The California End of Life Option Act lets terminally ill adults in California request a prescription for medication that will end their lives. The law took effect in June 2016, briefly went dark after a 2018 trial court ruling, was restored on appeal, and was made permanent when Governor Gavin Newsom signed SB 403 on October 3, 2025, repealing a sunset date that would have expired the law in 2031.1California Legislative Information. SB 4032California Senate District 38. Legislation to Preserve Californias End of Life Option Act Signed by Governor Since January 1, 2026, it has been in force with no expiration date.
Who Qualifies
To use the Act, you must be at least 18, a California resident, mentally capable of making your own medical decisions, and diagnosed with a terminal illness expected to cause death within six months. Residency can be shown with a state-issued ID, voter registration, a California property deed or lease, or a California tax return for the most recent year.3California Legislative Information. California Health and Safety Code HSC 443-2
Two limits are worth stating plainly. Age or disability alone never qualifies a person; the six-month terminal prognosis is required. And no one else can make the request for you. A power of attorney, an advance directive, or a conservator cannot invoke the Act on someone’s behalf. The patient must be able to physically self-administer the drug when the time comes.3California Legislative Information. California Health and Safety Code HSC 443-2
How to Request the Medication
The request has three parts: two oral requests to your attending physician made at least 48 hours apart, and one written request. The 48-hour interval is the result of a 2021 amendment (SB 380) that shortened the original 15-day waiting period, which had caused some patients to die or lose capacity before completing the process.4California Legislative Information. SB-380 End of Life
The written request must be signed and dated in front of two adult witnesses who attest that you appear to be of sound mind and are acting voluntarily. There are strict limits on who can witness: not your attending physician, not the consulting physician, not the mental health specialist if one is involved. No more than one witness may be a relative, and no more than one may be an employee of the facility where you’re receiving care.5California Legislative Information. California Health and Safety Code HSC 443-3
Protections for Patients, Families, and Doctors
Death from self-administering the prescribed medication is treated legally as a natural death from the underlying terminal illness, not as suicide. That distinction matters for life insurance: policies cannot be denied on the basis of a death under the Act, and insurers cannot condition the sale or issuance of a life, health, or annuity policy on whether someone has requested or rescinded a request for the medication.6Physician Assistant Board. Information Bulletin – California End of Life Option Act
People present when a patient self-administers the drug face no criminal or civil liability. Family members and others may help prepare the medication, but they cannot assist in the actual ingestion; the patient has to take it themselves.6Physician Assistant Board. Information Bulletin – California End of Life Option Act
Doctors are protected on both sides of the decision. A physician who prescribes in good faith under the Act cannot lose a medical license or hospital privileges for doing so. A physician who declines to participate is equally protected and cannot be penalized for refusing.6Physician Assistant Board. Information Bulletin – California End of Life Option Act
When Hospitals Opt Out
Not every hospital, hospice, or clinic in California participates. A healthcare entity is allowed to prohibit its employees and contractors from participating in the Act on its premises or during the course of their employment. If yours does, the entity must have given notice of that policy at hire or affiliation, provide annual notice, and post the policy on its public website. An entity that skipped that notice cannot enforce the opt-out against a staff member who participates anyway.7California Legislative Information. California Health and Safety Code HSC 443-15
The opt-out has limits. A hospital cannot stop its doctors from participating on their own time, at a different location, or outside the scope of their employment. If your physician works at a facility that has opted out, they may still be able to help you through a separate practice. Healthcare entities are also prohibited from misleading patients about whether they provide aid-in-dying services.7California Legislative Information. California Health and Safety Code HSC 443-15
Who Pays for the Medication
Federal money cannot cover aid-in-dying drugs. The Assisted Suicide Funding Restriction Act of 1997 blocks federal funds, including Medicare and Medicaid dollars, from paying for services that cause or assist in causing death.8Congress.gov. HR 1003 – 105th Congress – Assisted Suicide Funding Restriction Act of 1997 In practice, patients typically pay out of pocket. The cost can range from several hundred to several thousand dollars depending on the drug regimen. The federal restriction does not prevent California from authorizing the practice; it only keeps federal healthcare dollars from covering it.
How the Act Has Been Used
From the Act’s effective date of June 9, 2016 through December 31, 2024, 8,242 people in California received prescriptions under the law. Of those, 5,423 (about 66 percent) died after ingesting the medication. In 2024 alone, 346 physicians wrote prescriptions for 1,591 people, and 1,032 of those patients died following ingestion.9California Department of Public Health. California End of Life Option Act 2024 Data Report
The consistent gap between prescriptions written and medications taken reflects a pattern seen in aid-in-dying data generally: roughly a third of patients obtain the prescription but never use it. For many, simply having the medication on hand offers a sense of control, whether or not they end up taking it.
The 2018 Challenge and What Changed After
The Act was originally passed in 2015 during a special legislative session Governor Jerry Brown had called to address Medi-Cal spending. A group of physicians backed by the Life Legal Defense Fund sued in 2016, arguing the law had no proper connection to the special session’s stated topic. On May 15, 2018, a Riverside County Superior Court judge agreed and struck the Act down on that procedural ground, not on its substance. An emergency stay was denied, and the law was briefly suspended.10Institute for Health Policy Leadership. Is This the End of the End of Life Option Act
The California Court of Appeal then issued a writ of mandate directing the trial court to vacate its order and judgment, reversing the ruling.11Justia Law. California v Superior Court (Ahn) 2018 The legislature then passed AB 282 through the regular process, re-enacting the Act to eliminate any lingering procedural vulnerability. SB 380 followed in 2021 with the shorter waiting period and stronger transparency rules for opt-out institutions, and SB 403 removed the sunset date in 2025. The 2018 ruling has no continuing legal effect.