hundred confirmed cases in the state, and who knows how many of the 10,000+ Californians in self-quarantine are also my Bay Area neighbors.

This little virus brings with it a large bunch of life lessons. Some of them are shared here, as a public service.

First off (I hate to bring politics ever into this space, but what can you do?) if you ever believed anything said by our commander in chief, this is a good time to mend your ways. Covid-19 is not a Democrat hoax, it is not going to disappear in a short time, you really shouldn’t go to work if you’re sick, a vaccine is at best many months away, and good luck finding those test kits that anybody who wants can get. This is only a life lesson in the sense that, in today’s crazy information-overload reality, Truth is hard to find. So, Life Lesson #1: Seek Truth. Read several newspapers if you still read news. Otherwise, visit the CDC site and scroll through more than one mainstream news source, please; do not believe Facebook will give you Truth. Watch PBS and occasionally Fox News; if one disseminates truth, the other reinforces your neighbor’s version of truth – and we’re all in this together.    Covid-19 greenie

Other life lessons are happier, and equally easy to learn. For instance, at my church we very quickly learned to replace hugs and handshakes with fist bumps and peace signs. Not as much fun, but whatever. The ushers are equipped with bulletins and hand-sanitizer. Choir members last Sunday spaced themselves three feet apart, which looked rather elegant – but they sounded the same, i.e. gorgeous. We also learned translations of the word Covid into Hebrew and Yiddish, which I have already forgotten, and which doesn’t matter anyway since the name was chosen by the World Health Organization thusly: Co and Vi come from coronavirus, D stands for disease and 19 (as in 2019) = the year the first cases were seen. To connect all this: I belong to a Presbyterian church that is heavy into hugs, scientific truth and interfaith understanding.

As to flexibility, this viral pandemic is teaching us, wisely, not to be so rigid about stuff. I was dismayed when the San Francisco Symphony cancelled a concert on my regular series that I really wanted to hear; and the political roundtable at the Commonwealth Club, a favorite regular program at which I always volunteer, similarly disappeared. But symphony season will resume in good time, and do we really need to talk politics late into the evening when it invariably produces nightmares? Sleep is better. That long-planned trip to Tucson in a couple of weeks? Probably not the wisest thing for my octogenarian cardiovascular system. Purpose of trip, however, was to join my daughter for a visit with a childhood friend of hers (whose mother, lost to cancer decades ago, was a good friend of mine) – and they can definitely have a ball without me.

So take deep breaths and wash your hands. We and the planet will survive in good time.

Moon & clouds