Physician-Assisted Suicide Has Been Legal in California for a Year. How's it Going?
Bay Area Cancer Patient Confronts and Embraces His Right to Die
Terminally Ill San Diego Woman Plans To Take Advantage Of Aid-In-Dying Law
California’s Aid-in-Dying Law Takes Effect Today -- Here's What You Need to Know
Berkeley Physician Opens Practice Focusing on Aid-in-Dying
Pharmaceutical Companies Hiked Price on Aid in Dying Drug
California's 'Physician-Assisted Suicide' Law To Take Effect in June
Campaign to Repeal California’s ‘Right to Die’ Law Falls Short
Assisted-Death Laws Accentuate Need for Palliative Care, Doctors Say
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She specializes in covering altered states of mind, from postpartum depression to methamphetamine-induced psychosis to the insanity defense. Her investigative series on insurance companies sidestepping mental health laws won multiple awards, including first place in beat reporting from the national Association of Health Care Journalists. She is the recipient of numerous other prizes and fellowships, including a national Edward R. Murrow award for investigative reporting, a Society of Professional Journalists award for long-form storytelling, and a Carter Center Fellowship for Mental Health Journalism.\r\n\r\nDembosky reported and produced \u003cem>Soundtrack of Silence\u003c/em>, an audio documentary about music and memory that is currently being made into a feature film by Paramount Pictures.\r\n\r\nBefore joining KQED in 2013, Dembosky covered technology and Silicon Valley for \u003cem>The Financial Times of London,\u003c/em> and contributed business and arts stories to \u003cem>Marketplace \u003c/em>and \u003cem>The New York Times.\u003c/em> She got her undergraduate degree in philosophy from Smith College and her master's in journalism from the University of California, Berkeley. She is a classically trained violinist and proud alum of the first symphony orchestra at Burning Man.","avatar":"https://secure.gravatar.com/avatar/ef92999be4ceb9ea60701e7dc276f813?s=600&d=blank&r=g","twitter":"adembosky","facebook":null,"instagram":null,"linkedin":null,"sites":[{"site":"arts","roles":["author"]},{"site":"news","roles":["editor"]},{"site":"futureofyou","roles":["author"]},{"site":"stateofhealth","roles":["editor"]},{"site":"science","roles":["editor"]},{"site":"forum","roles":["editor"]}],"headData":{"title":"April Dembosky | KQED","description":"KQED Health Correspondent","ogImgSrc":"https://secure.gravatar.com/avatar/ef92999be4ceb9ea60701e7dc276f813?s=600&d=blank&r=g","twImgSrc":"https://secure.gravatar.com/avatar/ef92999be4ceb9ea60701e7dc276f813?s=600&d=blank&r=g"},"isLoading":false,"link":"/author/adembosky"},"state-of-health":{"type":"authors","id":"8344","meta":{"index":"authors_1591205172","id":"8344","found":true},"name":"State of Health","firstName":"State of Health","lastName":null,"slug":"state-of-health","email":"stateofhealth@kqed.org","display_author_email":false,"staff_mastheads":[],"title":null,"bio":null,"avatar":"https://secure.gravatar.com/avatar/66de4bf6d331fa7402bba1ffe8135e17?s=600&d=blank&r=g","twitter":null,"facebook":null,"instagram":null,"linkedin":null,"sites":[{"site":"arts","roles":["author"]},{"site":"stateofhealth","roles":["editor"]}],"headData":{"title":"State of Health | KQED","description":null,"ogImgSrc":"https://secure.gravatar.com/avatar/66de4bf6d331fa7402bba1ffe8135e17?s=600&d=blank&r=g","twImgSrc":"https://secure.gravatar.com/avatar/66de4bf6d331fa7402bba1ffe8135e17?s=600&d=blank&r=g"},"isLoading":false,"link":"/author/state-of-health"}},"breakingNewsReducer":{},"campaignFinanceReducer":{},"firebase":{"requesting":{},"requested":{},"timestamps":{},"data":{},"ordered":{},"auth":{"isLoaded":false,"isEmpty":true},"authError":null,"profile":{"isLoaded":false,"isEmpty":true},"listeners":{"byId":{},"allIds":[]},"isInitializing":false,"errors":[]},"navBarReducer":{"navBarId":"home","fullView":true,"showPlayer":false},"navMenuReducer":{"menus":[{"key":"menu1","items":[{"name":"News","link":"/","type":"title"},{"name":"Politics","link":"/politics"},{"name":"Science","link":"/science"},{"name":"Education","link":"/educationnews"},{"name":"Housing","link":"/housing"},{"name":"Immigration","link":"/immigration"},{"name":"Criminal Justice","link":"/criminaljustice"},{"name":"Silicon Valley","link":"/siliconvalley"},{"name":"Forum","link":"/forum"},{"name":"The California Report","link":"/californiareport"}]},{"key":"menu2","items":[{"name":"Arts & Culture","link":"/arts","type":"title"},{"name":"Critics’ Picks","link":"/thedolist"},{"name":"Cultural Commentary","link":"/artscommentary"},{"name":"Food & Drink","link":"/food"},{"name":"Bay Area Hip-Hop","link":"/bayareahiphop"},{"name":"Rebel Girls","link":"/rebelgirls"},{"name":"Arts Video","link":"/artsvideos"}]},{"key":"menu3","items":[{"name":"Podcasts","link":"/podcasts","type":"title"},{"name":"Bay Curious","link":"/podcasts/baycurious"},{"name":"Rightnowish","link":"/podcasts/rightnowish"},{"name":"The Bay","link":"/podcasts/thebay"},{"name":"On Our Watch","link":"/podcasts/onourwatch"},{"name":"Mindshift","link":"/podcasts/mindshift"},{"name":"Consider This","link":"/podcasts/considerthis"},{"name":"Political Breakdown","link":"/podcasts/politicalbreakdown"}]},{"key":"menu4","items":[{"name":"Live Radio","link":"/radio","type":"title"},{"name":"TV","link":"/tv","type":"title"},{"name":"Events","link":"/events","type":"title"},{"name":"For Educators","link":"/education","type":"title"},{"name":"Support KQED","link":"/support","type":"title"},{"name":"About","link":"/about","type":"title"},{"name":"Help Center","link":"https://kqed-helpcenter.kqed.org/s","type":"title"}]}]},"pagesReducer":{},"postsReducer":{"stream_live":{"type":"live","id":"stream_live","audioUrl":"https://streams.kqed.org/kqedradio","title":"Live Stream","excerpt":"Live Stream information currently unavailable.","link":"/radio","featImg":"","label":{"name":"KQED Live","link":"/"}},"stream_kqedNewscast":{"type":"posts","id":"stream_kqedNewscast","audioUrl":"https://www.kqed.org/.stream/anon/radio/RDnews/newscast.mp3?_=1","title":"KQED Newscast","featImg":"","label":{"name":"88.5 FM","link":"/"}},"stateofhealth_339498":{"type":"posts","id":"stateofhealth_339498","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"339498","score":null,"sort":[1496869257000]},"guestAuthors":[],"slug":"physician-assisted-suicide-has-been-legal-in-california-for-a-year-hows-it-going","title":"Physician-Assisted Suicide Has Been Legal in California for a Year. How's it Going?","publishDate":1496869257,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>John Minor, a retired psychologist, epitomized the active Californian. A resident of Manhattan Beach, Minor ran long distances, bicycled, and hiked.\u003c/p>\n\u003cp>“He and my mom were both members of the Sierra Club,” said Jackie Minor of San Mateo, one of his daughters. \"They went on tons of backpacking trips, you know -- climbing mountains and trekking through the desert. He was just a very active person.”\u003c/p>\n\u003cp>But in the fall of 2014, Minor became ill with pulmonary fibrosis, a lung disease, and it was terminal. His family members said the disease slowly but surely eroded his quality of life. He became increasingly confined to his home, wracked by pain and violent fits of coughing, and suffered frightening episodes of choking and suffocation.\u003c/p>\n\u003cp>So two years after the diagnosis, on Sept. 15, 2016, John Minor sipped his last drink: apple juice laced with a lethal dose of medication his doctor had prescribed for him. He died surrounded by family members, at the age of 80.\u003c/p>\n\u003cp>“He laid down and went to sleep, and he was in a coma for about two hours and then he passed,” Jackie said. “It was very peaceful.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>California’s \u003ca href=\"http://coalitionccc.org/tools-resources/end-of-life-option-act/\" target=\"_blank\" rel=\"noopener noreferrer\">End of Life Option Act\u003c/a> went into effect on June 9, 2016. The law created a process for dying patients to ask their doctors for a lethal prescription that the patients can then ingest privately, at home.\u003c/p>\n\u003cp>Since then, at least 500 Californians have received life-ending prescriptions, according to newly released data collected by \u003ca href=\"https://www.compassionandchoices.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Compassion and Choices\u003c/a>, an advocacy group that promotes aid-in-dying laws nationwide.\u003c/p>\n\u003cp>The organization also estimated that about 500 health systems and 100 hospice organizations now participate in the California law.\u003c/p>\n\u003cp>In addition, 80 percent of insurance companies in the state are paying claims involved in the process, such as doctor visits and the prescription itself.\u003c/p>\n\u003cp>“What the numbers are showing is that the law is working incredibly well,” said Matt Whitaker, the organization's director for California and Oregon. “It’s working as the lawmakers intended.”\u003cstrong> \u003c/strong>\u003c/p>\n\u003cp>But finding a doctor willing to prescribe the life-ending drugs isn’t always easy, in part because the state law allows doctors to opt out of prescribing -- even when the hospital where they work participates in the law.\u003c/p>\n\u003cp>The decision to prescribe does not come easily for many physicians.\u003c/p>\n\u003cp>“Even if they’re in support of aid-in-dying, they don’t necessarily want to be the person identified as the 'go-to' person for aid-in-dying. Because that’s a very different implication,” said Dr. Elizabeth Dzeng, an assistant professor of hospital medicine at the University of California, San Francisco.\u003c/p>\n\u003cp>About three dozen UCSF patients have requested such assistance since last June.\u003c/p>\n\u003cp>“There is a certain stigma for being known as a physician who writes these prescriptions,\" agreed Dr. Stephanie Harman, medical director of \u003ca href=\"https://stanfordhealthcare.org/medical-clinics/palliative-care.html\" target=\"_blank\" rel=\"noopener noreferrer\">palliative care services\u003c/a> at Stanford Health Care.\u003c/p>\n\u003cp>Harman decided to \u003ca href=\"http://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2628972\" target=\"_blank\" rel=\"noopener noreferrer\">study\u003c/a> how the law was playing out in the Stanford system. She tracked 13 Stanford patients who received prescriptions for lethal drugs, and learned that half of them initially couldn’t get the drugs from their own doctor.\u003c/p>\n\u003cp>\"There is in the field, in medicine, a question of whether this is an ethical act for a physician,” she explained.\u003c/p>\n\u003cp>Other hospitals and health systems statewide are also trying to get a sense of what their terminal patients are experiencing. At the University of California, Los Angeles, about 20 patients have received prescriptions since the law went into effect — but only about half of them have gone on to take the meds, said Dr. Neil Wenger, a professor of medicine at UCLA and director of the \u003ca href=\"https://www.uclahealth.org/ethics-center/\" target=\"_blank\" rel=\"noopener noreferrer\">UCLA Health Ethics Center\u003c/a>.\u003c/p>\n\u003cp>Wenger helped develop a protocol for UCLA doctors, to guide them through the requirements of administering the medication to qualified terminally ill patients.\u003c/p>\n\u003cp>Among those he’s spoken with, there is a “whole range of preferences” regarding how and whether to participate in the law.\u003c/p>\n\u003cp>A “relatively small number” oppose the law outright, he said. Many others, however, believe patients should have access to aid-in-dying assistance, but don’t want to be involved in prescribing themselves, since it involves legal requirements, paperwork and conversations that can often be difficult.\u003c/p>\n\u003cp>“It raises a lot of feelings on the part of the doctor. It is something very, very different than what a doctor does -- which is saving people,\" Wenger explained. \"And it’s complicated. It takes a whole lot of time.”\u003c/p>\n\u003cp>Dr. Catherine S. Forest is one doctor who has committed herself to taking that time, and assisting patients who want the prescription.\u003c/p>\n\u003cp>Forest practices family medicine in the Stanford health system. Since the law passed, she’s assisted five patients who came to her practice after their own doctors refused.\u003c/p>\n\u003cp>Forest says what’s happening now in California is reminiscent of what happened in the 1970s, when abortion became legal. Even among doctors who agreed with the \u003cem>Roe v. Wade \u003c/em>decision, there was a reluctance to perform abortions.\u003c/p>\n\u003cp>“It takes awhile for people to train, to feel comfortable and to provide, and that was because it was not legal, and then it \u003cem>was\u003c/em> legal. And there are very few instances where we do that in medicine,” Forest says.\u003c/p>\n\u003cp>Aid-in-dying, she says, is one of those challenging moments for doctors. She expects it will take time for California to catch up with other states, like Oregon, that have well-established training resources to help doctors learn the process.\u003c/p>\n\u003cp>John Minor wasn't able to get a prescription at first. His doctors would not write the necessary prescription, so his family started scrambling.\u003c/p>\n\u003cp>“I started cold-calling just different hospitals and different departments within different hospitals,” Jackie said.\u003c/p>\n\u003cp>Ultimately, the family took the step of enrolling her father in a Kaiser Permanente insurance plan, and he received the prescription that he took last fall.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“Mentally, he was ready,” said his widow, Sherry Minor. “It was an easy day for him.”\u003c/p>\n\n","blocks":[],"excerpt":"Hundreds of patients have requested the medication over the past year, but some report it took awhile to find a doctor to help. ","status":"publish","parent":0,"modified":1496812360,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":33,"wordCount":1057},"headData":{"title":"Physician-Assisted Suicide Has Been Legal in California for a Year. How's it Going? | KQED","description":"Hundreds of patients have requested the medication over the past year, but some report it took awhile to find a doctor to help. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Physician-Assisted Suicide Has Been Legal in California for a Year. How's it Going?","datePublished":"2017-06-07T21:00:57.000Z","dateModified":"2017-06-07T05:12:40.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"339498 https://ww2.kqed.org/stateofhealth/?p=339498","disqusUrl":"https://ww2.kqed.org/stateofhealth/2017/06/07/physician-assisted-suicide-has-been-legal-in-california-for-a-year-hows-it-going/","disqusTitle":"Physician-Assisted Suicide Has Been Legal in California for a Year. How's it Going?","nprByline":"Stephanie O'Neill","path":"/stateofhealth/339498/physician-assisted-suicide-has-been-legal-in-california-for-a-year-hows-it-going","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>John Minor, a retired psychologist, epitomized the active Californian. A resident of Manhattan Beach, Minor ran long distances, bicycled, and hiked.\u003c/p>\n\u003cp>“He and my mom were both members of the Sierra Club,” said Jackie Minor of San Mateo, one of his daughters. \"They went on tons of backpacking trips, you know -- climbing mountains and trekking through the desert. He was just a very active person.”\u003c/p>\n\u003cp>But in the fall of 2014, Minor became ill with pulmonary fibrosis, a lung disease, and it was terminal. His family members said the disease slowly but surely eroded his quality of life. He became increasingly confined to his home, wracked by pain and violent fits of coughing, and suffered frightening episodes of choking and suffocation.\u003c/p>\n\u003cp>So two years after the diagnosis, on Sept. 15, 2016, John Minor sipped his last drink: apple juice laced with a lethal dose of medication his doctor had prescribed for him. He died surrounded by family members, at the age of 80.\u003c/p>\n\u003cp>“He laid down and went to sleep, and he was in a coma for about two hours and then he passed,” Jackie said. “It was very peaceful.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>California’s \u003ca href=\"http://coalitionccc.org/tools-resources/end-of-life-option-act/\" target=\"_blank\" rel=\"noopener noreferrer\">End of Life Option Act\u003c/a> went into effect on June 9, 2016. The law created a process for dying patients to ask their doctors for a lethal prescription that the patients can then ingest privately, at home.\u003c/p>\n\u003cp>Since then, at least 500 Californians have received life-ending prescriptions, according to newly released data collected by \u003ca href=\"https://www.compassionandchoices.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Compassion and Choices\u003c/a>, an advocacy group that promotes aid-in-dying laws nationwide.\u003c/p>\n\u003cp>The organization also estimated that about 500 health systems and 100 hospice organizations now participate in the California law.\u003c/p>\n\u003cp>In addition, 80 percent of insurance companies in the state are paying claims involved in the process, such as doctor visits and the prescription itself.\u003c/p>\n\u003cp>“What the numbers are showing is that the law is working incredibly well,” said Matt Whitaker, the organization's director for California and Oregon. “It’s working as the lawmakers intended.”\u003cstrong> \u003c/strong>\u003c/p>\n\u003cp>But finding a doctor willing to prescribe the life-ending drugs isn’t always easy, in part because the state law allows doctors to opt out of prescribing -- even when the hospital where they work participates in the law.\u003c/p>\n\u003cp>The decision to prescribe does not come easily for many physicians.\u003c/p>\n\u003cp>“Even if they’re in support of aid-in-dying, they don’t necessarily want to be the person identified as the 'go-to' person for aid-in-dying. Because that’s a very different implication,” said Dr. Elizabeth Dzeng, an assistant professor of hospital medicine at the University of California, San Francisco.\u003c/p>\n\u003cp>About three dozen UCSF patients have requested such assistance since last June.\u003c/p>\n\u003cp>“There is a certain stigma for being known as a physician who writes these prescriptions,\" agreed Dr. Stephanie Harman, medical director of \u003ca href=\"https://stanfordhealthcare.org/medical-clinics/palliative-care.html\" target=\"_blank\" rel=\"noopener noreferrer\">palliative care services\u003c/a> at Stanford Health Care.\u003c/p>\n\u003cp>Harman decided to \u003ca href=\"http://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2628972\" target=\"_blank\" rel=\"noopener noreferrer\">study\u003c/a> how the law was playing out in the Stanford system. She tracked 13 Stanford patients who received prescriptions for lethal drugs, and learned that half of them initially couldn’t get the drugs from their own doctor.\u003c/p>\n\u003cp>\"There is in the field, in medicine, a question of whether this is an ethical act for a physician,” she explained.\u003c/p>\n\u003cp>Other hospitals and health systems statewide are also trying to get a sense of what their terminal patients are experiencing. At the University of California, Los Angeles, about 20 patients have received prescriptions since the law went into effect — but only about half of them have gone on to take the meds, said Dr. Neil Wenger, a professor of medicine at UCLA and director of the \u003ca href=\"https://www.uclahealth.org/ethics-center/\" target=\"_blank\" rel=\"noopener noreferrer\">UCLA Health Ethics Center\u003c/a>.\u003c/p>\n\u003cp>Wenger helped develop a protocol for UCLA doctors, to guide them through the requirements of administering the medication to qualified terminally ill patients.\u003c/p>\n\u003cp>Among those he’s spoken with, there is a “whole range of preferences” regarding how and whether to participate in the law.