I was leafing through a patient's chart last year when a colleague tapped me on the shoulder. "I have a patient who is asking about the End of Life Option Act," he said in a low voice. "Can we even do that here?"
I practice both critical and palliative care medicine at a public hospital in Oakland. In June 2016, our state became the fourth in the nation to allow medical aid in dying for patients suffering from terminal illness. Oregon was the pioneer 20 years ago. Washington and Vermont followed suit more recently. (Colorado voters passed a similar law in November.) Now, five months after the law took effect here in California, I was facing my first request for assistance to shorten the life of a patient.
That week, I was the attending physician on the palliative care service. Since palliative care medicine focuses on the treatment of all forms of suffering in serious illness, my colleague assumed that I would know what to do with this request. I didn't.
I could see my own discomfort mirrored in his face. "Can you help us with it?" he asked me. "Of course," I said. Then I felt my stomach lurch.
California's law permits physicians to prescribe a lethal cocktail to patients who request it and meet certain criteria: They must be adults expected to die within six months who are able to self-administer the drug and retain the mental capacity to make a decision like this.