The End of Life Option Act and hospice in California

What is the End of Life Option Act?

It is a California law, in effect since June 9, 2016, that allows a terminally ill adult to request a prescription for an aid-in-dying drug from their own doctor and to take it themselves. It is often called medical aid in dying. The law is in the Health and Safety Code, starting at section 443.

Taking part is voluntary for everyone: for the patient, for each doctor and for each health care organization. A person can change their mind at any time, including after the drug has been prescribed.

Who can use the End of Life Option Act?

Under section 443.2, a person must meet every one of these conditions. Age or disability alone never qualifies anyone.

• An adult (18 or older) who lives in California and can show it, for example with a California driver's license, voter registration, a lease or property, or a state tax return
• Diagnosed with a terminal illness expected to cause death within six months, confirmed by two doctors
• Able to make their own medical decisions
• Asking voluntarily, for themselves
• Physically and mentally able to take the drug themselves

What are the steps?

These are the steps the law sets, as amended by SB 380 from January 1, 2022.

1. Step 1

   Two spoken requests, at least 48 hours apart

   The person makes two oral requests directly to their attending doctor. Before 2022 the wait was 15 days; it is now 48 hours.

2. Step 2

   One written request

   The person signs a request form in front of two adult witnesses. The witnesses cannot be the person's doctors, and only one may be a relative or someone who would inherit.

3. Step 3

   The attending doctor's review

   The attending doctor confirms the diagnosis, the prognosis, the person's capacity and that the request is voluntary, and talks through other options, including comfort care, hospice and pain control. The person is told they may change their mind at any time.

4. Step 4

   A second doctor's review

   A consulting doctor separately confirms the diagnosis, the prognosis and the person's capacity. If either doctor sees signs of a mental health condition, a mental health specialist must assess the person first.

5. Step 5

   The prescription

   The attending doctor may then write the prescription. The person decides whether to fill it, and whether and when to take it. The person must take the drug themselves.

Does a patient on hospice keep hospice care?

Yes. Asking about or using the Act does not end the hospice benefit, and it is not a reason to discharge anyone from hospice. The hospice team keeps treating pain and other symptoms, supporting the family, and offering social work and chaplain visits. The family is offered grief support for 13 months after a death.

Most people who use the Act are already in hospice or palliative care. In CDPH's 2025 report, 94.3 percent of the people who died after taking the drug were receiving hospice or palliative care.

Hospice care, and the right to stop it, stay the patient's own choice. Choosing hospice is your decision. You can stop hospice at any time and return to regular Medicare coverage. You have the right to choose your hospice.

How many Californians use the Act?

These figures are from CDPH's End of Life Option Act 2025 Data Report, published in July 2026, based on doctors' forms received through February 1, 2026.

CDPH says cumulative counts differ from earlier reports because of late forms, death registration and removed duplicates.

What is Beta Hospice's policy on the End of Life Option Act?

Beta Hospice Care does not participate in the End of Life Option Act. Our doctors and staff, acting for Beta Hospice, do not serve as a patient's attending or consulting doctor under the Act, do not prescribe, deliver or prepare aid-in-dying drugs, and are not present when the drug is taken.

We never abandon a patient. A patient who asks about the Act, or who chooses it, stays our patient. We keep visiting, treating symptoms and supporting the family, through the end of life and into bereavement.

We will talk about it. Our staff will not refuse to discuss the Act or turn a patient away for asking. We will tell the patient plainly that Beta does not participate, refer the patient back to their own doctor for information about the Act, note the date of the request in the medical record, and send the patient's records to the doctor or provider they choose when asked.

This policy covers our doctors, staff, contractors and volunteers when they act for Beta Hospice. It does not limit what a patient's own doctor, who does not work for Beta, may do.

Does Medicare pay for the aid-in-dying drug?

No. Federal law does not allow Medicare or other federal health programs to pay for the drug. Hospice care itself stays covered: Medicare covers hospice care related to the terminal illness. Under Medicare, most people pay nothing for hospice care itself. Ask your health plan about the drug's cost.

Where to learn more

Start with your own doctor. CDPH publishes the law, the required forms and each year's data report on its End of Life Option Act page (opens in a new tab). For planning that applies to everyone, read advance directives and POLST in California, and for comfort medicines, does morphine speed up death?.

Common questions