Not all who receive end of life drugs, use them
On June 22, the California Department of Public Health (CDPH) released the 2017 End of Life Option Act (the Act) Annual Report. The Act, which became law on June 9, 2016, allows qualified individuals diagnosed with a terminal disease to obtain and self-administer aid-in-dying drugs.
According to a statement, the Act requires CDPH to provide annual reports, including information on the number of prescriptions written and the number of known individuals who died using aid-in-dying drugs. Additionally, the report includes demographic information on these individuals, including age and underlying illness.
According to the report, for the year January 1 through December 31, 2017, 632 individuals in California started the end-of-life option process, as set forth in the Act, by making two verbal requests to their physicians at least 15 days apart. 241 unique physicians prescribed 577 individuals aid-in-dying drugs. Of those 577 individuals receiving aid-in-dying drugs under the Act, 374 people died following ingestion of the prescribed drugs.
In addition, the outcome of the remaining 128 individuals, or 22.2 percent, who have been prescribed aid-in-dying drugs is currently undetermined, as there has been no outcome reported for these individuals within the period covered by this report. However, 86 individuals did not ingest the drugs, and subsequently died of their terminal illness. Eleven individuals prescribed medications in 2016, died from ingesting the drugs in 2017.
Of the 374 individuals who did utilize the medications, 90.4 percent were more than 60 years of age, 95.2 percent were insured and 83.4 percent were receiving hospice and/or palliative care. According to the report, the rate for those who died following ingestion of aid-in-dying drugs was 13.5 per 10,000 total deaths based on 269,044 deaths in California for 2017.
The report also outlines the types of illness afflicting the medication-seekers. The majority, or 68.5 percent of the underlying illnesses were identified as cancer. The top five types of cancer were lung and bronchus (17.2 percent), breast (11.3 percent), head and neck (10.9 percent), pancreatic (9.8 percent) and prostate (8.2 percent).
Neurological disorders such as Amyotrophic Lateral Sclerosis (ALS or Lou Gehrig’s disease) and Parkinson’s disease accounted for the second largest illness grouping, totaling 9.4 percent. The remaining major categories of underlying illnesses were documented as: cardiovascular diseases (8.0 percent), chronic lower respiratory diseases (non-cancer; 4.5 percent), cerebrovascular diseases (3.7 percent) and other underlying illnesses (5.9 percent).
The report also shows that slightly more women than men utilized the end-of-life medications (50.8 percent versus 47.1 percent) and that an overwhelming number of patients were white (88.9 percent).
Data in the report comes from Act-mandated physician reporting forms and California death certificates. Information is aggregated to protect individuals’ privacy. This is the first full year of data reported. The first report contained data from June 9, 2016 to December 31, 2016.
For more information about the End of Life Option Act and to read the report, visit http://www.cdph.ca.gov.
