End of Life Option Act: Resources and Materials

Below you will find detailed information on required End of Life Option Act forms, step-by-step guidelines for patients and healthcare providers, and general background information on the Act itself. For a broad overview of the Act and its implementation at UCLA, please visit: Introduction to California End of Life Option Act.

General Materials
Presentation on the End of Life Option Act at UCLA

• Video presentation and roundtable on implementation of the End of Life Option Act at UCLA

• Text of the End of Life Option Act

• Guidance and information regarding the End of Life Option Act from the California Medical Association

• Guidance from the California Hospital Association

• A comparative analysis of statewide aid-in-dying laws by UCLA Center for Health Policy Research

• UCLA Health policy on implementation of the California End of Life Option Act

State Documents
Documents may also be found on the Medical Board of California website.

• Official form for patient to request aid-in-dying drug from one’s attending physician

• Official form for patient to attest plan to ingest the aid-in-dying drug within 48 hours

• Official form for attending physician to ensure compliance in prescribing the aid-in-dying drug

• Official form for consulting physician to ensure compliance in prescribing the aid-in-dying drug

• Official form that attending physician completes after the patient’s death

• Official form for interpreter to sign after helping patient complete the aid-in-dying drug request

UCLA Patient Materials
Introductory, explanatory and guiding materials were developed by the clinical consultants team under the direction of Anne Coscarelli, PhD, of the Simms/Mann–UCLA Center for Integrative Oncology.

• Context and introduction to how the End of Life Option Act is implemented at UCLA Health

• An introduction to the End of Life Option Act for the person contemplating participation and the role of the clinical consultant

• Assistance in thinking about end-of-life care choices and its implications when thinking about end of life or aid-in-dying as one option

• Resources, ranging from transportation to hospice, for the patient or family facing end of life care

• An introduction and step-by-step guide to the End of Life Option Act for patients

• Practical information and guidance for loved ones and caregivers about being with a dying person

• Personal preparation for the experience of dying

• Important things to do or discuss when preparing for end of life that may benefit patient and family

• Safe Drug Drop-Off program’s sheriff station locations in the Los Angeles Area

• Guidance on creating a written legacy, a valuable resource that may comfort and guide children and others you care about in the future

UCLA Physician Materials
Physician Information Guide

• An introduction and step-by-step guide to UCLA implementation of the End of Life Option Act for physicians and other clinicians

• Checklist of steps for physicians and patients to complete for receipt of an aid-in-dying drug

• Informed consent form for patient to sign before aid-in-dying drug prescription is sent to the pharmacy

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