From the Research
In California, only licensed physicians who are Medical Doctors (MDs) or Doctors of Osteopathic Medicine (DOs) can prescribe medical aid-in-dying drugs under the End of Life Option Act. These physicians must be the patient's attending physician, meaning they have primary responsibility for the patient's healthcare and treatment of their terminal illness. Additionally, a second consulting physician must confirm the diagnosis, prognosis, and the patient's capacity to make medical decisions. The prescribing physician must ensure the patient meets all eligibility criteria: being a California resident, having a terminal illness with a prognosis of six months or less to live, having mental capacity to make healthcare decisions, and being able to self-administer the medication.
The most recent and highest quality study on aid-in-dying medication protocols was published in 2025 1, which analyzed data from 3332 death reports covering 2009 to 2023. This study compared four different medication protocols and found that a sedative alone had the best median time to death, but the most recent sedative/cardiotoxin protocol had an acceptable median time to death of 0.8 hours, with fewer prolonged-death outliers. However, the specific medication regimen is not the primary concern in determining which physicians can prescribe aid-in-dying drugs.
The key factors in determining eligibility for aid-in-dying drugs are the patient's terminal illness, mental capacity, and ability to self-administer the medication, as well as the physician's role as the patient's attending physician and their participation in the process, which is voluntary under California law. Other studies, such as those published in 1992 2, 2019 3, 2015 4, and 1994 5, provide additional context and information on aid-in-dying, but do not directly impact the determination of which physicians can prescribe aid-in-dying drugs in California.
Some key points to consider when evaluating a patient's eligibility for aid-in-dying drugs include:
- The patient's diagnosis and prognosis
- The patient's mental capacity to make healthcare decisions
- The patient's ability to self-administer the medication
- The physician's role as the patient's attending physician
- The physician's participation in the process, which is voluntary under California law
- The need for a second consulting physician to confirm the diagnosis, prognosis, and the patient's capacity to make medical decisions.