\u003c/p>\n\u003cp>A “relatively small number” oppose the law outright, he said. Many others, however, believe patients should have access to aid-in-dying assistance, but don’t want to be involved in prescribing themselves, since it involves legal requirements, paperwork and conversations that can often be difficult.\u003c/p>\n\u003cp>“It raises a lot of feelings on the part of the doctor. It is something very, very different than what a doctor does -- which is saving people,\" Wenger explained. \"And it’s complicated. It takes a whole lot of time.”\u003c/p>\n\u003cp>Dr. Catherine S. Forest is one doctor who has committed herself to taking that time, and assisting patients who want the prescription.\u003c/p>\n\u003cp>Forest practices family medicine in the Stanford health system. Since the law passed, she’s assisted five patients who came to her practice after their own doctors refused.\u003c/p>\n\u003cp>Forest says what’s happening now in California is reminiscent of what happened in the 1970s, when abortion became legal. Even among doctors who agreed with the \u003cem>Roe v. Wade \u003c/em>decision, there was a reluctance to perform abortions.\u003c/p>\n\u003cp>“It takes awhile for people to train, to feel comfortable and to provide, and that was because it was not legal, and then it \u003cem>was\u003c/em> legal. And there are very few instances where we do that in medicine,” Forest says.\u003c/p>\n\u003cp>Aid-in-dying, she says, is one of those challenging moments for doctors. She expects it will take time for California to catch up with other states, like Oregon, that have well-established training resources to help doctors learn the process.\u003c/p>\n\u003cp>John Minor wasn't able to get a prescription at first. His doctors would not write the necessary prescription, so his family started scrambling.\u003c/p>\n\u003cp>“I started cold-calling just different hospitals and different departments within different hospitals,” Jackie said.\u003c/p>\n\u003cp>Ultimately, the family took the step of enrolling her father in a Kaiser Permanente insurance plan, and he received the prescription that he took last fall.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“Mentally, he was ready,” said his widow, Sherry Minor. “It was an easy day for him.”\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/339498/physician-assisted-suicide-has-been-legal-in-california-for-a-year-hows-it-going","authors":["byline_stateofhealth_339498"],"categories":["stateofhealth_12","stateofhealth_13","stateofhealth_1"],"tags":["stateofhealth_914","stateofhealth_2847","stateofhealth_2808","stateofhealth_2519","stateofhealth_754"],"featImg":"stateofhealth_339516","label":"stateofhealth"},"stateofhealth_281518":{"type":"posts","id":"stateofhealth_281518","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"281518","score":null,"sort":[1483743098000]},"guestAuthors":[],"slug":"bay-area-man-confronts-and-embraces-his-right-to-die","title":"Bay Area Cancer Patient Confronts and Embraces His Right to Die","publishDate":1483743098,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>\u003cem>Last year, California became the fifth state to allow terminally ill patients to take lethal medication to end their lives. The new law -- the \u003ca href=\"https://ww2.kqed.org/stateofhealth/2016/03/10/californias-physician-assisted-suicide-law-to-take-effect-in-june/\" target=\"_blank\">End of Life Option Act\u003c/a> -- took effect in June, 2016.\u003c/em>\u003c/p>\n\u003cp>\u003cem>Piedmont resident \u003cstrong>Ray Perman\u003c/strong> always knew this is the way he wanted to go. He’s 64, a retired pilot, like his father, and an entrepreneur. He’s dying of cancer. I interviewed him about his decision. The following words, culled from that interview, are his.\u003c/em>\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/301315866\" params=\"color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" iframe=\"true\" /]\u003c/p>\n\u003cp>My pelvis is fully populated by prostate cancer. I have a one-inch tumor in my tailbone. I have seven tumors in my ribs, like little Christmas tree lights. So about two months ago, my physician called me in and said, 'Well Ray, we've done everything we can.' I said, 'Well then I want to be on hospice. And I'd like to have you start with End of Life Options.' He looked at me and said 'I'll write the prescription.'\u003c/p>\n\u003cp>So now I have my medical aid-in-dying drugs up in my bedroom, ready to go. You're not allowed to go to the pharmacy and go pick them up. They won’t have you inadvertently leave them on the seat of the 57 bus. It has to be delivered like a loaded weapon. So the end-of-life options team came here with three people, the pharmacist with the drugs, my case manager and also another witness. They arrived here with these drugs and they went through the instructions on how to use them, and had me sign all the appropriate documents under witness, which is what they should absolutely do.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Remember that I have to take these prescriptions on my own. No one can assist me. No one can cajole or put the straw in my mouth or squeeze the drugs into my mouth. I have to take them, which means I have to have the ability to swallow. So what the hospice team is learning, they give you about a five-day window when you can do this drug and do the deed. And they’re learning, because they’ve missed a couple of times with other patients. They didn't call it early enough, and the person could no longer do the drug and they feel very badly.\u003c/p>\n\u003cfigure id=\"attachment_281642\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-281642\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2017/01/RayPermanPercussion-800x1002.jpg\" alt=\"Ray Perman is a percussionist, avid traveler and self-described “manic volunteer.” Here he plays the Cuban bell during a trip to Havana last March, where he played with six bands.\" width=\"800\" height=\"1002\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayPermanPercussion.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayPermanPercussion-160x200.jpg 160w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayPermanPercussion-768x962.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayPermanPercussion-240x301.jpg 240w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayPermanPercussion-375x470.jpg 375w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayPermanPercussion-520x651.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Ray Perman is a percussionist, avid traveler and self-described “manic volunteer.” Here he plays the Cuban bell during a trip to Havana last March, where he played with six bands. \u003ccite>(Courtesy Ray Perman)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>They’ve giving me markers, clues as you get closer to the end. You look for changes in perception of food taste, general weakness, or the need to take a mid-morning nap, which I'm starting to do now. My stairway is a measuring device. People say, ‘Ray, should you get a hospital bed down here?’ I say, no I don't want to die in my living room. I have a beautiful bedroom with windows on three sides, I want to look at my view. So if I can't get up the stairway anymore, it means we’re darn close. And we are kind of close.\u003c/p>\n\u003cp>It will be a hard decision. People who go for the aid-in-dying option, I understand only 65 percent actually do it. Of the people who don't, some basically die of symptoms prior to using the option, some simply change their mind. You know, I'm not a hero. I may chicken out.\u003c/p>\n\u003cp>I attended my daughter's wedding in September and afterwards my oncologist said, the whole department, we figured you had 50/50 odds of attending. And I had a 70 percent chance of dying last month in December. I mean, who knows how it'll go. Some days I wake up and I can feel cancer coming. It feels like I'm not going to make it to January 15. I have meetings on January 15 -- I’ve got to make those meetings. And my wonderful in-home care provider, she’s pregnant and she's going to give birth around February 15.\u003c/p>\n\u003cp>Our goal is for me to hold the baby. It'll be great. Maybe I’ll get there.\u003c/p>\n\u003cfigure id=\"attachment_281644\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-281644\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2017/01/RayFlying-800x778.jpg\" alt=\"Ray Perman’s first career was as a pilot, similar to his father. He poses here with his daughter, Andrea, before a recreational flight. Andrea is now 24. His son, Eric, is 27.\" width=\"800\" height=\"778\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayFlying.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayFlying-160x156.jpg 160w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayFlying-768x747.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayFlying-240x233.jpg 240w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayFlying-375x365.jpg 375w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayFlying-520x506.jpg 520w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayFlying-32x32.jpg 32w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayFlying-50x50.jpg 50w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Ray Perman’s first career was as a pilot, similar to his father. He poses here with his daughter, Andrea, before a recreational flight. Andrea is now 24. His son, Eric, is 27. \u003ccite>(Courtesy Ray Perman)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>I made sure that the newspapers don't say 'Ray lost his battle with cancer.' There’s no battle. If I were to be battling or struggling I would be preempting my ability to soak in all the wonderful things that are happening to me emotionally.\u003c/p>\n\u003cp>For me the epiphany in all of this is that I shifted from wanting to die quickly to wanting to enjoy this last phase. I think it's the explorer in me. I want to carry the torch into that last phase and say 'My gosh, look what I'm discovering. It's beautiful.' You shouldn't miss it. Don't fear death. It's wrong.\u003c/p>\n\u003cfigure id=\"attachment_281521\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-281521\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2017/01/KP-Racing-Team-2016-05-1-800x450.jpg\" alt=\"Ray Perman says he's maintained his "rollicking" sense of humor after being diagnosed with two types of cancer.\" width=\"800\" height=\"450\">\u003cfigcaption class=\"wp-caption-text\">Ray Perman says he's maintained his \"rollicking\" sense of humor after being diagnosed with two types of cancer. \u003ccite>(Courtesy of Ray Perman)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>When the hospice team gives me the five day window, I will announce to my relatives: It's time. I'm going to make it this day, come.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>I will have my closest loved ones around me when I do that. I'll have an open house in the morning for my friends to give me a hug goodbye and then we'll probably do the deed in the afternoon. Then my family can have time with my body in the evening, as long as they’d like. And I have a complete description on where to dispose of my ashes. It'll be in the departure path of a Boeing aircraft that took off with my father, on an outgoing tide.\u003c/p>\n\n","blocks":[],"excerpt":"Piedmont resident Ray Perman tells the story of how he's approaching his last phase of life.","status":"publish","parent":0,"modified":1483754678,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":16,"wordCount":1049},"headData":{"title":"Bay Area Cancer Patient Confronts and Embraces His Right to Die | KQED","description":"Piedmont resident Ray Perman tells the story of how he's approaching his last phase of life.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Bay Area Cancer Patient Confronts and Embraces His Right to Die","datePublished":"2017-01-06T22:51:38.000Z","dateModified":"2017-01-07T02:04:38.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"281518 http://ww2.kqed.org/stateofhealth/?p=281518","disqusUrl":"https://ww2.kqed.org/stateofhealth/2017/01/06/bay-area-man-confronts-and-embraces-his-right-to-die/","disqusTitle":"Bay Area Cancer Patient Confronts and Embraces His Right to Die","path":"/stateofhealth/281518/bay-area-man-confronts-and-embraces-his-right-to-die","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Last year, California became the fifth state to allow terminally ill patients to take lethal medication to end their lives. The new law -- the \u003ca href=\"https://ww2.kqed.org/stateofhealth/2016/03/10/californias-physician-assisted-suicide-law-to-take-effect-in-june/\" target=\"_blank\">End of Life Option Act\u003c/a> -- took effect in June, 2016.\u003c/em>\u003c/p>\n\u003cp>\u003cem>Piedmont resident \u003cstrong>Ray Perman\u003c/strong> always knew this is the way he wanted to go. He’s 64, a retired pilot, like his father, and an entrepreneur. He’s dying of cancer. I interviewed him about his decision. The following words, culled from that interview, are his.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='100%' height='166'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/301315866&visual=true&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false'\n title='https://api.soundcloud.com/tracks/301315866'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>My pelvis is fully populated by prostate cancer. I have a one-inch tumor in my tailbone. I have seven tumors in my ribs, like little Christmas tree lights. So about two months ago, my physician called me in and said, 'Well Ray, we've done everything we can.' I said, 'Well then I want to be on hospice. And I'd like to have you start with End of Life Options.' He looked at me and said 'I'll write the prescription.'\u003c/p>\n\u003cp>So now I have my medical aid-in-dying drugs up in my bedroom, ready to go. You're not allowed to go to the pharmacy and go pick them up. They won’t have you inadvertently leave them on the seat of the 57 bus. It has to be delivered like a loaded weapon. So the end-of-life options team came here with three people, the pharmacist with the drugs, my case manager and also another witness. They arrived here with these drugs and they went through the instructions on how to use them, and had me sign all the appropriate documents under witness, which is what they should absolutely do.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Remember that I have to take these prescriptions on my own. No one can assist me. No one can cajole or put the straw in my mouth or squeeze the drugs into my mouth. I have to take them, which means I have to have the ability to swallow. So what the hospice team is learning, they give you about a five-day window when you can do this drug and do the deed. And they’re learning, because they’ve missed a couple of times with other patients. They didn't call it early enough, and the person could no longer do the drug and they feel very badly.\u003c/p>\n\u003cfigure id=\"attachment_281642\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-281642\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2017/01/RayPermanPercussion-800x1002.jpg\" alt=\"Ray Perman is a percussionist, avid traveler and self-described “manic volunteer.” Here he plays the Cuban bell during a trip to Havana last March, where he played with six bands.\" width=\"800\" height=\"1002\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayPermanPercussion.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayPermanPercussion-160x200.jpg 160w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayPermanPercussion-768x962.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayPermanPercussion-240x301.jpg 240w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayPermanPercussion-375x470.jpg 375w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayPermanPercussion-520x651.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Ray Perman is a percussionist, avid traveler and self-described “manic volunteer.” Here he plays the Cuban bell during a trip to Havana last March, where he played with six bands. \u003ccite>(Courtesy Ray Perman)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>They’ve giving me markers, clues as you get closer to the end. You look for changes in perception of food taste, general weakness, or the need to take a mid-morning nap, which I'm starting to do now. My stairway is a measuring device. People say, ‘Ray, should you get a hospital bed down here?’ I say, no I don't want to die in my living room. I have a beautiful bedroom with windows on three sides, I want to look at my view. So if I can't get up the stairway anymore, it means we’re darn close. And we are kind of close.\u003c/p>\n\u003cp>It will be a hard decision. People who go for the aid-in-dying option, I understand only 65 percent actually do it. Of the people who don't, some basically die of symptoms prior to using the option, some simply change their mind. You know, I'm not a hero. I may chicken out.\u003c/p>\n\u003cp>I attended my daughter's wedding in September and afterwards my oncologist said, the whole department, we figured you had 50/50 odds of attending. And I had a 70 percent chance of dying last month in December. I mean, who knows how it'll go. Some days I wake up and I can feel cancer coming. It feels like I'm not going to make it to January 15. I have meetings on January 15 -- I’ve got to make those meetings. And my wonderful in-home care provider, she’s pregnant and she's going to give birth around February 15.\u003c/p>\n\u003cp>Our goal is for me to hold the baby. It'll be great. Maybe I’ll get there.\u003c/p>\n\u003cfigure id=\"attachment_281644\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-281644\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2017/01/RayFlying-800x778.jpg\" alt=\"Ray Perman’s first career was as a pilot, similar to his father. He poses here with his daughter, Andrea, before a recreational flight. Andrea is now 24. His son, Eric, is 27.\" width=\"800\" height=\"778\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayFlying.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayFlying-160x156.jpg 160w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayFlying-768x747.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayFlying-240x233.jpg 240w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayFlying-375x365.jpg 375w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayFlying-520x506.jpg 520w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayFlying-32x32.jpg 32w, https://ww2.kqed.org/app/uploads/sites/27/2017/01/RayFlying-50x50.jpg 50w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Ray Perman’s first career was as a pilot, similar to his father. He poses here with his daughter, Andrea, before a recreational flight. Andrea is now 24. His son, Eric, is 27. \u003ccite>(Courtesy Ray Perman)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>I made sure that the newspapers don't say 'Ray lost his battle with cancer.' There’s no battle. If I were to be battling or struggling I would be preempting my ability to soak in all the wonderful things that are happening to me emotionally.\u003c/p>\n\u003cp>For me the epiphany in all of this is that I shifted from wanting to die quickly to wanting to enjoy this last phase. I think it's the explorer in me. I want to carry the torch into that last phase and say 'My gosh, look what I'm discovering. It's beautiful.' You shouldn't miss it. Don't fear death. It's wrong.\u003c/p>\n\u003cfigure id=\"attachment_281521\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-281521\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2017/01/KP-Racing-Team-2016-05-1-800x450.jpg\" alt=\"Ray Perman says he's maintained his "rollicking" sense of humor after being diagnosed with two types of cancer.\" width=\"800\" height=\"450\">\u003cfigcaption class=\"wp-caption-text\">Ray Perman says he's maintained his \"rollicking\" sense of humor after being diagnosed with two types of cancer. \u003ccite>(Courtesy of Ray Perman)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>When the hospice team gives me the five day window, I will announce to my relatives: It's time. I'm going to make it this day, come.