End of Life Care FAQs
Can patients talk with their physicians about assisted suicide?
We believe all physicians have a responsibility to discuss end-of-life
care with their patients who may be facing choices on their care. We are
committed to providing the best care to every person at every stage of life.
We respect the rights of patients and their care team to discuss and explore
all treatment options and believe those conversations are important and
confidential. As part of a discussion, patient requests for self-administered
life-ending medication may occur, but our providers do not participate
in any way in assisted suicide.
We provide all other requested end-of-life and palliative care and other
services to patients and families.
Do your providers write or fill lethal prescriptions?
No, while we respect the rights of patients and their care team to discuss
and explore all treatment options and believe those conversations are
important and confidential, our providers do not participate in any way
in assisted suicide.
Will patients’ advance directive or POLST documentation be respected?
Yes. We have long believed that everyone deserves the best possible care
at every stage of life, particularly in the final years. That’s
why we want every American to have the opportunity to plan in advance
– in consultation with their physicians – for the type of
care they wish to receive through the end of life. Advance directives
and POLST documentation for all patients are respected
What does our St. Joseph Health Mission and Values say about physician
assisted suicide or “aid in dying?
Practicing within the context of St. Joseph Health (“SJH”)
core values of Dignity, Excellence, Service and Justice ensures the provision
of respect for each person, accountability, commitment to quality, opportunities
to serve each other and a sense of community among all persons. SJH provides
end-of-life care that takes care of the physical, emotional, social and
spiritual needs of the patient and his or her family. The end-of-life
care SJH provides is grounded in the values of respecting the sacredness
of life, providing compassionate care to dying and vulnerable persons,
and respecting the integrity of health care providers. SJH believes that
compassionate, end-of-life care should neither prolong nor hasten the
natural dying process.
We are committed to providing full and appropriate support for dying persons
and their families through the final stages of life including:
1. Providing and supporting patient use of advance directives.
2. Offering palliative care, hospice and other supportive care to patients
and their families.
3. Providing effective pain and symptom management.
4. Offering a full range of social, spiritual, and pastoral care support services.
What is allowed under the End of Life Option Act in California?
The law will give terminally ill adults in California the option to end
their lives by swallowing lethal doses of physician-prescribed drugs.
For a patient to receive the drug, two doctors must confirm the patient’s
prognosis of six months or less to live and determine that the patient
is mentally competent to make informed health care decisions. The patient
must then make two oral requests 15 days apart, and one written request,
to a physician for assisted death, with witnesses to all requests.
Patients must be able to self-administer the drugs. Under this law, it
is a felony to coerce a patient into making a request or to forge such
a request. A request can only come from the patient and cannot be made
on the patient’s behalf through any means, including power of attorney,
advance health care directive, conservator, health care agent, surrogate
or any other legally recognized health care decision maker.
Will SJH physicians write or fill lethal prescriptions on SJH premises?
We encourage patients and their care team to discuss and explore all treatment
options and believe those conversations are important and confidential.
Our providers will not participate in assisted suicide if they are working
on "SJH time" or on SJH premises, which includes within our
medical foundation or in our hospitals under a contractual agreement (i.e.,
anesthesia, radiology, pathology).
A physician who has privileges at one of our hospitals but chooses to be
a "prescribing physician" on "non-SJH time" and in
their own office space at another medical office building (not SJH premises)
can do so because we have no authority/responsibility with them in that
When will this law go into effect?
It was recently announced that the law will go into effect on June 9.
What palliative and hospice care does St. Joseph Health offer?
Each of our ministries offers strong programs in the care of the dying.
These programs are called palliative care and hospice. Palliative care
is for anyone with a serious illness. You can have it at any age and any
stage of an illness, and you can have it along with curative treatment.
It is not dependent on prognosis.
At St. Joseph Health, we believe in treating the whole person – body,
mind and spirit. That means tending not just to an individual’s
physical condition, but also to their emotional and spiritual needs. Our
palliative caregivers provide compassionate care while helping patients
manage symptoms associated with chronic or life-threatening illness. The
goal is to improve quality of life for both the patient and the family.
Hospice is an important Medicare benefit that provides palliative care
for terminally ill patients who may have only months to live. People who
receive hospice are also no longer receiving curative treatment for their
At our ministries, palliative care is provided by a specially-trained team
of doctors, nurses and other specialists who work together with a patient’s
other doctors to provide an extra layer of support. It is appropriate
at any age and at any stage in a serious illness and can be provided along
with curative treatment. Palliative care treats people suffering from
serious and chronic illnesses such as cancer, cardiac disease such as
congestive heart failure (CHF),
chronic obstructive pulmonary disease (COPD), kidney failure, Alzheimer’s, Parkinson’s,
Amyotrophic Lateral Sclerosis (ALS) and many more.
Palliative care focuses on symptoms such as pain, shortness of breath,
fatigue, constipation, nausea, loss of appetite, difficulty sleeping and
depression. It also helps a person gain the strength to carry on with
daily life. It improves the ability to tolerate medical treatments. And
it helps patients have more control over care by improving their understanding
of their choices for treatment.
Are health care systems allowed to prohibit their employees from participating
in “aid in dying” on their premises?
Yes. Section 443.15 of the End of Life Options Act states the following:
Subject to subdivision (b), notwithstanding any other law, a health care
provider may prohibit its employees, independent contractors, or other
persons or entities, including other health care providers, from participating
in activities under this part while on premises owned or under the management
or direct control of that prohibiting health care provider or while acting
within the course and scope of any employment by, or contract with, the
prohibiting health care provider.
Who monitors and enforces this law?
The California Public Health Department is required to review a sample
of records annually and adopt regulations establishing reporting requirements
for physicians and pharmacists. The reporting requirements will be designed
to collect information about how this law is used while protecting the
privacy of patients and their families and medical providers.
Can the patient change his or her mind?
Yes, a patient can rescind a request at any time and in any manner. The
physician also will offer the patient an opportunity to rescind his or
her request at the end of the 15-day waiting period following the patient’s
initial oral request to participate.