California Right to Die Law: Who Qualifies and How to Request It

California’s right to die law is the End of Life Option Act, which lets a terminally ill adult resident ask a doctor for a prescription they can take themselves to end their life. It took effect on June 9, 2016, and was tightened up in 2022 by Senate Bill 380, which shortened the waiting period between requests from 15 days to 48 hours and removed a final attestation form that had previously been required just before taking the medication.¹ The Act is scheduled to sunset on January 1, 2031, unless the legislature extends it.

Who Qualifies

You have to meet every one of these requirements to use the Act:²

You are 18 or older.
You are a California resident. A driver’s license, voter registration, property ownership or a lease, or a California tax return can prove it.
Your attending physician has diagnosed you with a terminal disease, defined by statute as an incurable and irreversible disease that in reasonable medical judgment will cause death within six months.³
You have the capacity to make your own medical decisions. If either physician involved thinks a mental disorder might be affecting your judgment, you must be evaluated by a mental health specialist before a prescription can be written.⁴
You are physically and mentally able to take the medication yourself.
You are making the request on your own behalf. No one can request it for you through a power of attorney, advance directive, conservatorship, or any other form of substituted decision-making.

Age or a disability, on its own, is not enough to disqualify you and also is not enough to qualify you.²

How to Request the Medication

The request process has five parts:

You make an oral request directly to your attending physician, who documents it in your medical record.
At least 48 hours later, you make a second oral request to the same physician.⁵
You sign and date a written request in front of two adult witnesses who attest that you appear to be of sound mind and are not being coerced.
Your attending physician refers you to a consulting physician, who independently confirms your diagnosis, prognosis, and mental capacity.⁴
Your attending physician goes over your diagnosis, the risks and probable outcome of taking the medication, and the alternatives — hospice, palliative care, and pain management.

The two witnesses have to be adults. Neither can be your attending physician, consulting physician, or mental health specialist. Only one of the two can be a relative, someone entitled to a share of your estate, or an employee of the healthcare facility treating you.⁵

You Can Change Your Mind at Any Point

Withdrawing your request carries no consequences, and you can do it at any stage for any reason. Filling the prescription does not commit you to taking it. In 2023, 1,281 Californians received prescriptions under the Act but only 884 took the medication, meaning about 31 percent of people who obtained a prescription never used it.⁶ For many, having the option available is itself the point.

Only You Can Take the Medication

This is not euthanasia. No one else — not a doctor, a nurse, a spouse, or an adult child — can administer the medication to you. You take it yourself, or it is not taken. That requirement is why the Act limits eligibility to people who still have the physical and mental ability to self-administer at the time they use it.

When a Doctor or Hospital Declines

No physician, pharmacist, or healthcare system is required to participate. Catholic-affiliated hospitals and some other faith-based systems have said publicly they will not, and individual physicians inside participating systems can also decline.² A physician who declines is not required to refer you to one who will participate, though many do.

If you have already made oral requests to a doctor who then declines, or you switch physicians for another reason, the earlier requests documented in your medical record still count. You do not have to restart the oral request sequence from zero.⁵

Death Certificate and Insurance

A death under the End of Life Option Act is not classified as suicide. The California Department of Public Health tells death certificate certifiers to list the underlying terminal disease as the cause of death, so the certificate reads the same as it would for someone who died of the illness without using the Act.⁷

Your decision to use the Act cannot be used to deny or alter your life insurance, health insurance, or annuity contracts, and it does not affect your will or other estate documents. The financial consequences families most often worry about are addressed directly by the statute.

What Happens to Unused Medication

If the medication is left over after the patient’s death, whoever has custody of it must dispose of it properly. That means delivering it to the nearest facility that disposes of controlled substances, using a DEA-approved take-back program, or following the California State Board of Pharmacy’s disposal guidance.⁸ The DEA keeps a searchable directory of year-round drop-off locations.⁹ It is not optional.

How the Law Is Actually Used

Of the 884 Californians who died under the Act in 2023, the median age was 78 and the split between men and women was roughly even. Cancer accounted for about 64 percent of cases, cardiovascular disease 12 percent, and neurological disease 9 percent. Around 57 percent were covered by Medicare.⁶ Use has climbed steadily since 2016, and the 2022 change to a 48-hour waiting period appears to have opened access to patients who previously would have died before completing the process.

1
California Legislative Information. SB 380 End of Life Option Act
2
California Legislative Information. California Health and Safety Code 443.2
3
California Legislative Information. California Health and Safety Code 443.1
4
California Legislative Information. California Health and Safety Code 443.5
5
California Legislative Information. California Health and Safety Code 443.3
6
California Department of Public Health. California End of Life Option Act 2023 Data Report
7
California Department of Public Health. Reporting Causes of Death for End of Life Option Act
8
California Physician Assistant Board. California End of Life Option Act
9
Diversion Control Division. Drug Disposal Information