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>I will have my closest loved ones around me when I do that. I'll have an open house in the morning for my friends to give me a hug goodbye and then we'll probably do the deed in the afternoon. Then my family can have time with my body in the evening, as long as they’d like. And I have a complete description on where to dispose of my ashes. It'll be in the departure path of a Boeing aircraft that took off with my father, on an outgoing tide.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/281518/bay-area-man-confronts-and-embraces-his-right-to-die","authors":["3205"],"categories":["stateofhealth_14","stateofhealth_1"],"tags":["stateofhealth_914","stateofhealth_3024","stateofhealth_2847","stateofhealth_3022","stateofhealth_2808","stateofhealth_3023","stateofhealth_2519","stateofhealth_754"],"featImg":"stateofhealth_281571","label":"stateofhealth"},"stateofhealth_196481":{"type":"posts","id":"stateofhealth_196481","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"196481","score":null,"sort":[1465585203000]},"guestAuthors":[],"slug":"terminally-ill-san-diego-woman-plans-to-take-advantage-of-aid-in-dying-law","title":"Terminally Ill San Diego Woman Plans To Take Advantage Of Aid-In-Dying Law","publishDate":1465585203,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>Eurika Strotto has always led an active life.\u003c/p>\n\u003cp>Growing up in South Africa, Eurika played field hockey for her high school and college teams. She also became a judo champion.\u003c/p>\n\u003cp>So her wife, Nita, wasn’t surprised that when it came time to remodel their University Heights home, Eurika did most of the work herself — starting with the kitchen.\u003c/p>\n\u003cp>“She decided she wanted to knock out the load-bearing wall, but we had to leave the post,\" Nita Strotto said. \"So she figured out, well, why don’t we just put the post in the middle of the bar counter, and it ended up looking really good.”\u003c/p>\n\u003cp>Then Eurika tackled a bathroom.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“And she actually, herself, tore out all the old bathroom, and then rebuilt the walls up to the sheetrock,\" Nita said.\u003c/p>\n\u003cp>It was during this project in 2013 that Eurika suddenly had problems with one of her feet.\u003c/p>\n\u003cp>\"We really thought that it was just a sprain, or some sort of weakness thing,\" Nita said. \"We finished the bathroom, and got married. And then a week later she was diagnosed with \u003ca href=\"http://www.ninds.nih.gov/disorders/amyotrophiclateralsclerosis/detail_ALS.htm\" target=\"_blank\">ALS (amyotrophic lateral sclerosis)\u003c/a>.”\u003c/p>\n\u003cfigure id=\"attachment_196485\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003cimg class=\"size-thumbnail wp-image-196485\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/06/Screen-Shot-2016-06-10-at-11.38.24-AM-400x201.png\" alt=\"Juanita and Eurika Strotto hold hands. \" width=\"400\" height=\"201\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/06/Screen-Shot-2016-06-10-at-11.38.24-AM-400x201.png 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/06/Screen-Shot-2016-06-10-at-11.38.24-AM-800x402.png 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/06/Screen-Shot-2016-06-10-at-11.38.24-AM-768x386.png 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/06/Screen-Shot-2016-06-10-at-11.38.24-AM-1180x593.png 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/06/Screen-Shot-2016-06-10-at-11.38.24-AM-960x482.png 960w, https://ww2.kqed.org/app/uploads/sites/27/2016/06/Screen-Shot-2016-06-10-at-11.38.24-AM.png 1270w\" sizes=\"(max-width: 400px) 100vw, 400px\">\u003cfigcaption class=\"wp-caption-text\">Juanita and Eurika Strotto hold hands. \u003ccite>(Katie Schoolov/KPBS)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>When we first \u003ca href=\"http://www.kpbs.org/news/2015/dec/09/aid-dying-law-comes-california-2016/\" target=\"_blank\">profiled\u003c/a> Eurika last fall, she was living in a wheelchair. But she had no trouble breathing.\u003c/p>\n\u003cp>These days, because her diaphragm muscles are so weak, Eurika needs a machine to help her breathe most of the time. The way she figures, it won’t be long before she’ll lose the ability to swallow.\u003c/p>\n\u003cp>At an appointment with Eurika's physician, Dr. Sunita Shailam, the Strottos listen intently as Shailam fills a requirement of the new law by reading them a statement that Eurika will have to sign before she can get a prescription for a lethal dose of drugs. Sitting in Shailam's office, the couple hold hands as the family medicine doctor describes the different medications Strotto will be advised to take on that final day: an anti-nausea drug, an anti-anxiety pill, and then a handful of barbiturates crushed up and dissolved in a glass of water.\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/268520673\" params=\"color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" iframe=\"true\" /]\u003c/p>\n\u003cp>Eurika was planning to take advantage of California’s End of Life Option Act as soon as it went into effect. But some close friends are getting married June 11.\u003c/p>\n\u003cp>“If it wasn’t ... if it wasn’t for their wedding,\" Eurika says, through tears, \"I probably would have exercised my right sooner. But I don’t want to spoil their wedding.”\u003c/p>\n\u003cp>Right after that, Eurika says she will fill the prescription and take her own life.\u003c/p>\n\u003cp>Nita said they never really talked about death before Eurika was diagnosed with ALS. Since then, the topic has been unavoidable.\u003c/p>\n\u003cp>“And it’s weird, how it hasn’t diminished the beauty of life at all,\" Nita said. \"In fact, if anything, it’s highlighted how awesome our lives have been, independently and together.”\u003c/p>\n\u003cfigure id=\"attachment_196487\" class=\"wp-caption aligncenter\" style=\"max-width: 1258px\">\u003cimg class=\"size-full wp-image-196487\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/06/Screen-Shot-2016-06-10-at-11.42.15-AM.png\" alt=\"Eurika's wife, Nita Strotto. \" width=\"1258\" height=\"624\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/06/Screen-Shot-2016-06-10-at-11.42.15-AM.png 1258w, https://ww2.kqed.org/app/uploads/sites/27/2016/06/Screen-Shot-2016-06-10-at-11.42.15-AM-400x198.png 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/06/Screen-Shot-2016-06-10-at-11.42.15-AM-800x397.png 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/06/Screen-Shot-2016-06-10-at-11.42.15-AM-768x381.png 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/06/Screen-Shot-2016-06-10-at-11.42.15-AM-1180x585.png 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/06/Screen-Shot-2016-06-10-at-11.42.15-AM-960x476.png 960w\" sizes=\"(max-width: 1258px) 100vw, 1258px\">\u003cfigcaption class=\"wp-caption-text\">Eurika's wife, Nita Strotto. \u003ccite>(Katie Schoolov/KPBS)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Nita said even though her father is dying in an assisted living center, she just doesn’t have the emotional bandwidth to deal with that right now.\u003c/p>\n\u003cp>“I’m full-time taking on the passing of my life partner, my wife, the love of my life, my best friend,\" Nita said. \"And it’s really becoming close to the end now, and I’m still not really thinking about her dying. I’m thinking about her being alive right now and in the living room. And that that’s where I want to be.”\u003c/p>\n\u003cp>So that’s where they’re spending a lot of their remaining time together — in the living room in the house that Eurika remodeled herself.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"Yeah, I’ve done a lot in my life, and we’ve done a lot since we’ve been together,\" Eurika said. \"And I don’t regret any of it. It’s been cut a little short,\" she says, crying. \"But it’s been fantastic.”\u003c/p>\n\n","blocks":[],"excerpt":"Eurika Strotto, of San Diego, is terminally ill with ALS and plans to take her own life now that California's End of Life Option Act has taken effect.","status":"publish","parent":0,"modified":1465594551,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":23,"wordCount":729},"headData":{"title":"Terminally Ill San Diego Woman Plans To Take Advantage Of Aid-In-Dying Law | KQED","description":"Eurika Strotto, of San Diego, is terminally ill with ALS and plans to take her own life now that California's End of Life Option Act has taken effect.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Terminally Ill San Diego Woman Plans To Take Advantage Of Aid-In-Dying Law","datePublished":"2016-06-10T19:00:03.000Z","dateModified":"2016-06-10T21:35:51.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"196481 http://ww2.kqed.org/stateofhealth/?p=196481","disqusUrl":"https://ww2.kqed.org/stateofhealth/2016/06/10/terminally-ill-san-diego-woman-plans-to-take-advantage-of-aid-in-dying-law/","disqusTitle":"Terminally Ill San Diego Woman Plans To Take Advantage Of Aid-In-Dying Law","nprByline":"Kenny Goldberg\u003cbr />\u003ca href=\"http://www.kpbs.org/news/2016/may/26/terminally-ill-san-diego-woman-plans-take-advantag/\">KPBS\u003c/a>","path":"/stateofhealth/196481/terminally-ill-san-diego-woman-plans-to-take-advantage-of-aid-in-dying-law","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Eurika Strotto has always led an active life.\u003c/p>\n\u003cp>Growing up in South Africa, Eurika played field hockey for her high school and college teams. She also became a judo champion.\u003c/p>\n\u003cp>So her wife, Nita, wasn’t surprised that when it came time to remodel their University Heights home, Eurika did most of the work herself — starting with the kitchen.\u003c/p>\n\u003cp>“She decided she wanted to knock out the load-bearing wall, but we had to leave the post,\" Nita Strotto said. \"So she figured out, well, why don’t we just put the post in the middle of the bar counter, and it ended up looking really good.”\u003c/p>\n\u003cp>Then Eurika tackled a bathroom.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“And she actually, herself, tore out all the old bathroom, and then rebuilt the walls up to the sheetrock,\" Nita said.\u003c/p>\n\u003cp>It was during this project in 2013 that Eurika suddenly had problems with one of her feet.\u003c/p>\n\u003cp>\"We really thought that it was just a sprain, or some sort of weakness thing,\" Nita said. \"We finished the bathroom, and got married. And then a week later she was diagnosed with \u003ca href=\"http://www.ninds.nih.gov/disorders/amyotrophiclateralsclerosis/detail_ALS.htm\" target=\"_blank\">ALS (amyotrophic lateral sclerosis)\u003c/a>.”\u003c/p>\n\u003cfigure id=\"attachment_196485\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003cimg class=\"size-thumbnail wp-image-196485\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/06/Screen-Shot-2016-06-10-at-11.38.24-AM-400x201.png\" alt=\"Juanita and Eurika Strotto hold hands. \" width=\"400\" height=\"201\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/06/Screen-Shot-2016-06-10-at-11.38.24-AM-400x201.png 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/06/Screen-Shot-2016-06-10-at-11.38.24-AM-800x402.png 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/06/Screen-Shot-2016-06-10-at-11.38.24-AM-768x386.png 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/06/Screen-Shot-2016-06-10-at-11.38.24-AM-1180x593.png 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/06/Screen-Shot-2016-06-10-at-11.38.24-AM-960x482.png 960w, https://ww2.kqed.org/app/uploads/sites/27/2016/06/Screen-Shot-2016-06-10-at-11.38.24-AM.png 1270w\" sizes=\"(max-width: 400px) 100vw, 400px\">\u003cfigcaption class=\"wp-caption-text\">Juanita and Eurika Strotto hold hands. \u003ccite>(Katie Schoolov/KPBS)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>When we first \u003ca href=\"http://www.kpbs.org/news/2015/dec/09/aid-dying-law-comes-california-2016/\" target=\"_blank\">profiled\u003c/a> Eurika last fall, she was living in a wheelchair. But she had no trouble breathing.\u003c/p>\n\u003cp>These days, because her diaphragm muscles are so weak, Eurika needs a machine to help her breathe most of the time. The way she figures, it won’t be long before she’ll lose the ability to swallow.\u003c/p>\n\u003cp>At an appointment with Eurika's physician, Dr. Sunita Shailam, the Strottos listen intently as Shailam fills a requirement of the new law by reading them a statement that Eurika will have to sign before she can get a prescription for a lethal dose of drugs. Sitting in Shailam's office, the couple hold hands as the family medicine doctor describes the different medications Strotto will be advised to take on that final day: an anti-nausea drug, an anti-anxiety pill, and then a handful of barbiturates crushed up and dissolved in a glass of water.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='100%' height='166'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/268520673&visual=true&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false'\n title='https://api.soundcloud.com/tracks/268520673'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Eurika was planning to take advantage of California’s End of Life Option Act as soon as it went into effect. But some close friends are getting married June 11.\u003c/p>\n\u003cp>“If it wasn’t ... if it wasn’t for their wedding,\" Eurika says, through tears, \"I probably would have exercised my right sooner. But I don’t want to spoil their wedding.”\u003c/p>\n\u003cp>Right after that, Eurika says she will fill the prescription and take her own life.\u003c/p>\n\u003cp>Nita said they never really talked about death before Eurika was diagnosed with ALS. Since then, the topic has been unavoidable.\u003c/p>\n\u003cp>“And it’s weird, how it hasn’t diminished the beauty of life at all,\" Nita said. \"In fact, if anything, it’s highlighted how awesome our lives have been, independently and together.”\u003c/p>\n\u003cfigure id=\"attachment_196487\" class=\"wp-caption aligncenter\" style=\"max-width: 1258px\">\u003cimg class=\"size-full wp-image-196487\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/06/Screen-Shot-2016-06-10-at-11.42.15-AM.png\" alt=\"Eurika's wife, Nita Strotto. \" width=\"1258\" height=\"624\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/06/Screen-Shot-2016-06-10-at-11.42.15-AM.png 1258w, https://ww2.kqed.org/app/uploads/sites/27/2016/06/Screen-Shot-2016-06-10-at-11.42.15-AM-400x198.png 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/06/Screen-Shot-2016-06-10-at-11.42.15-AM-800x397.png 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/06/Screen-Shot-2016-06-10-at-11.42.15-AM-768x381.png 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/06/Screen-Shot-2016-06-10-at-11.42.15-AM-1180x585.png 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/06/Screen-Shot-2016-06-10-at-11.42.15-AM-960x476.png 960w\" sizes=\"(max-width: 1258px) 100vw, 1258px\">\u003cfigcaption class=\"wp-caption-text\">Eurika's wife, Nita Strotto. \u003ccite>(Katie Schoolov/KPBS)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Nita said even though her father is dying in an assisted living center, she just doesn’t have the emotional bandwidth to deal with that right now.\u003c/p>\n\u003cp>“I’m full-time taking on the passing of my life partner, my wife, the love of my life, my best friend,\" Nita said. \"And it’s really becoming close to the end now, and I’m still not really thinking about her dying. I’m thinking about her being alive right now and in the living room. And that that’s where I want to be.”\u003c/p>\n\u003cp>So that’s where they’re spending a lot of their remaining time together — in the living room in the house that Eurika remodeled herself.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"Yeah, I’ve done a lot in my life, and we’ve done a lot since we’ve been together,\" Eurika said. \"And I don’t regret any of it. It’s been cut a little short,\" she says, crying. \"But it’s been fantastic.”\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/196481/terminally-ill-san-diego-woman-plans-to-take-advantage-of-aid-in-dying-law","authors":["byline_stateofhealth_196481"],"categories":["stateofhealth_14"],"tags":["stateofhealth_914","stateofhealth_2519","stateofhealth_754"],"featImg":"stateofhealth_196486","label":"stateofhealth"},"stateofhealth_195237":{"type":"posts","id":"stateofhealth_195237","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"195237","score":null,"sort":[1465407377000]},"guestAuthors":[],"slug":"what-you-need-to-know-about-californias-aid-in-dying-law","title":"California’s Aid-in-Dying Law Takes Effect Today -- Here's What You Need to Know","publishDate":1465407377,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>Starting Thursday, June 9, terminally ill Californians with six months or less to live can request a doctor’s prescription for medications intended to end their lives peacefully.\u003c/p>\n\u003cp>If that sounds simple, it won’t be.\u003c/p>\n\u003caside class=\"pullquote alignright\">The patient has to jump through a lot of hoops -- that's to make sure the decision is made voluntarily.\u003c/aside>\n\u003cp>California’s \u003ca href=\"http://www.leginfo.ca.gov/pub/15-16/bill/asm/ab_0001-0050/abx2_15_bill_20151005_chaptered.htm\" target=\"_blank\">End of Life Option Act\u003c/a> creates a long list of administrative hurdles that both patients and their doctors must clear.\u003c/p>\n\u003cp>For instance, you must make multiple requests for the drugs, orally and in writing, and provide a written attestation within 48 hours of taking the medication (you must be able to take the drugs yourself, without help, to qualify).\u003c/p>\n\u003cp>Two doctors must confirm your diagnosis, prognosis and ability to make medical decisions, and you must prove you’re a California resident.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>And more.\u003c/p>\n\u003cp>“This will not be an on-demand service,” says Sarah Hooper, executive director of the \u003ca href=\"http://www.ucconsortium.org/\" target=\"_blank\">UCSF/UC Hastings Consortium on Law, Science and Health Policy\u003c/a>.\u003c/p>\n\u003cp>“The patient has to jump through a lot of hoops before accessing the prescription. Those hoops are designed to ensure that the patient has really thought about this and is making the decision voluntarily.\"\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/268313233\" params=\"color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" iframe=\"true\" /]\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/lowdown/2015/10/06/california-becomes-fifth-state-to-legalize-physician-assisted-suicide-interactive-map/\" target=\"_blank\">California will be the fifth state \u003c/a>to implement an aid-in-dying law, and the Golden State’s version of it is considered the most stringent, says Sean Crowley, spokesman for the advocacy group \u003ca href=\"https://www.compassionandchoices.org/\" target=\"_blank\">Compassion & Choices\u003c/a>.\u003c/p>\n\u003cp>Rather than list every requirement, I’m going to describe a few potential challenges you might face if you or a loved one is considering asking for these medications — ranging from doctors who are unwilling to write prescriptions to the cost of the medications themselves.\u003c/p>\n\u003cp>This law is voluntary “every step of the way,” says state Sen. Bill Monning, D-Carmel, co-author of the law.\u003c/p>\n\u003cp>That means everyone — patients, physicians, health systems and pharmacies — gets to choose whether or not to participate.\u003c/p>\n\u003cp>Nothing requires patients to take the drugs once they have obtained a prescription.\u003c/p>\n\u003cp>[contextly_sidebar id=\"oappkhqYOxY2odvQWXkqxRUPDLXRQOaq\"]Since Oregon implemented its law in 1997, more than one-third of people who obtained prescriptions didn’t take the medications, according to \u003ca href=\"http://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Documents/year18.pdf\" target=\"_blank\">data compiled by the Oregon Public Health Division\u003c/a>.\u003c/p>\n\u003cp>“You can still at any point decide, ‘I’m not going to need this. The hospice care is effective. The palliative care is effective,’ ” Monning says.\u003c/p>\n\u003cp>But before you can make that decision, you must first get a prescription — and that might take some doing. That’s because not all health care providers will be on board with the new law. It will be up to you to find the ones who are.