This page provides information on California's End of Life Option Act (EOLOA) and specific guidelines for UCSF patients.
What is the End of Life Option Act (EOLOA)?
The End of Life Option Act (PDF) is a California law that went into effect on June 9, 2016, and was updated on January 1, 2022. The law allows individuals who have a serious, life-limiting illness (with a prognosis of six months or less) to request prescription medications from their doctor to end their life. This practice is also known as medical aid in dying (MAID).
Participation in the act is voluntary for UCSF patients, doctors and staff.
Who is eligible to pursue EOLOA?
In order to qualify, a UCSF patient must meet the following criteria:
- Be at least 18 years old
- Have the capacity to make medical decisions
- Reside in the state of California
- Have a diagnosis of a serious, life-limiting illness with a prognosis of six months or less (as estimated by two doctors)
- Be able to self-administer aid-in-dying medications via mouth, rectum or feeding tube
What are the steps of the EOLOA process?
- If you think you might be interested in pursuing EOLOA, please talk to a doctor on your medical team as soon as possible, even if you're not certain. Many patients wait until they become very sick or are already enrolled in hospice to discuss the topic, and this can make it much more challenging to access an aid-in-dying prescription. Completing this process can take two to four weeks, so it's important to allow ample time for each step.
- Your doctor can provide more information about the EOLOA process and talk with you about your eligibility. If your doctor doesn't participate in EOLOA, your request will be documented and you'll be referred to a participating provider.
- Once you have identified a doctor who is willing to prescribe EOLOA medications for you (often called your attending or prescribing physician), you need to make two verbal requests for these medications from your doctor. These requests need to occur directly from you to your doctor. No one else can be in the room or present at the telehealth visit at the time of these requests. A waiting period of at least 48 hours must separate the requests.
- In addition to meeting with your prescribing doctor, you'll be referred to a consulting doctor who will confirm your eligibility for and your wish to proceed with EOLOA.
- Your prescribing doctor may choose to refer you for a single mental health evaluation to ensure that emotional distress isn't impairing your capacity to make a clear and thoughtful decision. This referral is based on your medical history, the doctor's clinical judgment and standard screening tools.
- You'll complete an aid-in-dying request form (PDF) from the Medical Board of California declaring your wish to pursue EOLOA, which needs to be signed by you and two witnesses, then sent to your doctor.
- Once your eligibility has been confirmed and you have completed the oral requests, your prescribing doctor will work with you to prescribe the medications if and when it is appropriate and you choose to move forward. For safety reasons, your doctor will typically prescribe the medications within one to two weeks of your potential date of administration. We encourage ongoing close communication among you, your loved ones and your doctor as the date approaches.
- We strongly recommend enrolling in hospice before ingesting your EOLOA medications to ensure you and your loved ones are well supported during this time. Your doctor can facilitate this referral when the time is right for you.
