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California's right-to-die law has been in effect for a year now. The End of Life Option Act created a process for dying patients to ask for a prescription of lethal drugs that they can take at home. Stephanie O'Neill reports that many doctors are still struggling with how to serve patients who make that request.
STEPHANIE O'NEILL, BYLINE: Retired psychologist John Minor of Manhattan Beach epitomized the active Californian, says his daughter Jackie Minor.
JACKIE MINOR: He and my mom were both members of the Sierra Club. They went on tons of backpacking trips, you know, climbing mountains and trekking through the desert.
O'NEILL: But almost three years ago, he fell ill with a terminal lung disease that destroyed his quality of life. So last September 15, surrounded by his family, 80-year-old John Minor sipped his last drink - apple juice laced with a lethal dose of medication his doctor prescribed for him.
J. MINOR: And he laid down and went to sleep. He was in a coma for about two hours, and then he passed, and it was very peaceful.
O'NEILL: Since the law took effect, at least 500 Californians have received life-ending prescriptions. That's according to data collected by Compassion & Choices, an advocacy group for aid-in-dying laws. The organization also reports that about 600 health systems and hospice organizations also participate. Matt Whitaker is the group's California director. He says a large number of insurers are also on board.
MATT WHITAKER: What the numbers are showing is that the law is worked incredibly well, that it's working as the lawmakers intended.
O'NEILL: But participation in the law is voluntary. That means doctors can opt out of prescribing even when the hospital where they work participates. Dr. Elizabeth Dzeng is a professor at the University of California, San Francisco where she estimates about three dozen patients have made the request so far. The decision to prescribe, she says, doesn't come easy for many doctors.
ELIZABETH DZENG: 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 because that's a very different implication.
O'NEILL: At nearby Stanford University, Dr. Stephanie Harman has also been looking into the issue. She tracked 13 Stanford patients given a lethal prescription and learned that half of them could not get the prescription from their own doctor. One reason...
STEPHANIE HARMAN: There is a certain stigma for being known as a physician who writes these prescriptions. You know, there is in the field in medicine a question of whether this is, you know, an ethical act for a physician.
O'NEILL: And many others who support the law aren't yet comfortable enough with it to prescribe. Dr. Neil Wenger specializes in medical ethics at UCLA.
NEIL WENGER: 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. And it's complicated. It takes a whole lot of time.
O'NEILL: Time for the patient counseling and extensive paperwork and protocols the law requires. Dr. Catherine Forest, who practices family medicine at the Stanford health system, has assisted five patients who came to her after their own doctors refused. Forest says this hesitancy reminds her of the 1970s when abortion became legal.
CATHERINE FOREST: It takes a while for people to train, to feel comfortable and to provide. And that was because it was not legal and then it was legal, and there are very few instances where we do that in medicine.
O'NEILL: Aid in dying, she says, isn't one of those transitional moments. For John Minor's family, tracking down a willing doctor was tough. Ultimately, they enrolled him in a Kaiser Permanente plan where he received the prescription that he took last fall. Sherry Minor is his widow.
SHERRY MINOR: Mentally, he was ready. It was an easy day for him, I think.
O'NEILL: California's End of Life Option Act turns 1-year-old tomorrow. For NPR News, I'm Stephanie O'Neil.
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