\u003c/p>\n\u003cp>“Patients and families should expect that they will have to be a little proactive in asking questions and getting educated about their care,” Hooper says.\u003c/p>\n\u003cp>For instance, the Kaiser Permanente system will participate, and patients will be paired with a coordinator to guide them through the process, says spokeswoman Amy Thoma.\u003c/p>\n\u003cp>If your Kaiser Permanente doctor chooses not to participate, which is his or her right under the law, your coordinator will connect you with a physician who does, Thoma says.\u003c/p>\n\u003cp>But U.S. military veterans who receive health care from the U.S. Department of Veterans Affairs will have to look elsewhere for participating doctors, because federal law prohibits the use of federal money for such a purpose, Hooper says.\u003c/p>\n\u003cp>Nor will the 48 Catholic and Catholic-affiliated hospitals in California participate, including their doctors and staff, says Lori Dangberg, vice president of the \u003ca href=\"http://www.thealliance.net/\" target=\"_blank\">Alliance of Catholic Health Care\u003c/a>.\u003c/p>\n\u003cp>Dangberg insists that those providers will not abandon any patient who chooses to end his or her own life. “We will be with that patient and continue to care for that patient throughout their diagnosis and their dying process,” she says. “We just cannot participate in any action that would intentionally hasten a person’s death.”\u003c/p>\n\u003cp>If your doctor doesn’t participate, ask him or her to refer you to one who does. If your doctor won’t provide a reference, “call us and we can probably help,” says Crowley of Compassion & Choices. That number is 800-893-4548.\u003c/p>\n\u003cp>[contextly_sidebar id=\"eEwOCzZsqwP8UpYpMkLX1qXElE4Krqd6\"]Another potential obstacle is the cost of the drugs. Your insurance might not cover them. California’s law does not require health insurers to cover the medications, Monning says.\u003c/p>\n\u003cp>In Oregon, Washington and Montana — states where aid-in-dying is legal — some health plans cover the cost and some don’t, he says. He expects the same to occur here.\u003c/p>\n\u003cp>Insurers “are currently working on how they will implement this law,” says Nicole Kasabian Evans of the \u003ca href=\"http://www.calhealthplans.org/\" target=\"_blank\">California Association of Health Plans\u003c/a>.\u003c/p>\n\u003cp>If you have questions about coverage, she suggests you contact your insurer directly.\u003c/p>\n\u003cp>Medi-Cal, California’s version of the federal Medicaid program for low-income residents, will cover the cost of the drugs without relying on any federal money, says state Department of Health Care Services spokeswoman Katharine Weir.\u003c/p>\n\u003cp>If affordability becomes an issue, Compassion & Choices again urges you to call. “We try to work with people to find a way for them to access the law, through any challenges,” Crowley says.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>If you need more step-by-step guidance about the law, tap into these resources:\u003c/p>\n\u003cul>\n\u003cli>Compassion & Choices has online guides for consumers and doctors at \u003ca href=\"http://www.endoflifeoption.org/\" target=\"_blank\">www.EndOfLifeOption.org\u003c/a>. You can also call the group’s help line at 800-893-4548.\u003c/li>\n\u003cli>The UCSF/UC Hastings Consortium on Law, Science and Health Policy has a \u003ca href=\"http://www.ucconsortium.org/wp-content/uploads/2015/12/FACT-SHEET-End-of-Life-Option-Act-Updated-01.15.16.pdf\" target=\"_blank\">helpful fact sheet\u003c/a> at \u003ca href=\"http://bit.ly/248Z2l6\" target=\"_blank\">http://bit.ly/248Z2l6\u003c/a>.\u003c/li>\n\u003cli>The California Medical Association, which represents doctors, has a detailed, \u003ca href=\"http://www.cmanet.org/resource-library/detail/?item=the-california-end-of-life-option-act&r_search=Document%203459&r_page=1&return_to=list\" target=\"_blank\">14-page document\u003c/a> at \u003ca href=\"http://www.cmanet.org/endoflife\" target=\"_blank\">www.cmanet.org/endoflife\u003c/a>. You’ll need to register on the site to read the document.\u003c/li>\n\u003cli>Once the law takes effect, or soon thereafter, you will be able to find the forms you and your physician need to sign at the Medical Board of California’s website: \u003ca href=\"http://www.mbc.ca.gov/\" target=\"_blank\">www.mbc.ca.gov\u003c/a>.\u003c/li>\n\u003c/ul>\n\n","blocks":[],"excerpt":"The law takes effect Thursday and gives certain terminally ill patients the right to end their lives at a time of their choosing. ","status":"publish","parent":0,"modified":1465515776,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":33,"wordCount":1089},"headData":{"title":"California’s Aid-in-Dying Law Takes Effect Today -- Here's What You Need to Know | KQED","description":"The law takes effect Thursday and gives certain terminally ill patients the right to end their lives at a time of their choosing. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"California’s Aid-in-Dying Law Takes Effect Today -- Here's What You Need to Know","datePublished":"2016-06-08T17:36:17.000Z","dateModified":"2016-06-09T23:42:56.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"195237 http://ww2.kqed.org/stateofhealth/?p=195237","disqusUrl":"https://ww2.kqed.org/stateofhealth/2016/06/08/what-you-need-to-know-about-californias-aid-in-dying-law/","disqusTitle":"California’s Aid-in-Dying Law Takes Effect Today -- Here's What You Need to Know","nprByline":"Emily Bazar\u003cbr />\u003ca href=\"http://californiahealthline.org/\">California Healthline\u003c/a>","path":"/stateofhealth/195237/what-you-need-to-know-about-californias-aid-in-dying-law","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Starting Thursday, June 9, terminally ill Californians with six months or less to live can request a doctor’s prescription for medications intended to end their lives peacefully.\u003c/p>\n\u003cp>If that sounds simple, it won’t be.\u003c/p>\n\u003caside class=\"pullquote alignright\">The patient has to jump through a lot of hoops -- that's to make sure the decision is made voluntarily.\u003c/aside>\n\u003cp>California’s \u003ca href=\"http://www.leginfo.ca.gov/pub/15-16/bill/asm/ab_0001-0050/abx2_15_bill_20151005_chaptered.htm\" target=\"_blank\">End of Life Option Act\u003c/a> creates a long list of administrative hurdles that both patients and their doctors must clear.\u003c/p>\n\u003cp>For instance, you must make multiple requests for the drugs, orally and in writing, and provide a written attestation within 48 hours of taking the medication (you must be able to take the drugs yourself, without help, to qualify).\u003c/p>\n\u003cp>Two doctors must confirm your diagnosis, prognosis and ability to make medical decisions, and you must prove you’re a California resident.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>And more.\u003c/p>\n\u003cp>“This will not be an on-demand service,” says Sarah Hooper, executive director of the \u003ca href=\"http://www.ucconsortium.org/\" target=\"_blank\">UCSF/UC Hastings Consortium on Law, Science and Health Policy\u003c/a>.\u003c/p>\n\u003cp>“The patient has to jump through a lot of hoops before accessing the prescription. Those hoops are designed to ensure that the patient has really thought about this and is making the decision voluntarily.\"\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='100%' height='166'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/268313233&visual=true&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false'\n title='https://api.soundcloud.com/tracks/268313233'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/lowdown/2015/10/06/california-becomes-fifth-state-to-legalize-physician-assisted-suicide-interactive-map/\" target=\"_blank\">California will be the fifth state \u003c/a>to implement an aid-in-dying law, and the Golden State’s version of it is considered the most stringent, says Sean Crowley, spokesman for the advocacy group \u003ca href=\"https://www.compassionandchoices.org/\" target=\"_blank\">Compassion & Choices\u003c/a>.\u003c/p>\n\u003cp>Rather than list every requirement, I’m going to describe a few potential challenges you might face if you or a loved one is considering asking for these medications — ranging from doctors who are unwilling to write prescriptions to the cost of the medications themselves.\u003c/p>\n\u003cp>This law is voluntary “every step of the way,” says state Sen. Bill Monning, D-Carmel, co-author of the law.\u003c/p>\n\u003cp>That means everyone — patients, physicians, health systems and pharmacies — gets to choose whether or not to participate.\u003c/p>\n\u003cp>Nothing requires patients to take the drugs once they have obtained a prescription.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>Since Oregon implemented its law in 1997, more than one-third of people who obtained prescriptions didn’t take the medications, according to \u003ca href=\"http://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Documents/year18.pdf\" target=\"_blank\">data compiled by the Oregon Public Health Division\u003c/a>.\u003c/p>\n\u003cp>“You can still at any point decide, ‘I’m not going to need this. The hospice care is effective. The palliative care is effective,’ ” Monning says.\u003c/p>\n\u003cp>But before you can make that decision, you must first get a prescription — and that might take some doing. That’s because not all health care providers will be on board with the new law. It will be up to you to find the ones who are.\u003c/p>\n\u003cp>“Patients and families should expect that they will have to be a little proactive in asking questions and getting educated about their care,” Hooper says.\u003c/p>\n\u003cp>For instance, the Kaiser Permanente system will participate, and patients will be paired with a coordinator to guide them through the process, says spokeswoman Amy Thoma.\u003c/p>\n\u003cp>If your Kaiser Permanente doctor chooses not to participate, which is his or her right under the law, your coordinator will connect you with a physician who does, Thoma says.\u003c/p>\n\u003cp>But U.S. military veterans who receive health care from the U.S. Department of Veterans Affairs will have to look elsewhere for participating doctors, because federal law prohibits the use of federal money for such a purpose, Hooper says.\u003c/p>\n\u003cp>Nor will the 48 Catholic and Catholic-affiliated hospitals in California participate, including their doctors and staff, says Lori Dangberg, vice president of the \u003ca href=\"http://www.thealliance.net/\" target=\"_blank\">Alliance of Catholic Health Care\u003c/a>.\u003c/p>\n\u003cp>Dangberg insists that those providers will not abandon any patient who chooses to end his or her own life. “We will be with that patient and continue to care for that patient throughout their diagnosis and their dying process,” she says. “We just cannot participate in any action that would intentionally hasten a person’s death.”\u003c/p>\n\u003cp>If your doctor doesn’t participate, ask him or her to refer you to one who does. If your doctor won’t provide a reference, “call us and we can probably help,” says Crowley of Compassion & Choices. That number is 800-893-4548.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>Another potential obstacle is the cost of the drugs. Your insurance might not cover them. California’s law does not require health insurers to cover the medications, Monning says.\u003c/p>\n\u003cp>In Oregon, Washington and Montana — states where aid-in-dying is legal — some health plans cover the cost and some don’t, he says. He expects the same to occur here.\u003c/p>\n\u003cp>Insurers “are currently working on how they will implement this law,” says Nicole Kasabian Evans of the \u003ca href=\"http://www.calhealthplans.org/\" target=\"_blank\">California Association of Health Plans\u003c/a>.\u003c/p>\n\u003cp>If you have questions about coverage, she suggests you contact your insurer directly.\u003c/p>\n\u003cp>Medi-Cal, California’s version of the federal Medicaid program for low-income residents, will cover the cost of the drugs without relying on any federal money, says state Department of Health Care Services spokeswoman Katharine Weir.\u003c/p>\n\u003cp>If affordability becomes an issue, Compassion & Choices again urges you to call. “We try to work with people to find a way for them to access the law, through any challenges,” Crowley says.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>If you need more step-by-step guidance about the law, tap into these resources:\u003c/p>\n\u003cul>\n\u003cli>Compassion & Choices has online guides for consumers and doctors at \u003ca href=\"http://www.endoflifeoption.org/\" target=\"_blank\">www.EndOfLifeOption.org\u003c/a>. You can also call the group’s help line at 800-893-4548.\u003c/li>\n\u003cli>The UCSF/UC Hastings Consortium on Law, Science and Health Policy has a \u003ca href=\"http://www.ucconsortium.org/wp-content/uploads/2015/12/FACT-SHEET-End-of-Life-Option-Act-Updated-01.15.16.pdf\" target=\"_blank\">helpful fact sheet\u003c/a> at \u003ca href=\"http://bit.ly/248Z2l6\" target=\"_blank\">http://bit.ly/248Z2l6\u003c/a>.\u003c/li>\n\u003cli>The California Medical Association, which represents doctors, has a detailed, \u003ca href=\"http://www.cmanet.org/resource-library/detail/?item=the-california-end-of-life-option-act&r_search=Document%203459&r_page=1&return_to=list\" target=\"_blank\">14-page document\u003c/a> at \u003ca href=\"http://www.cmanet.org/endoflife\" target=\"_blank\">www.cmanet.org/endoflife\u003c/a>. You’ll need to register on the site to read the document.\u003c/li>\n\u003cli>Once the law takes effect, or soon thereafter, you will be able to find the forms you and your physician need to sign at the Medical Board of California’s website: \u003ca href=\"http://www.mbc.ca.gov/\" target=\"_blank\">www.mbc.ca.gov\u003c/a>.\u003c/li>\n\u003c/ul>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/195237/what-you-need-to-know-about-californias-aid-in-dying-law","authors":["byline_stateofhealth_195237"],"categories":["stateofhealth_14"],"tags":["stateofhealth_914","stateofhealth_2519","stateofhealth_754"],"featImg":"stateofhealth_195585","label":"stateofhealth"},"stateofhealth_192287":{"type":"posts","id":"stateofhealth_192287","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"192287","score":null,"sort":[1464885108000]},"guestAuthors":[],"slug":"berkeley-physician-opens-practice-focusing-on-aid-in-dying","title":"Berkeley Physician Opens Practice Focusing on Aid-in-Dying","publishDate":1464885108,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>Few people have the unusual set of professional experiences that Lonny Shavelson does. He worked as an emergency room physician in Berkeley for years -- while also working as a journalist. He has written several books and takes hauntingly beautiful photographs.\u003c/p>\n\u003caside class=\"pullquote alignright\">'This can only work when you're sure that the patients have been given the best end-of-life care, which to me is most guaranteed by being a part of hospice or at least having a good palliative care physician.' \u003ccite>Dr. Lonny Shavelson \u003c/cite>\u003c/aside>\n\u003cp>Now he'll add another specialty. Just as California's \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billHistoryClient.xhtml?bill_id=201520162AB15\" target=\"_blank\">End of Life Option Act\u003c/a>, a law legalizing physician aid-in-dying for people who are terminally ill, is set to take effect next week, Shavelson has become a consultant aimed at answering questions from physicians and patients about the practice -- even becoming a physician to terminally ill patients seeking to end their lives.\u003c/p>\n\u003cp>I first met Shavelson in 1996 as I was covering the reaction to Oregon voters' approval of \u003ca href=\"https://ballotpedia.org/Oregon_%22Death_with_Dignity%22,_Measure_16_(1994)\" target=\"_blank\">Measure 16, the state's Death with Dignity Act\u003c/a>.\u003c/p>\n\u003cp>Oregon was the first state to approve the practice, and in 1996 the law was held up in court. I turned to Shavelson as he had published \"\u003ca href=\"http://www.photowords.com/index.php?page=books\" target=\"_blank\">A Chosen Death\u003c/a>,\" a moving book following five terminally ill people over two years as they determined whether to amass drugs on their own and end their lives at a time of their choosing. He was present at the death of all of them.\u003c/p>\n\u003cp>He followed the issue of assisted suicide closely for several years more, but ultimately moved on to other major projects -- among them \u003ca href=\"http://www.photowords.com/index.php?page=books\" target=\"_blank\">a book about addiction\u003c/a> and a \u003ca href=\"http://www.threetoinfinity.com\" target=\"_blank\">documentary\u003c/a> about people who identify as neither male nor female.\u003c/p>\n\u003cfigure id=\"attachment_192314\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"size-full wp-image-192314\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/06/lonnybooks-e1464884484238.jpg\" alt=\"The wall of Lonny Shavelson's office, lined with covers of the books he has written. \" width=\"1920\" height=\"1440\">\u003cfigcaption class=\"wp-caption-text\">The wall of Lonny Shavelson's office, lined with covers of the books he has written. \u003ccite>(Lisa Aliferis/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Then last fall came the \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/10/05/governor-brown-signs-physician-assisted-suicide-bill-into-law-california-right-to-die/\" target=\"_blank\">surprising passage of California's End of Life Option Act,\u003c/a> giving terminally ill adults with six months to live the right to request lethal medication to end their lives. The law takes effect June 9.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Shavelson decided he had to act, although he feels \"quite guilty\" about having been away from the issue while others pushed it forward.\u003c/p>\n\u003cp>\"Can I just sit back and watch?\" Shavelson told me from his cottage office in his backyard in Berkeley. \"This is really an amazing opportunity to be part of establishing policy and initiating something in medicine. This is a major change ... [that] very, very few people know anything about and how to do it.\"\u003c/p>\n\u003cp>His website, \u003ca href=\"https://bayareaendoflifeoptions.com\" target=\"_blank\">Bay Area End of Life Options,\u003c/a> went up in April, and he's outlined the law at \"grand rounds\" at several Bay Area hospitals this spring. His practice will be focused on consulting not only with physicians whose patients request aid-in-dying, but also with patients themselves, including offering care to patients who choose him as their \"attending End-of-Life physician,\" as he indicates on his site.\u003c/p>\n\u003cp>Shavelson is adamant that this is \"something that has to be done right.\" To him, that means starting every patient encounter with a one-word question: \"Why?\"\u003c/p>\n\u003cp>\"In fact, it's the only initial approach that I think is acceptable. If somebody calls me and says, 'I want to take the medication,' my first question is, why? Let me talk to you about all the various alternatives and all the ways that we can think about this,\" he predicts he will say.\u003c/p>\n\u003cp>Shavelson worries that patients may seek aid-in-dying because they are in pain, so first, he would like all his patients to be enrolled in hospice care.\u003c/p>\n\u003cp>\"This can only work when you're sure that the patients have been given the best end-of-life care, which to me is most guaranteed by being a part of hospice or at least having a good palliative care physician. Then this is a rational decision. If you're doing it otherwise, it's because of lack of good care.\"\u003c/p>\n\u003cp>California is the fifth state to legalize aid-in-dying, joining Oregon, Washington, Vermont and Montana. The option is very rarely used. For example, in \u003ca href=\"http://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Documents/year17.pdf\" target=\"_blank\">2014 in Oregon\u003c/a>, 155 lethal prescriptions were written under the state's law, and 105 people ultimately took the medicine and died, a death rate under this method of less than 0.5 percent.