The much maligned Terminal Patients’ Right to Know End-of-Life Options Act has finally passed in California.  This was a law that was blasted by critics from every side when it was first introduced.  The final version, which takes effect on January1st  of 2009, creates a legal right in patients at that end of life to have access to information about number of end of life issues.  Included in these are Advance Directives, Hospice care, and pain and symptom management. 

Major opponents of the original language of the bill (which required doctors to discuss palliative care and refusing artificial hydration and nutrition for any patient with a prognosis of less than one year) worried that end of life patients would be given too much overwhelming information.  They feared the patient would not have a meaningful conversation with their doctor, and would only suffer mental distress when the physician ran through a checklist of end of life issues. 

The new language gives more discretion for when the conversation must take place and what is involved in it.  Essentially, the new law creates a right that can be engaged by the patient (they ask their doctor) instead of existing passively (the doctor gives the information whether solicited or not).  

This legislation is really the first of its kind in the US, but the changes in the law will probably not ensure information to a patient who wasn’t already going to get it.  What it does do is put end of life issues in the vanguard of legislative concerns – a turn of events which is both welcome and sorely needed.