\u003c/p>\n\u003cp>Under the law, two doctors must agree that a mentally competent patient has six months or less to live. One of the patient-doctor meetings must be private, between only the patient and the physician, to ensure the patient is acting independently. Patients must be able to swallow the medication themselves and must state, in writing, within 48 hours before taking the medication, that they will do so.\u003c/p>\n\u003cp>Shavelson says he has been surprised by the lack of understanding he hears from some health care providers about the law. One person insisted the law was not taking effect this year; another asked how the law would benefit his patients with Alzheimer's disease. To be clear, the law takes effect next week, and patients with dementia cannot access the law because they are not mentally competent.\u003c/p>\n\u003cfigure id=\"attachment_192674\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003cimg class=\"wp-image-192674 size-thumbnail\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/06/Renee-1-copy-400x598.jpg\" alt='Renee Sahm, one of five terminally ill people followed by Lonny Shavelson in his 1994 book \"A Chosen Death.\"' width=\"400\" height=\"598\">\u003cfigcaption class=\"wp-caption-text\">Renee Sahm, one of five terminally ill people followed by Lonny Shavelson in his 1995 book \"A Chosen Death.\" \u003ccite>(Courtesy: Lonny Shavelson)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The law does not mandate participation by any health care providers. Many physicians are \"queasy\" with the new law, Shavelson says he's hearing, and are unwilling to prescribe to patients who request the lethal medication -- even though they tell him they think the law is the right thing to do.\u003c/p>\n\u003cp>\"My response to that is as health care providers, you might have been uncomfortable the first time you drew blood. You might have been uncomfortable the first time you took out somebody's gall bladder,\" he says. \"If it's a medical procedure you believe in and you believe it's the patient's right, then it's your obligation to learn how to do it -- and do it correctly.\"\u003c/p>\n\u003cp>Shavelson said he predicts that many physicians who are initially reluctant to provide this option to their patients may become more comfortable after the law goes into effect and they see how it works.\u003c/p>\n\u003cp>Burt Presberg, an East Bay psychiatrist who works specifically with cancer patients and their families, said a talk he attended by Shavelson sparked a conversation at his practice. Yet, in my own talk with him, he peppered his statements with \"on the other hand,\" as he clearly wrestled with his own comfort level of handling patient requests.\u003c/p>\n\u003cp>Presberg spoke of his concern that patients suffer from clinical depression at the end of life, sometimes feeling they are a burden to family members who could \"really push for the end of life to happen a little sooner than the patient themselves.\" He spoke from his experience of successfully treating terminally ill patients with clinical depression.\u003c/p>\n\u003cp>\"Depression is something that's really undertreated,\" Presberg said. \"I often talk to people about the difference between normal sadness and normal grieving at the end of life.\"\u003c/p>\n\u003cp>He said he believes Shavelson will be aware of treating depression, \"but I do have concerns about other physicians,\" he said. \"On the other hand, I think it's really good that this is an option.\"\u003c/p>\n\u003cp>Shavelson says he's already received a handful of calls from patients, but he's mostly spent this time before the law takes effect talking to other physicians. He needs a consulting physician and a pharmacist that will accept prescriptions for the lethal dose of medicine.\u003c/p>\n\u003cp>Then he returns to the patient. \"It's important ... that we're moving forward,\" he says. \"It's crucial that we do that because this is part of the rights of patient care to have a certain level of autonomy in how they die.\"\u003c/p>\n\u003cp>To many of the doctors who feel \"queasy\" about moving to end a patient's life, this type of care \"isn't so tangibly different to me,\" Shavelson says, than other kinds of questions doctors address.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\"I'm just one of those docs who sees dying as a process, and method of death is less important than making sure it's a good death.\"\u003c/p>\n\n","blocks":[],"excerpt":"California's law permitting doctors to prescribe lethal medications to terminally ill patients who request it takes effect next week.","status":"publish","parent":0,"modified":1465000662,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":29,"wordCount":1372},"headData":{"title":"Berkeley Physician Opens Practice Focusing on Aid-in-Dying | KQED","description":"California's law permitting doctors to prescribe lethal medications to terminally ill patients who request it takes effect next week.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Berkeley Physician Opens Practice Focusing on Aid-in-Dying","datePublished":"2016-06-02T16:31:48.000Z","dateModified":"2016-06-04T00:37:42.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"192287 http://ww2.kqed.org/stateofhealth/?p=192287","disqusUrl":"https://ww2.kqed.org/stateofhealth/2016/06/02/berkeley-physician-opens-practice-focusing-on-aid-in-dying/","disqusTitle":"Berkeley Physician Opens Practice Focusing on Aid-in-Dying","path":"/stateofhealth/192287/berkeley-physician-opens-practice-focusing-on-aid-in-dying","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Few people have the unusual set of professional experiences that Lonny Shavelson does. He worked as an emergency room physician in Berkeley for years -- while also working as a journalist. He has written several books and takes hauntingly beautiful photographs.\u003c/p>\n\u003caside class=\"pullquote alignright\">'This can only work when you're sure that the patients have been given the best end-of-life care, which to me is most guaranteed by being a part of hospice or at least having a good palliative care physician.' \u003ccite>Dr. Lonny Shavelson \u003c/cite>\u003c/aside>\n\u003cp>Now he'll add another specialty. Just as California's \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billHistoryClient.xhtml?bill_id=201520162AB15\" target=\"_blank\">End of Life Option Act\u003c/a>, a law legalizing physician aid-in-dying for people who are terminally ill, is set to take effect next week, Shavelson has become a consultant aimed at answering questions from physicians and patients about the practice -- even becoming a physician to terminally ill patients seeking to end their lives.\u003c/p>\n\u003cp>I first met Shavelson in 1996 as I was covering the reaction to Oregon voters' approval of \u003ca href=\"https://ballotpedia.org/Oregon_%22Death_with_Dignity%22,_Measure_16_(1994)\" target=\"_blank\">Measure 16, the state's Death with Dignity Act\u003c/a>.\u003c/p>\n\u003cp>Oregon was the first state to approve the practice, and in 1996 the law was held up in court. I turned to Shavelson as he had published \"\u003ca href=\"http://www.photowords.com/index.php?page=books\" target=\"_blank\">A Chosen Death\u003c/a>,\" a moving book following five terminally ill people over two years as they determined whether to amass drugs on their own and end their lives at a time of their choosing. He was present at the death of all of them.\u003c/p>\n\u003cp>He followed the issue of assisted suicide closely for several years more, but ultimately moved on to other major projects -- among them \u003ca href=\"http://www.photowords.com/index.php?page=books\" target=\"_blank\">a book about addiction\u003c/a> and a \u003ca href=\"http://www.threetoinfinity.com\" target=\"_blank\">documentary\u003c/a> about people who identify as neither male nor female.\u003c/p>\n\u003cfigure id=\"attachment_192314\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"size-full wp-image-192314\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/06/lonnybooks-e1464884484238.jpg\" alt=\"The wall of Lonny Shavelson's office, lined with covers of the books he has written. \" width=\"1920\" height=\"1440\">\u003cfigcaption class=\"wp-caption-text\">The wall of Lonny Shavelson's office, lined with covers of the books he has written. \u003ccite>(Lisa Aliferis/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Then last fall came the \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/10/05/governor-brown-signs-physician-assisted-suicide-bill-into-law-california-right-to-die/\" target=\"_blank\">surprising passage of California's End of Life Option Act,\u003c/a> giving terminally ill adults with six months to live the right to request lethal medication to end their lives. The law takes effect June 9.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Shavelson decided he had to act, although he feels \"quite guilty\" about having been away from the issue while others pushed it forward.\u003c/p>\n\u003cp>\"Can I just sit back and watch?\" Shavelson told me from his cottage office in his backyard in Berkeley. \"This is really an amazing opportunity to be part of establishing policy and initiating something in medicine. This is a major change ... [that] very, very few people know anything about and how to do it.\"\u003c/p>\n\u003cp>His website, \u003ca href=\"https://bayareaendoflifeoptions.com\" target=\"_blank\">Bay Area End of Life Options,\u003c/a> went up in April, and he's outlined the law at \"grand rounds\" at several Bay Area hospitals this spring. His practice will be focused on consulting not only with physicians whose patients request aid-in-dying, but also with patients themselves, including offering care to patients who choose him as their \"attending End-of-Life physician,\" as he indicates on his site.\u003c/p>\n\u003cp>Shavelson is adamant that this is \"something that has to be done right.\" To him, that means starting every patient encounter with a one-word question: \"Why?\"\u003c/p>\n\u003cp>\"In fact, it's the only initial approach that I think is acceptable. If somebody calls me and says, 'I want to take the medication,' my first question is, why? Let me talk to you about all the various alternatives and all the ways that we can think about this,\" he predicts he will say.\u003c/p>\n\u003cp>Shavelson worries that patients may seek aid-in-dying because they are in pain, so first, he would like all his patients to be enrolled in hospice care.\u003c/p>\n\u003cp>\"This can only work when you're sure that the patients have been given the best end-of-life care, which to me is most guaranteed by being a part of hospice or at least having a good palliative care physician. Then this is a rational decision. If you're doing it otherwise, it's because of lack of good care.\"\u003c/p>\n\u003cp>California is the fifth state to legalize aid-in-dying, joining Oregon, Washington, Vermont and Montana. The option is very rarely used. For example, in \u003ca href=\"http://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Documents/year17.pdf\" target=\"_blank\">2014 in Oregon\u003c/a>, 155 lethal prescriptions were written under the state's law, and 105 people ultimately took the medicine and died, a death rate under this method of less than 0.5 percent.\u003c/p>\n\u003cp>Under the law, two doctors must agree that a mentally competent patient has six months or less to live. One of the patient-doctor meetings must be private, between only the patient and the physician, to ensure the patient is acting independently. Patients must be able to swallow the medication themselves and must state, in writing, within 48 hours before taking the medication, that they will do so.\u003c/p>\n\u003cp>Shavelson says he has been surprised by the lack of understanding he hears from some health care providers about the law. One person insisted the law was not taking effect this year; another asked how the law would benefit his patients with Alzheimer's disease. To be clear, the law takes effect next week, and patients with dementia cannot access the law because they are not mentally competent.\u003c/p>\n\u003cfigure id=\"attachment_192674\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003cimg class=\"wp-image-192674 size-thumbnail\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/06/Renee-1-copy-400x598.jpg\" alt='Renee Sahm, one of five terminally ill people followed by Lonny Shavelson in his 1994 book \"A Chosen Death.\"' width=\"400\" height=\"598\">\u003cfigcaption class=\"wp-caption-text\">Renee Sahm, one of five terminally ill people followed by Lonny Shavelson in his 1995 book \"A Chosen Death.\" \u003ccite>(Courtesy: Lonny Shavelson)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The law does not mandate participation by any health care providers. Many physicians are \"queasy\" with the new law, Shavelson says he's hearing, and are unwilling to prescribe to patients who request the lethal medication -- even though they tell him they think the law is the right thing to do.\u003c/p>\n\u003cp>\"My response to that is as health care providers, you might have been uncomfortable the first time you drew blood. You might have been uncomfortable the first time you took out somebody's gall bladder,\" he says. \"If it's a medical procedure you believe in and you believe it's the patient's right, then it's your obligation to learn how to do it -- and do it correctly.\"\u003c/p>\n\u003cp>Shavelson said he predicts that many physicians who are initially reluctant to provide this option to their patients may become more comfortable after the law goes into effect and they see how it works.\u003c/p>\n\u003cp>Burt Presberg, an East Bay psychiatrist who works specifically with cancer patients and their families, said a talk he attended by Shavelson sparked a conversation at his practice. Yet, in my own talk with him, he peppered his statements with \"on the other hand,\" as he clearly wrestled with his own comfort level of handling patient requests.\u003c/p>\n\u003cp>Presberg spoke of his concern that patients suffer from clinical depression at the end of life, sometimes feeling they are a burden to family members who could \"really push for the end of life to happen a little sooner than the patient themselves.\" He spoke from his experience of successfully treating terminally ill patients with clinical depression.\u003c/p>\n\u003cp>\"Depression is something that's really undertreated,\" Presberg said. \"I often talk to people about the difference between normal sadness and normal grieving at the end of life.\"\u003c/p>\n\u003cp>He said he believes Shavelson will be aware of treating depression, \"but I do have concerns about other physicians,\" he said. \"On the other hand, I think it's really good that this is an option.\"\u003c/p>\n\u003cp>Shavelson says he's already received a handful of calls from patients, but he's mostly spent this time before the law takes effect talking to other physicians. He needs a consulting physician and a pharmacist that will accept prescriptions for the lethal dose of medicine.\u003c/p>\n\u003cp>Then he returns to the patient. \"It's important ... that we're moving forward,\" he says. \"It's crucial that we do that because this is part of the rights of patient care to have a certain level of autonomy in how they die.\"\u003c/p>\n\u003cp>To many of the doctors who feel \"queasy\" about moving to end a patient's life, this type of care \"isn't so tangibly different to me,\" Shavelson says, than other kinds of questions doctors address.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"I'm just one of those docs who sees dying as a process, and method of death is less important than making sure it's a good death.\"\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/192287/berkeley-physician-opens-practice-focusing-on-aid-in-dying","authors":["240"],"categories":["stateofhealth_2407","stateofhealth_13"],"tags":["stateofhealth_914","stateofhealth_40","stateofhealth_2519","stateofhealth_754"],"featImg":"stateofhealth_192726","label":"stateofhealth"},"stateofhealth_163375":{"type":"posts","id":"stateofhealth_163375","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"163375","score":null,"sort":[1458703412000]},"guestAuthors":[],"slug":"pharmaceutical-companies-hiked-price-on-aid-in-dying-drug","title":"Pharmaceutical Companies Hiked Price on Aid in Dying Drug","publishDate":1458703412,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>When California's\u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/10/05/governor-brown-signs-physician-assisted-suicide-bill-into-law-california-right-to-die/\" target=\"_blank\"> aid-in-dying law\u003c/a> takes effect this June, terminally ill patients who decide to end their lives could be faced with a hefty bill for the lethal medication. It retails for more than $3,000.\u003c/p>\n\u003cp>Valeant Pharmaceuticals, the company that makes the drug most commonly used in physician-assisted suicide, doubled the drug's price last year, one month after California lawmakers \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/01/22/california-bill-would-allow-terminally-ill-to-end-their-own-lives/\" target=\"_blank\">proposed legalizing the practice\u003c/a>.\u003c/p>\n\u003cp>“It’s just pharmaceutical company greed,” said David Grube, a family doctor in Oregon, where physician-assisted death has been legal for 20 years.\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/254659907\" params=\"color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" iframe=\"true\" /]\u003c/p>\n\u003cp>The drug is Seconal, or secobarbital, its generic name. Originally developed in the 1930s as a sleeping pill, it fell out of favor when people died from taking too much, or from taking it in combination with alcohol. But when intended as a lethal medication to hasten the death of someone suffering from a terminal disease, Seconal is the drug of choice.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“It works very quickly and very gently,” Grube says. “People fall asleep with no complications. It's a very gentle passing.”\u003c/p>\n\u003cp>In 2009, Grube remembers the price of a lethal dose of Seconal -- 100 capsules -- was less than $200. Over the next six years, it shot up to $1,500, according to drug price databases Medi-Span and First Databank. Then Valeant bought Seconal last February and immediately doubled the price to $3,000.\u003c/p>\n\u003cp>Most drug companies justify such hikes by pointing to high research costs. But Grube says that’s not the case with Seconal. It’s been around for 80 years.\u003c/p>\n\u003cp>“It’s not a complicated thing to make, there’s no research being done on it, there’s no development,” he says. “That to me is unconscionable.”\u003c/p>\n\u003cp>Valeant bought several other drugs at the same time it bought Seconal, raising some of those prices as much as 500 percent. That sparked a \u003ca href=\"http://www.npr.org/sections/health-shots/2015/12/09/458976680/senate-questions-egregious-price-hikes-for-specialty-medicines\" target=\"_blank\">congressional investigation\u003c/a> into its pricing practices. (The CEO resigned Monday amid an accounting controversy).\u003c/p>\n\u003caside class=\"pullquote alignright\">'You are literally, at that point, taking the money from children.'\u003ccite>Elizabeth Wallner, stage 4 cancer patient\u003c/cite>\u003c/aside>\n\u003cp>“Valeant sets prices for drugs based on a number of factors,” the company said in a statement, including the cost of developing or acquiring the drug, the availability of generics and the benefits of the drug compared with costly alternative treatments. “When possible, we offer patient assistance programs to mitigate the effects of price adjustments and keep out-of-pocket costs affordable for patients.”\u003c/p>\n\u003cp>The most likely explanation for raising the price of Seconal is the lack of generics, says Mick Kolassa, founding partner of Medical Marketing Economics, a firm that advises drug companies on how to price and market their drugs.\u003c/p>\n\u003cp>Seconal went off patent in the early '90s. There were some generics for a while, but then demand shrank and manufacturers abandoned them.\u003c/p>\n\u003cp>“So that meant when the current company bought it, they didn't have any generic competition, simply because the market got so small that it left,” Kolassa said. “So in situations like that, a company can acquire it and raise the price.”\u003c/p>\n\u003cp>Kolassa says it’s also possible that the demand for even the brand-name drug is so low that it’s hard to recoup the costs of making and selling it.\u003c/p>\n\u003cp>“Here's a company that said, well, we can raise the price, keep it on the market and make some money with it,” he said. “Or we can walk away and the product goes away.”\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/254347186\" params=\"color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" iframe=\"true\" /]\u003c/p>\n\u003cp>Whatever the explanation, what cancer patients like Elizabeth Wallner see is a drug company taking advantage. She has one word to describe the pharmaceutical executive who decided to double the price of Seconal: “Scumbag.”\u003c/p>\n\u003cp>Wallner was diagnosed with Stage 4 colon cancer five years ago. It spread to her liver and lungs. She always thought that if her suffering became too unbearable, she would consider ending her life. But she never thought about the price tag of the lethal drug.\u003c/p>\n\u003cp>“You're going to make money off my death,” she said.\u003c/p>\n\u003cp>She’s most worried about her son.\u003c/p>\n\u003cp>“You are literally, at that point, taking the money from children,” she said. “Everything I have, if I’m going to die tomorrow, everything I have will be left to my son who will be 20 years old and almost 100 percent on his own.”\u003c/p>\n\u003cp>[contextly_sidebar id=\"idxXpDM3MGhhfWlN5bJA10v3JP8sAgQZ\"]\u003c/p>\n\u003cp>Under the California aid-in-dying law, it is optional for health insurance companies to cover the costs of the practice. Most private insurers plan to do so, according to the California Association of Health Plans. So does the state’s \u003ca href=\"http://www.usnews.com/news/articles/2016-03-21/in-california-government-to-pick-up-the-tab-for-death-with-dignity\" target=\"_blank\">Medicaid program\u003c/a>.\u003c/p>\n\u003cp>But for patients who aren’t covered, there is a cheaper alternative: a three-part drug cocktail that can be mixed by a compounding pharmacy for about $400.\u003c/p>\n\u003cp>Grube says the cocktail works just as well, but doctors usually don't prescribe it because of the hassle some patients have to go through to get it. Seconal, on the other hand, is a ready-made pill, routinely available at most retail drugstores.\u003c/p>\n\u003cp>He says advocacy groups like Compassion & Choices are working on campaigns to reduce drug costs and to \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/10/12/education-push-to-help-doctors-field-patients-assisted-death-requests/\" target=\"_blank\">educate doctors\u003c/a> and patients about the law.\u003c/p>\n\u003cp>“My dream is that any Californian who will choose aid in dying would have few burdens or barriers to jump through,” Grube said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Katie Orr contributed reporting from Sacramento. \u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"The drug's price went from $200 in 2009 to $3,000 today. Doctors and patients want to know why.","status":"publish","parent":0,"modified":1458768491,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":31,"wordCount":1007},"headData":{"title":"Pharmaceutical Companies Hiked Price on Aid in Dying Drug | KQED","description":"The drug's price went from $200 in 2009 to $3,000 today. Doctors and patients want to know why.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Pharmaceutical Companies Hiked Price on Aid in Dying Drug","datePublished":"2016-03-23T03:23:32.000Z","dateModified":"2016-03-23T21:28:11.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"163375 http://ww2.kqed.org/stateofhealth/?p=163375","disqusUrl":"https://ww2.kqed.org/stateofhealth/2016/03/22/pharmaceutical-companies-hiked-price-on-aid-in-dying-drug/","disqusTitle":"Pharmaceutical Companies Hiked Price on Aid in Dying Drug","path":"/stateofhealth/163375/pharmaceutical-companies-hiked-price-on-aid-in-dying-drug","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>When California's\u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/10/05/governor-brown-signs-physician-assisted-suicide-bill-into-law-california-right-to-die/\" target=\"_blank\"> aid-in-dying law\u003c/a> takes effect this June, terminally ill patients who decide to end their lives could be faced with a hefty bill for the lethal medication. It retails for more than $3,000.\u003c/p>\n\u003cp>Valeant Pharmaceuticals, the company that makes the drug most commonly used in physician-assisted suicide, doubled the drug's price last year, one month after California lawmakers \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/01/22/california-bill-would-allow-terminally-ill-to-end-their-own-lives/\" target=\"_blank\">proposed legalizing the practice\u003c/a>.\u003c/p>\n\u003cp>“It’s just pharmaceutical company greed,” said David Grube, a family doctor in Oregon, where physician-assisted death has been legal for 20 years.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='100%' height='166'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/254659907&visual=true&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false'\n title='https://api.soundcloud.com/tracks/254659907'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The drug is Seconal, or secobarbital, its generic name. Originally developed in the 1930s as a sleeping pill, it fell out of favor when people died from taking too much, or from taking it in combination with alcohol. But when intended as a lethal medication to hasten the death of someone suffering from a terminal disease, Seconal is the drug of choice.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“It works very quickly and very gently,” Grube says. “People fall asleep with no complications. It's a very gentle passing.”\u003c/p>\n\u003cp>In 2009, Grube remembers the price of a lethal dose of Seconal -- 100 capsules -- was less than $200. Over the next six years, it shot up to $1,500, according to drug price databases Medi-Span and First Databank. Then Valeant bought Seconal last February and immediately doubled the price to $3,000.\u003c/p>\n\u003cp>Most drug companies justify such hikes by pointing to high research costs. But Grube says that’s not the case with Seconal. It’s been around for 80 years.\u003c/p>\n\u003cp>“It’s not a complicated thing to make, there’s no research being done on it, there’s no development,” he says. “That to me is unconscionable.”\u003c/p>\n\u003cp>Valeant bought several other drugs at the same time it bought Seconal, raising some of those prices as much as 500 percent. That sparked a \u003ca href=\"http://www.npr.org/sections/health-shots/2015/12/09/458976680/senate-questions-egregious-price-hikes-for-specialty-medicines\" target=\"_blank\">congressional investigation\u003c/a> into its pricing practices. (The CEO resigned Monday amid an accounting controversy).\u003c/p>\n\u003caside class=\"pullquote alignright\">'You are literally, at that point, taking the money from children.'\u003ccite>Elizabeth Wallner, stage 4 cancer patient\u003c/cite>\u003c/aside>\n\u003cp>“Valeant sets prices for drugs based on a number of factors,” the company said in a statement, including the cost of developing or acquiring the drug, the availability of generics and the benefits of the drug compared with costly alternative treatments. “When possible, we offer patient assistance programs to mitigate the effects of price adjustments and keep out-of-pocket costs affordable for patients.”\u003c/p>\n\u003cp>The most likely explanation for raising the price of Seconal is the lack of generics, says Mick Kolassa, founding partner of Medical Marketing Economics, a firm that advises drug companies on how to price and market their drugs.\u003c/p>\n\u003cp>Seconal went off patent in the early '90s. There were some generics for a while, but then demand shrank and manufacturers abandoned them.\u003c/p>\n\u003cp>“So that meant when the current company bought it, they didn't have any generic competition, simply because the market got so small that it left,” Kolassa said. “So in situations like that, a company can acquire it and raise the price.”\u003c/p>\n\u003cp>Kolassa says it’s also possible that the demand for even the brand-name drug is so low that it’s hard to recoup the costs of making and selling it.\u003c/p>\n\u003cp>“Here's a company that said, well, we can raise the price, keep it on the market and make some money with it,” he said. “Or we can walk away and the product goes away.”\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='100%' height='166'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/254347186&visual=true&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false'\n title='https://api.soundcloud.com/tracks/254347186'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Whatever the explanation, what cancer patients like Elizabeth Wallner see is a drug company taking advantage. She has one word to describe the pharmaceutical executive who decided to double the price of Seconal: “Scumbag.”\u003c/p>\n\u003cp>Wallner was diagnosed with Stage 4 colon cancer five years ago. It spread to her liver and lungs. She always thought that if her suffering became too unbearable, she would consider ending her life. But she never thought about the price tag of the lethal drug.\u003c/p>\n\u003cp>“You're going to make money off my death,” she said.\u003c/p>\n\u003cp>She’s most worried about her son.\u003c/p>\n\u003cp>“You are literally, at that point, taking the money from children,” she said. “Everything I have, if I’m going to die tomorrow, everything I have will be left to my son who will be 20 years old and almost 100 percent on his own.”\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Under the California aid-in-dying law, it is optional for health insurance companies to cover the costs of the practice. Most private insurers plan to do so, according to the California Association of Health Plans. So does the state’s \u003ca href=\"http://www.usnews.com/news/articles/2016-03-21/in-california-government-to-pick-up-the-tab-for-death-with-dignity\" target=\"_blank\">Medicaid program\u003c/a>.\u003c/p>\n\u003cp>But for patients who aren’t covered, there is a cheaper alternative: a three-part drug cocktail that can be mixed by a compounding pharmacy for about $400.\u003c/p>\n\u003cp>Grube says the cocktail works just as well, but doctors usually don't prescribe it because of the hassle some patients have to go through to get it. Seconal, on the other hand, is a ready-made pill, routinely available at most retail drugstores.\u003c/p>\n\u003cp>He says advocacy groups like Compassion & Choices are working on campaigns to reduce drug costs and to \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/10/12/education-push-to-help-doctors-field-patients-assisted-death-requests/\" target=\"_blank\">educate doctors\u003c/a> and patients about the law.\u003c/p>\n\u003cp>“My dream is that any Californian who will choose aid in dying would have few burdens or barriers to jump through,” Grube said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Katie Orr contributed reporting from Sacramento. \u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/163375/pharmaceutical-companies-hiked-price-on-aid-in-dying-drug","authors":["3205"],"categories":["stateofhealth_13"],"tags":["stateofhealth_914","stateofhealth_2640","stateofhealth_2519","stateofhealth_754"],"featImg":"stateofhealth_163454","label":"stateofhealth"},"stateofhealth_158367":{"type":"posts","id":"stateofhealth_158367","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"158367","score":null,"sort":[1457645298000]},"guestAuthors":[],"slug":"californias-physician-assisted-suicide-law-to-take-effect-in-june","title":"California's 'Physician-Assisted Suicide' Law To Take Effect in June","publishDate":1457645298,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>California Gov. Jerry Brown \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/10/05/governor-brown-signs-physician-assisted-suicide-bill-into-law-california-right-to-die/\" target=\"_blank\">signed landmark legislation\u003c/a> last October that would allow terminally ill people to request life-ending medication from their physicians.\u003c/p>\n\u003cp>But no one knew when the law would take effect, because of the unusual way in which the law was passed -- in a legislative \"extraordinary session\" called by Gov. Brown. The bill could not go into effect until 90 days after the session adjourned.\u003c/p>\n\u003cp>That was this morning, after the Senate sent\u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/03/10/california-legislature-raises-tobacco-age-to-21-on-to-gov-brown/\" target=\"_blank\"> new tobacco regulations \u003c/a>to the governor's desk and means the \"\u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520162AB15\" target=\"_blank\">End of Life Option Act\u003c/a>\" will go into effect June 9.\u003c/p>\n\u003cp>\"We're glad to finally have arrived at this day where we have a date certain,\" said Sen. Bill Monning, D-Carmel, in an interview.\u003c/p>\n\u003cp>[contextly_sidebar id=\"QprUvNgADZTCik5lQFnDPC4zn6m3MBQ0\"]\"It's a historic achievement for California, and for a limited universe of people dealing with a terminal illness, it could indeed be a transformative way of giving them the option of a compassionate end-of-life process.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Disability-rights advocates fought hard last year against passage of the act and continue to voice concern.\u003c/p>\n\u003cp>Golden said it's impossible to know if a depressed patient went to many doctors who all denied the request for lethal medication before finding one who agreed to write the prescription.\u003c/p>\n\u003cp>\"We are looking ahead at measures to protect people from abuse,\" said Marilyn Golden, senior policy analyst with the Disability Rights Education & Defense Fund, \"and to explore and inform doctors, nurses and pharmacists that they don't have to participate.\"\u003c/p>\n\u003cp>As written, \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520162AB15\" target=\"_blank\">the law \u003c/a>requires two doctors to agree that a patient has six months or less to live before prescribing the drugs. Patients must be able to swallow the medication themselves and must affirm in writing 48 hours before taking the medication that they will do so.\u003c/p>\n\u003cp>California is the \u003ca href=\"http://ww2.kqed.org/lowdown/2015/10/06/california-becomes-fifth-state-to-legalize-physician-assisted-suicide-interactive-map/\" target=\"_blank\">fifth state\u003c/a> to permit this end of life option. It joins Vermont, Oregon, Washington and Montana.\u003c/p>\n\u003cp>Across the state, some patients with advanced cancer welcomed the news.\u003c/p>\n\u003cp>\"It gives me a great peace of mind to know that I will not be forced to die slowly and painfully,\" said Elizabeth Wallner, in a release from Compassion & Choices, an advocacy group. Wallner, 52, of Sacramento, is a single mother\u003cstrong> \u003c/strong>with stage IV colon cancer that has spread to her liver and lungs.\u003c/p>\n\u003cp>\"It gives great comfort to know that the agonizingly traumatic image of me suffering will not be my family's last memory of me,\" she said.\u003c/p>\n\u003cp>Sen. Monning expressed his gratitude to people who worked for passage of the law, some in their final days:\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>Brittany Maynard\u003c/strong>, an Orange County woman with brain cancer who moved to Oregon to take advantage of aid-in-dying there. Before she died, \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/03/25/posthumous-brittany-maynard-video-supports-calif-death-with-dignity-bill/\" target=\"_blank\">she recorded a video\u003c/a> that was shown during hearings on the \"End of Life Option Act\" in Sacramento\u003c/li>\n\u003cli>\u003cstrong>Jennifer Glass\u003c/strong>, of San Mateo, who helped to \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/04/07/death-with-dignity-advocates-launch-new-campaign-for-physician-assisted-suicide-in-california/\" target=\"_blank\">launch the campaign in 2014\u003c/a>, then died of lung cancer last year\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"http://www.latimes.com/local/politics/la-me-0212-christy-odonnell-20160212-story.html\" target=\"_blank\">Christy O'Donnell\u003c/a>\u003c/strong>, 47, of Los Angeles, who died of lung cancer last month\u003c/li>\n\u003c/ul>\n\u003cp>\u003c/p>\n\u003cp>\"I really believe we use today to mark and dedicate the memory .. of some true champions,\" Monning said.\u003c/p>\n\n","blocks":[],"excerpt":"The law had to wait until 90 days after the end of a \"special session\" of the legislature. It was adjourned on Thursday.","status":"publish","parent":0,"modified":1457708742,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":17,"wordCount":531},"headData":{"title":"California's 'Physician-Assisted Suicide' Law To Take Effect in June | KQED","description":"The law had to wait until 90 days after the end of a "special session" of the legislature. It was adjourned on Thursday.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"California's 'Physician-Assisted Suicide' Law To Take Effect in June","datePublished":"2016-03-10T21:28:18.000Z","dateModified":"2016-03-11T15:05:42.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"158367 http://ww2.kqed.org/stateofhealth/?p=158367","disqusUrl":"https://ww2.kqed.org/stateofhealth/2016/03/10/californias-physician-assisted-suicide-law-to-take-effect-in-june/","disqusTitle":"California's 'Physician-Assisted Suicide' Law To Take Effect in June","path":"/stateofhealth/158367/californias-physician-assisted-suicide-law-to-take-effect-in-june","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>California Gov. Jerry Brown \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/10/05/governor-brown-signs-physician-assisted-suicide-bill-into-law-california-right-to-die/\" target=\"_blank\">signed landmark legislation\u003c/a> last October that would allow terminally ill people to request life-ending medication from their physicians.\u003c/p>\n\u003cp>But no one knew when the law would take effect, because of the unusual way in which the law was passed -- in a legislative \"extraordinary session\" called by Gov. Brown. The bill could not go into effect until 90 days after the session adjourned.\u003c/p>\n\u003cp>That was this morning, after the Senate sent\u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/03/10/california-legislature-raises-tobacco-age-to-21-on-to-gov-brown/\" target=\"_blank\"> new tobacco regulations \u003c/a>to the governor's desk and means the \"\u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520162AB15\" target=\"_blank\">End of Life Option Act\u003c/a>\" will go into effect June 9.\u003c/p>\n\u003cp>\"We're glad to finally have arrived at this day where we have a date certain,\" said Sen. Bill Monning, D-Carmel, in an interview.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\"It's a historic achievement for California, and for a limited universe of people dealing with a terminal illness, it could indeed be a transformative way of giving them the option of a compassionate end-of-life process.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Disability-rights advocates fought hard last year against passage of the act and continue to voice concern.\u003c/p>\n\u003cp>Golden said it's impossible to know if a depressed patient went to many doctors who all denied the request for lethal medication before finding one who agreed to write the prescription.\u003c/p>\n\u003cp>\"We are looking ahead at measures to protect people from abuse,\" said Marilyn Golden, senior policy analyst with the Disability Rights Education & Defense Fund, \"and to explore and inform doctors, nurses and pharmacists that they don't have to participate.\"\u003c/p>\n\u003cp>As written, \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520162AB15\" target=\"_blank\">the law \u003c/a>requires two doctors to agree that a patient has six months or less to live before prescribing the drugs. Patients must be able to swallow the medication themselves and must affirm in writing 48 hours before taking the medication that they will do so.\u003c/p>\n\u003cp>California is the \u003ca href=\"http://ww2.kqed.org/lowdown/2015/10/06/california-becomes-fifth-state-to-legalize-physician-assisted-suicide-interactive-map/\" target=\"_blank\">fifth state\u003c/a> to permit this end of life option. It joins Vermont, Oregon, Washington and Montana.\u003c/p>\n\u003cp>Across the state, some patients with advanced cancer welcomed the news.\u003c/p>\n\u003cp>\"It gives me a great peace of mind to know that I will not be forced to die slowly and painfully,\" said Elizabeth Wallner, in a release from Compassion & Choices, an advocacy group. Wallner, 52, of Sacramento, is a single mother\u003cstrong> \u003c/strong>with stage IV colon cancer that has spread to her liver and lungs.\u003c/p>\n\u003cp>\"It gives great comfort to know that the agonizingly traumatic image of me suffering will not be my family's last memory of me,\" she said.\u003c/p>\n\u003cp>Sen. Monning expressed his gratitude to people who worked for passage of the law, some in their final days:\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>Brittany Maynard\u003c/strong>, an Orange County woman with brain cancer who moved to Oregon to take advantage of aid-in-dying there. Before she died, \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/03/25/posthumous-brittany-maynard-video-supports-calif-death-with-dignity-bill/\" target=\"_blank\">she recorded a video\u003c/a> that was shown during hearings on the \"End of Life Option Act\" in Sacramento\u003c/li>\n\u003cli>\u003cstrong>Jennifer Glass\u003c/strong>, of San Mateo, who helped to \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/04/07/death-with-dignity-advocates-launch-new-campaign-for-physician-assisted-suicide-in-california/\" target=\"_blank\">launch the campaign in 2014\u003c/a>, then died of lung cancer last year\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"http://www.latimes.com/local/politics/la-me-0212-christy-odonnell-20160212-story.html\" target=\"_blank\">Christy O'Donnell\u003c/a>\u003c/strong>, 47, of Los Angeles, who died of lung cancer last month\u003c/li>\n\u003c/ul>\n\u003cp>\u003c/p>\n\u003cp>\"I really believe we use today to mark and dedicate the memory .. of some true champions,\" Monning said.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/158367/californias-physician-assisted-suicide-law-to-take-effect-in-june","authors":["240"],"categories":["stateofhealth_14"],"tags":["stateofhealth_914","stateofhealth_2519","stateofhealth_754"],"featImg":"stateofhealth_25005","label":"stateofhealth"},"stateofhealth_134532":{"type":"posts","id":"stateofhealth_134532","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"134532","score":null,"sort":[1451955502000]},"guestAuthors":[],"slug":"challenge-to-californias-right-to-die-law-fails-repeal-effort","title":"Campaign to Repeal California’s ‘Right to Die’ Law Falls Short","publishDate":1451955502,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{},"content":"\u003cp>Opponents of a \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/10/05/governor-brown-signs-physician-assisted-suicide-bill-into-law-california-right-to-die/\" target=\"_blank\">new California law\u003c/a> that will allow terminally ill patients to legally end their own lives say they did not collect enough signatures to ask voters to repeal the law.\u003c/p>\n\u003cp>The group Seniors Against Suicide had hoped to take the right-to-die question to California voters in November. Proponents needed to submit nearly 366,000 signatures by Monday to qualify for the ballot.\u003c/p>\n\u003cp>But backer Mark Hoffman says in an email to supporters that the group does not have enough signatures to qualify.\u003c/p>\n\u003cp>[contextly_sidebar id=\"Lsbqe97gfMpXGFZFjLqQ37PGHO1BEBOl\"]Right-to-die was among the most hotly contested issues last year. The legislative debate followed the case of Brittany Maynard, a terminally ill 29-year-old who moved to Oregon from California to take her own life. \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/03/25/posthumous-brittany-maynard-video-supports-calif-death-with-dignity-bill/\" target=\"_blank\">In a video aired posthumously\u003c/a>, Maynard called for California lawmakers to legalize the option.\u003c/p>\n\u003cp>\u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520162AB15\" target=\"_blank\">Under the law\u003c/a>, two doctors must determine that a patient has six months or less to live. The patient must request the life-ending medications and be physically able to swallow the drugs. Patients must be mentally competent to make the decision and reaffirm the decision in writing within 48 hours of taking the medication.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>California is the fifth state to legalize \"aid in dying,\" along with Oregon, Washington, Montana and Vermont. The law cannot take effect until California's special session on health care ends.\u003c/p>\n\n","blocks":[],"excerpt":"The group Seniors Against Suicide had hoped to take the right-to-die question to California voters in November. ","status":"publish","parent":0,"modified":1452005270,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":8,"wordCount":234},"headData":{"title":"Campaign to Repeal California’s ‘Right to Die’ Law Falls Short | KQED","description":"The group Seniors Against Suicide had hoped to take the right-to-die question to California voters in November. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Campaign to Repeal California’s ‘Right to Die’ Law Falls Short","datePublished":"2016-01-05T00:58:22.000Z","dateModified":"2016-01-05T14:47:50.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"134532 http://ww2.kqed.org/stateofhealth/?p=134532","disqusUrl":"https://ww2.kqed.org/stateofhealth/2016/01/04/challenge-to-californias-right-to-die-law-fails-repeal-effort/","disqusTitle":"Campaign to Repeal California’s ‘Right to Die’ Law Falls Short","source":"Associated Press","path":"/stateofhealth/134532/challenge-to-californias-right-to-die-law-fails-repeal-effort","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Opponents of a \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/10/05/governor-brown-signs-physician-assisted-suicide-bill-into-law-california-right-to-die/\" target=\"_blank\">new California law\u003c/a> that will allow terminally ill patients to legally end their own lives say they did not collect enough signatures to ask voters to repeal the law.\u003c/p>\n\u003cp>The group Seniors Against Suicide had hoped to take the right-to-die question to California voters in November. Proponents needed to submit nearly 366,000 signatures by Monday to qualify for the ballot.\u003c/p>\n\u003cp>But backer Mark Hoffman says in an email to supporters that the group does not have enough signatures to qualify.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>Right-to-die was among the most hotly contested issues last year. The legislative debate followed the case of Brittany Maynard, a terminally ill 29-year-old who moved to Oregon from California to take her own life. \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/03/25/posthumous-brittany-maynard-video-supports-calif-death-with-dignity-bill/\" target=\"_blank\">In a video aired posthumously\u003c/a>, Maynard called for California lawmakers to legalize the option.\u003c/p>\n\u003cp>\u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520162AB15\" target=\"_blank\">Under the law\u003c/a>, two doctors must determine that a patient has six months or less to live. The patient must request the life-ending medications and be physically able to swallow the drugs. Patients must be mentally competent to make the decision and reaffirm the decision in writing within 48 hours of taking the medication.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>California is the fifth state to legalize \"aid in dying,\" along with Oregon, Washington, Montana and Vermont. The law cannot take effect until California's special session on health care ends.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/134532/challenge-to-californias-right-to-die-law-fails-repeal-effort","authors":["8344"],"categories":["stateofhealth_14"],"tags":["stateofhealth_914","stateofhealth_2519","stateofhealth_754"],"featImg":"stateofhealth_22731","label":"source_stateofhealth_134532"},"stateofhealth_118441":{"type":"posts","id":"stateofhealth_118441","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"118441","score":null,"sort":[1449331826000]},"guestAuthors":[],"slug":"assisted-death-laws-accentuate-need-for-palliative-care-doctors-say","title":"Assisted-Death Laws Accentuate Need for Palliative Care, Doctors Say","publishDate":1449331826,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{},"content":"\u003cp>More times than she can count, Dr. Carin van Zyl has heard terminally ill patients beg to die. They tell her they can’t handle the pain, that the nausea is unbearable and the anxiety overwhelming.\u003c/p>\n\u003cp>If she were in the same situation, she too would want life-ending medication, even though she doubts she would ever take it. “I would want an escape hatch,” she said.\u003c/p>\n\u003cp>In October, California became the fifth — and largest — state to allow physicians to prescribe lethal medications to certain patients who ask for it. The law takes effect in 2016.\u003c/p>\n\u003cp>Yet van Zyl can’t see herself as one of those doctors.\u003c/p>\n\u003cp>“This is my life’s work, to relieve suffering,” said van Zyl, head of palliative care medicine at Los Angeles County-USC Medical Center. To her, that does not mean cutting short a life.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“I can’t imagine pulling the trigger,” she said.\u003c/p>\n\u003cp>Weeks after California Gov. Jerry Brown signed the “\u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520162AB15\" target=\"_blank\">end-of-life option act\u003c/a>” into law, palliative care physicians like van Zyl are trying to come to terms with what it means for them and their terminally ill patients.\u003c/p>\n\u003cfigure id=\"attachment_118447\" class=\"wp-caption aligncenter\" style=\"max-width: 1919px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/12/palliative-care-7-e1449270374470.jpg\">\u003cimg class=\"size-full wp-image-118447\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/12/palliative-care-7-e1449270374470.jpg\" alt=\"Jose Garcia Flores, 60, listens to Dr. Carin van Zyl as she explains that chemotherapy might not be an option to treat his colon cancer.\" width=\"1919\" height=\"1281\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Jose Garcia Flores, 60, listens to Dr. Carin van Zyl as she explains that chemotherapy might not be an option to treat his colon cancer. \u003ccite>(Heidi de Marco/KHN)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>It’s not just a question of whether they support aid-in-dying or personally would ever help end a life. Palliative care doctors say the law underscores the need to raise awareness among doctors and patients about what they do and to expand access to high-quality programs.\u003c/p>\n\u003cp>Contrary to some patients’ fears, they say, palliative care doctors are not there to hasten death. Their job is to help seriously ill people get relief from symptoms and stress, and to improve quality of life for them and their families, regardless of how long the patients have to live.\u003c/p>\n\u003cp>The California law should be a “wake-up” call because it shows “how terrified patients are of what they will experience at the end of life,” said Dr. R. Sean Morrison, professor of geriatrics and palliative care medicine at Mt. Sinai’s Icahn School of Medicine in New York.\u003c/p>\n\u003cp>Morrison said that once patients who want to hasten their death get their symptoms controlled and their spiritual needs addressed, the overwhelming majority want to keep living.\u003c/p>\n\u003cp>“Their choice shouldn’t be an assisted death or living with intractable suffering,” Morrison said. “That’s what laws allowing assisted suicide, in the absence of palliative care, present as a choice to patients.”\u003c/p>\n\u003cp>Palliative care has become more widespread in recent years, and more doctors, nurses and social workers are being trained in how to provide it. In addition, \u003ca href=\"http://Dr.%20Carin%20van%20Zyl%20talks%20to%20patient%20Jose%20Garcia%20Flores%20about%20his%20treatment%20options%20for%20his%20advanced%20stage%20colon%20cancer.\" target=\"_blank\">recent legislation in California\u003c/a> requires that Medi-Cal managed care plans ensure access to programs.\u003c/p>\n\u003cfigure id=\"attachment_118446\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/12/palliative-care-5-e1449270386245.jpg\">\u003cimg class=\"size-full wp-image-118446\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/12/palliative-care-5-e1449270386245.jpg\" alt=\"Dr. Carin van Zyl and patient Jose Garcia Flores hold hands as van Zyl promised to do everything she could to ease his pain and control his symptoms. \" width=\"1920\" height=\"1281\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Dr. Carin van Zyl and patient Jose Garcia Flores hold hands as van Zyl promised to do everything she could to ease his pain and control his symptoms. \u003ccite>(Heidi de Marco/KHN)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>But gaps remain. A \u003ca href=\"http://www.chcf.org/publications/2015/02/palliative-care-data\" target=\"_blank\">recent report by\u003c/a> the California HealthCare Foundation showed that residents in 22 of 58 California counties don’t have access to community-based palliative care, and those in 19 counties don’t have access to in-patient programs. Foundation researchers also found recently that specialists are in short supply and that there is no reliable way to pay for such care.\u003c/p>\n\u003cp>Dr. Ira Byock, a palliative care expert who opposed the California law, said its passage makes it more important than ever that all doctors receive more education on how to treat symptoms in seriously ill patients and talk with patients about what they want in their final months.\u003c/p>\n\u003cp>“As hard as illness and dying are … people still have the capacity to experience the sense of well-being,” said Byock, who heads the Providence Institute for Human Caring in Torrance, Calif.\u003c/p>\n\u003cp>Without palliative care programs, Byock and others say those conversations don’t always take place. Only about 17 percent of patients have had end-of-life discussions with their doctors, though nearly 90 percent believe doctors should be doing so, according to a \u003ca href=\"http://kff.org/health-costs/poll-finding/kaiser-health-tracking-poll-september-2015/\" target=\"_blank\">recent poll by the Kaiser Family Foundation\u003c/a>. In addition, \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/25488909\" target=\"_blank\">research out of the Mayo Clinic\u003c/a> found that only 12 percent of doctors had yearly end-of-life discussions with heart failure patients, and about 30 percent of the physicians had “little confidence” doing so.\u003c/p>\n\u003cp>Dr. Tony Back, who is co-director of the University of Washington’s Cambia Palliative Care Center of Excellence, said that after a similar aid-in-dying law passed in his state, more doctors realized that they “couldn’t just push it off on somebody else.”\u003c/p>\n\u003cp>As van Zyl struggles with her own reactions to the new law, she continues to have those tough conversations with one patient after another, every day.\u003c/p>\n\u003cfigure id=\"attachment_118445\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/12/palliative-care-3-e1449270397355.jpg\">\u003cimg class=\"size-thumbnail wp-image-118445\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/12/palliative-care-3-400x599.jpg\" alt=\"Jose Garcia Flores’ wife stands quietly at her husband’s bedside.\" width=\"400\" height=\"599\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Jose Garcia Flores’ wife stands quietly at her husband’s bedside. \u003ccite>(Heidi de Marco/KHN)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>On a recent day, more than two dozen names were listed on a white board in her hospital offices — all of them patients referred to her team for care. A 33-year-old woman with metastatic breast cancer. A 50-year-old with pancreatic cancer that had spread to her lungs. A 20-year-old man with a fast-growing brain tumor.\u003c/p>\n\u003cp>One patient van Zyl visited that day was Jose Garcia Flores, a gaunt, 60-year-old with advanced stage colon cancer. The former electrician had been diagnosed in the spring and was back in the hospital because of pain and nausea.\u003c/p>\n\u003cp>Van Zyl told him that there was a possibility that doctors would no longer be able to continue chemotherapy because of a complication. Van Zyl asked what he valued more — living longer, no matter what that looked like, or not living as long but being able to spend quality time with family at home.\u003c/p>\n\u003cp>“There is no right answer,” she said, promising to do everything she could to ease his pain and control his symptoms, regardless of whether he wanted to continue treatment for his cancer.\u003c/p>\n\u003cp>Garcia Flores paused and looked over at his wife standing next to the hospital bed. “I would prefer… to enjoy time with my family,” he said in Spanish.\u003c/p>\n\u003cp>“This isn’t fair — any of this,” she told him. “You are very brave.”\u003c/p>\n\u003cp>Van Zyl said that none of her patients have asked yet about the aid-in-dying law, which takes effect next year. She wonders if many of them even know about it.\u003c/p>\n\u003cp>A native of South Africa who used to work in emergency medicine, van Zyl said she recognizes that her views on the new law are hypocritical. “I don’t have a logical answer why I would want it for myself but not want to offer it to my patients,” she said. “I don’t know why I am still sitting on this fence that is increasingly pointy and uncomfortable.”\u003c/p>\n\u003cp>Part of it, she believes, is simple: “I’m deeply afraid of dying.”\u003c/p>\n\u003cfigure id=\"attachment_118448\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/12/palliative-care-6-e1449270360767.jpg\">\u003cimg class=\"size-full wp-image-118448\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/12/palliative-care-6-e1449270360767.jpg\" alt=\"Dr. Carin van Zyl, head of palliative care medicine, at Los Angeles County-USC Medical Center.\" width=\"1920\" height=\"1281\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Dr. Carin van Zyl, head of palliative care medicine, at Los Angeles County-USC Medical Center. \u003ccite>(Heidi de Marco/KHN)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Yet she knows, as a doctor, that death doesn’t have to be scary. Some problems, she says, have medical solutions — there are effective medications for pain and anxiety, for instance, so people can die peacefully. Van Zyl says her patients have always stopped asking to have their lives shortened once their symptoms were controlled.\u003c/p>\n\u003cp>Van Zyl believes medical providers, regardless of specialty, can be taught how to provide palliative care. That’s part of her job. And on this day, she stood before half a dozen medical residents, reviewing the best treatments for nausea, pain and shortness of breath. But suffering isn’t always physical, she said. Patients and families also need help coping with emotional suffering, she said.\u003c/p>\n\u003cp>“It is possible to screw up a family for life with a bad conversation,” she said. Van Zyl urged the residents not to run away from direct and honest — though hard — discussions. “Don’t do what so many doctors do, which is crumble.”\u003c/p>\n\u003cp>Then van Zyl brought up the aid-in-dying law. “What will you do when your patients says, ‘Can you kill me?’” she asked the group. “Somebody, at some point, is going to ask you to do that.”\u003c/p>\n\u003cp>One resident said that for her, prescribing lethal medication would be on a case-by-case basis. She would want to make sure the patient’s symptoms and pain were under control first. Another said she worried about how her own family would view her decision to help patients end their lives.\u003c/p>\n\u003cp>A third, Roshel Graham, said that no matter what, she hoped the law will help raise awareness about the benefits of palliative care. “I don’t think a lot of people even know palliative care exists,” she said.\u003c/p>\n\u003cp>As time goes on and doctors in California begin prescribing medicine to help people hasten their deaths, van Zyl said, perhaps her own views will become less conflicted.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“Maybe my position will evolve,” she said. “I could imagine one bad death tipping me over.”\u003c/p>\n\n","blocks":[],"excerpt":"In wake of new law, palliative care physicians are trying to come to grips with what it means to them and their terminally ill patients. ","status":"publish","parent":0,"modified":1449465399,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":38,"wordCount":1612},"headData":{"title":"Assisted-Death Laws Accentuate Need for Palliative Care, Doctors Say | KQED","description":"In wake of new law, palliative care physicians are trying to come to grips with what it means to them and their terminally ill patients. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Assisted-Death Laws Accentuate Need for Palliative Care, Doctors Say","datePublished":"2015-12-05T16:10:26.000Z","dateModified":"2015-12-07T05:16:39.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"118441 http://ww2.kqed.org/stateofhealth/?p=118441","disqusUrl":"https://ww2.kqed.org/stateofhealth/2015/12/05/assisted-death-laws-accentuate-need-for-palliative-care-doctors-say/","disqusTitle":"Assisted-Death Laws Accentuate Need for Palliative Care, Doctors Say","source":"Kaiser Health News","sourceUrl":"http://khn.org/news/aid-in-dying-laws-only-accentuate-need-for-palliative-care-providers-say/","nprByline":"Anna Gorman","path":"/stateofhealth/118441/assisted-death-laws-accentuate-need-for-palliative-care-doctors-say","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>More times than she can count, Dr. Carin van Zyl has heard terminally ill patients beg to die. They tell her they can’t handle the pain, that the nausea is unbearable and the anxiety overwhelming.\u003c/p>\n\u003cp>If she were in the same situation, she too would want life-ending medication, even though she doubts she would ever take it. “I would want an escape hatch,” she said.\u003c/p>\n\u003cp>In October, California became the fifth — and largest — state to allow physicians to prescribe lethal medications to certain patients who ask for it. The law takes effect in 2016.\u003c/p>\n\u003cp>Yet van Zyl can’t see herself as one of those doctors.\u003c/p>\n\u003cp>“This is my life’s work, to relieve suffering,” said van Zyl, head of palliative care medicine at Los Angeles County-USC Medical Center. To her, that does not mean cutting short a life.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“I can’t imagine pulling the trigger,” she said.\u003c/p>\n\u003cp>Weeks after California Gov. Jerry Brown signed the “\u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520162AB15\" target=\"_blank\">end-of-life option act\u003c/a>” into law, palliative care physicians like van Zyl are trying to come to terms with what it means for them and their terminally ill patients.\u003c/p>\n\u003cfigure id=\"attachment_118447\" class=\"wp-caption aligncenter\" style=\"max-width: 1919px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/12/palliative-care-7-e1449270374470.jpg\">\u003cimg class=\"size-full wp-image-118447\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/12/palliative-care-7-e1449270374470.jpg\" alt=\"Jose Garcia Flores, 60, listens to Dr. Carin van Zyl as she explains that chemotherapy might not be an option to treat his colon cancer.\" width=\"1919\" height=\"1281\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Jose Garcia Flores, 60, listens to Dr. Carin van Zyl as she explains that chemotherapy might not be an option to treat his colon cancer. \u003ccite>(Heidi de Marco/KHN)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>It’s not just a question of whether they support aid-in-dying or personally would ever help end a life. Palliative care doctors say the law underscores the need to raise awareness among doctors and patients about what they do and to expand access to high-quality programs.\u003c/p>\n\u003cp>Contrary to some patients’ fears, they say, palliative care doctors are not there to hasten death. Their job is to help seriously ill people get relief from symptoms and stress, and to improve quality of life for them and their families, regardless of how long the patients have to live.\u003c/p>\n\u003cp>The California law should be a “wake-up” call because it shows “how terrified patients are of what they will experience at the end of life,” said Dr. R. Sean Morrison, professor of geriatrics and palliative care medicine at Mt. Sinai’s Icahn School of Medicine in New York.\u003c/p>\n\u003cp>Morrison said that once patients who want to hasten their death get their symptoms controlled and their spiritual needs addressed, the overwhelming majority want to keep living.\u003c/p>\n\u003cp>“Their choice shouldn’t be an assisted death or living with intractable suffering,” Morrison said. “That’s what laws allowing assisted suicide, in the absence of palliative care, present as a choice to patients.”\u003c/p>\n\u003cp>Palliative care has become more widespread in recent years, and more doctors, nurses and social workers are being trained in how to provide it. In addition, \u003ca href=\"http://Dr.%20Carin%20van%20Zyl%20talks%20to%20patient%20Jose%20Garcia%20Flores%20about%20his%20treatment%20options%20for%20his%20advanced%20stage%20colon%20cancer.\" target=\"_blank\">recent legislation in California\u003c/a> requires that Medi-Cal managed care plans ensure access to programs.\u003c/p>\n\u003cfigure id=\"attachment_118446\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/12/palliative-care-5-e1449270386245.jpg\">\u003cimg class=\"size-full wp-image-118446\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/12/palliative-care-5-e1449270386245.jpg\" alt=\"Dr. Carin van Zyl and patient Jose Garcia Flores hold hands as van Zyl promised to do everything she could to ease his pain and control his symptoms. \" width=\"1920\" height=\"1281\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Dr. Carin van Zyl and patient Jose Garcia Flores hold hands as van Zyl promised to do everything she could to ease his pain and control his symptoms. \u003ccite>(Heidi de Marco/KHN)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>But gaps remain. A \u003ca href=\"http://www.chcf.org/publications/2015/02/palliative-care-data\" target=\"_blank\">recent report by\u003c/a> the California HealthCare Foundation showed that residents in 22 of 58 California counties don’t have access to community-based palliative care, and those in 19 counties don’t have access to in-patient programs. Foundation researchers also found recently that specialists are in short supply and that there is no reliable way to pay for such care.\u003c/p>\n\u003cp>Dr. Ira Byock, a palliative care expert who opposed the California law, said its passage makes it more important than ever that all doctors receive more education on how to treat symptoms in seriously ill patients and talk with patients about what they want in their final months.\u003c/p>\n\u003cp>“As hard as illness and dying are … people still have the capacity to experience the sense of well-being,” said Byock, who heads the Providence Institute for Human Caring in Torrance, Calif.\u003c/p>\n\u003cp>Without palliative care programs, Byock and others say those conversations don’t always take place. Only about 17 percent of patients have had end-of-life discussions with their doctors, though nearly 90 percent believe doctors should be doing so, according to a \u003ca href=\"http://kff.org/health-costs/poll-finding/kaiser-health-tracking-poll-september-2015/\" target=\"_blank\">recent poll by the Kaiser Family Foundation\u003c/a>. In addition, \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/25488909\" target=\"_blank\">research out of the Mayo Clinic\u003c/a> found that only 12 percent of doctors had yearly end-of-life discussions with heart failure patients, and about 30 percent of the physicians had “little confidence” doing so.\u003c/p>\n\u003cp>Dr. Tony Back, who is co-director of the University of Washington’s Cambia Palliative Care Center of Excellence, said that after a similar aid-in-dying law passed in his state, more doctors realized that they “couldn’t just push it off on somebody else.”\u003c/p>\n\u003cp>As van Zyl struggles with her own reactions to the new law, she continues to have those tough conversations with one patient after another, every day.\u003c/p>\n\u003cfigure id=\"attachment_118445\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/12/palliative-care-3-e1449270397355.jpg\">\u003cimg class=\"size-thumbnail wp-image-118445\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/12/palliative-care-3-400x599.jpg\" alt=\"Jose Garcia Flores’ wife stands quietly at her husband’s bedside.\" width=\"400\" height=\"599\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Jose Garcia Flores’ wife stands quietly at her husband’s bedside. \u003ccite>(Heidi de Marco/KHN)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>On a recent day, more than two dozen names were listed on a white board in her hospital offices — all of them patients referred to her team for care. A 33-year-old woman with metastatic breast cancer. A 50-year-old with pancreatic cancer that had spread to her lungs. A 20-year-old man with a fast-growing brain tumor.\u003c/p>\n\u003cp>One patient van Zyl visited that day was Jose Garcia Flores, a gaunt, 60-year-old with advanced stage colon cancer. The former electrician had been diagnosed in the spring and was back in the hospital because of pain and nausea.\u003c/p>\n\u003cp>Van Zyl told him that there was a possibility that doctors would no longer be able to continue chemotherapy because of a complication. Van Zyl asked what he valued more — living longer, no matter what that looked like, or not living as long but being able to spend quality time with family at home.\u003c/p>\n\u003cp>“There is no right answer,” she said, promising to do everything she could to ease his pain and control his symptoms, regardless of whether he wanted to continue treatment for his cancer.\u003c/p>\n\u003cp>Garcia Flores paused and looked over at his wife standing next to the hospital bed. “I would prefer… to enjoy time with my family,” he said in Spanish.\u003c/p>\n\u003cp>“This isn’t fair — any of this,” she told him. “You are very brave.”\u003c/p>\n\u003cp>Van Zyl said that none of her patients have asked yet about the aid-in-dying law, which takes effect next year. She wonders if many of them even know about it.\u003c/p>\n\u003cp>A native of South Africa who used to work in emergency medicine, van Zyl said she recognizes that her views on the new law are hypocritical. “I don’t have a logical answer why I would want it for myself but not want to offer it to my patients,” she said. “I don’t know why I am still sitting on this fence that is increasingly pointy and uncomfortable.”\u003c/p>\n\u003cp>Part of it, she believes, is simple: “I’m deeply afraid of dying.”\u003c/p>\n\u003cfigure id=\"attachment_118448\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/12/palliative-care-6-e1449270360767.jpg\">\u003cimg class=\"size-full wp-image-118448\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/12/palliative-care-6-e1449270360767.jpg\" alt=\"Dr. Carin van Zyl, head of palliative care medicine, at Los Angeles County-USC Medical Center.\" width=\"1920\" height=\"1281\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Dr. Carin van Zyl, head of palliative care medicine, at Los Angeles County-USC Medical Center. \u003ccite>(Heidi de Marco/KHN)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Yet she knows, as a doctor, that death doesn’t have to be scary. Some problems, she says, have medical solutions — there are effective medications for pain and anxiety, for instance, so people can die peacefully. Van Zyl says her patients have always stopped asking to have their lives shortened once their symptoms were controlled.\u003c/p>\n\u003cp>Van Zyl believes medical providers, regardless of specialty, can be taught how to provide palliative care. That’s part of her job. And on this day, she stood before half a dozen medical residents, reviewing the best treatments for nausea, pain and shortness of breath. But suffering isn’t always physical, she said. Patients and families also need help coping with emotional suffering, she said.\u003c/p>\n\u003cp>“It is possible to screw up a family for life with a bad conversation,” she said. Van Zyl urged the residents not to run away from direct and honest — though hard — discussions. “Don’t do what so many doctors do, which is crumble.”\u003c/p>\n\u003cp>Then van Zyl brought up the aid-in-dying law. “What will you do when your patients says, ‘Can you kill me?’” she asked the group. “Somebody, at some point, is going to ask you to do that.”\u003c/p>\n\u003cp>One resident said that for her, prescribing lethal medication would be on a case-by-case basis. She would want to make sure the patient’s symptoms and pain were under control first. Another said she worried about how her own family would view her decision to help patients end their lives.\u003c/p>\n\u003cp>A third, Roshel Graham, said that no matter what, she hoped the law will help raise awareness about the benefits of palliative care. “I don’t think a lot of people even know palliative care exists,” she said.\u003c/p>\n\u003cp>As time goes on and doctors in California begin prescribing medicine to help people hasten their deaths, van Zyl said, perhaps her own views will become less conflicted.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Maybe my position will evolve,” she said. “I could imagine one bad death tipping me over.”\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/118441/assisted-death-laws-accentuate-need-for-palliative-care-doctors-say","authors":["byline_stateofhealth_118441"],"categories":["stateofhealth_11","stateofhealth_14","stateofhealth_13"],"tags":["stateofhealth_914","stateofhealth_2519","stateofhealth_754"],"featImg":"stateofhealth_118444","label":"source_stateofhealth_118441"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. 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But is this once sleepy suburb ready for them?","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/American-Suburb-Podcast-Tile-703x703-1.jpg","officialWebsiteLink":"/news/series/american-suburb-podcast","meta":{"site":"news","source":"kqed","order":"13"},"link":"/news/series/american-suburb-podcast/","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?mt=2&id=1287748328","tuneIn":"https://tunein.com/radio/American-Suburb-p1086805/","rss":"https://ww2.kqed.org/news/series/american-suburb-podcast/feed/podcast","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkMzMDExODgxNjA5"}},"baycurious":{"id":"baycurious","title":"Bay Curious","tagline":"Exploring the Bay Area, one question at a time","info":"KQED’s new podcast, Bay Curious, gets to the bottom of the mysteries — both profound and peculiar — that give the Bay Area its unique identity. And we’ll do it with your help! 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Hosts Steve Inskeep, David Greene and Rachel Martin bring you the latest breaking news and features to prepare you for the day.","airtime":"MON-FRI 3am-9am","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Morning-Edition-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.npr.org/programs/morning-edition/","meta":{"site":"news","source":"npr"},"link":"/radio/program/morning-edition"},"onourwatch":{"id":"onourwatch","title":"On Our Watch","tagline":"Police secrets, unsealed","info":"For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/On-Our-Watch-Podcast-Tile-703x703-1.jpg","imageAlt":"On Our Watch from NPR and KQED","officialWebsiteLink":"/podcasts/onourwatch","meta":{"site":"news","source":"kqed","order":"1"},"link":"/podcasts/onourwatch","subscribe":{"apple":"https://podcasts.apple.com/podcast/id1567098962","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5ucHIub3JnLzUxMDM2MC9wb2RjYXN0LnhtbD9zYz1nb29nbGVwb2RjYXN0cw","npr":"https://rpb3r.app.goo.gl/onourwatch","spotify":"https://open.spotify.com/show/0OLWoyizopu6tY1XiuX70x","tuneIn":"https://tunein.com/radio/On-Our-Watch-p1436229/","stitcher":"https://www.stitcher.com/show/on-our-watch","rss":"https://feeds.npr.org/510360/podcast.xml"}},"on-the-media":{"id":"on-the-media","title":"On The Media","info":"Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us","airtime":"SUN 2pm-3pm, MON 12am-1am","imageSrc":"https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/onTheMedia.png","officialWebsiteLink":"https://www.wnycstudios.org/shows/otm","meta":{"site":"news","source":"wnyc"},"link":"/radio/program/on-the-media","subscribe":{"apple":"https://itunes.apple.com/us/podcast/on-the-media/id73330715?mt=2","tuneIn":"https://tunein.com/radio/On-the-Media-p69/","rss":"http://feeds.wnyc.org/onthemedia"}},"our-body-politic":{"id":"our-body-politic","title":"Our Body Politic","info":"Presented by KQED, KCRW and KPCC, and created and hosted by award-winning journalist Farai Chideya, Our Body Politic is unapologetically centered on reporting on not just how women of color experience the major political events of today, but how they’re impacting those very issues.","airtime":"SAT 6pm-7pm, SUN 1am-2am","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Our-Body-Politic-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://our-body-politic.simplecast.com/","meta":{"site":"news","source":"kcrw"},"link":"/radio/program/our-body-politic","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/our-body-politic/id1533069868","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5zaW1wbGVjYXN0LmNvbS9feGFQaHMxcw","spotify":"https://open.spotify.com/show/4ApAiLT1kV153TttWAmqmc","rss":"https://feeds.simplecast.com/_xaPhs1s","tuneIn":"https://tunein.com/podcasts/News--Politics-Podcasts/Our-Body-Politic-p1369211/"}},"pbs-newshour":{"id":"pbs-newshour","title":"PBS NewsHour","info":"Analysis, background reports and updates from the PBS NewsHour putting today's news in context.","airtime":"MON-FRI 3pm-4pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/PBS-News-Hour-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.pbs.org/newshour/","meta":{"site":"news","source":"pbs"},"link":"/radio/program/pbs-newshour","subscribe":{"apple":"https://itunes.apple.com/us/podcast/pbs-newshour-full-show/id394432287?mt=2","tuneIn":"https://tunein.com/radio/PBS-NewsHour---Full-Show-p425698/","rss":"https://www.pbs.org/newshour/feeds/rss/podcasts/show"}},"perspectives":{"id":"perspectives","title":"Perspectives","tagline":"KQED's series of of daily listener commentaries since 1991","info":"KQED's series of of daily listener commentaries since 1991.","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Perspectives-Podcast-Tile-703x703-1.jpg","officialWebsiteLink":"/perspectives/","meta":{"site":"radio","source":"kqed","order":"15"},"link":"/perspectives","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/id73801135","npr":"https://www.npr.org/podcasts/432309616/perspectives","rss":"https://ww2.kqed.org/perspectives/category/perspectives/feed/","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93dzIua3FlZC5vcmcvcGVyc3BlY3RpdmVzL2NhdGVnb3J5L3BlcnNwZWN0aXZlcy9mZWVkLw"}},"planet-money":{"id":"planet-money","title":"Planet Money","info":"The economy explained. 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