The California End of Life Option Act is a permanent state law that lets a terminally ill adult California resident request a prescription for medication they can take themselves to end their life. The Act first took effect on June 9, 2016, was briefly suspended by a trial court in 2018, and was restored on appeal. On October 3, 2025, Governor Gavin Newsom signed SB 403, which eliminated a scheduled 2031 sunset and made the law permanent as of January 1, 2026.1California Legislative Information. SB 403
Who Qualifies
To use the Act, you must be at least 18, have the mental capacity to make your own medical decisions, and have a terminal diagnosis with a prognosis of six months or less to live. You must also be a California resident. Residency can be established with a California-issued ID, voter registration, property ownership or a lease in the state, or a California tax return for the most recent year.2California Legislative Information. California Health and Safety Code HSC 443-2
You must be physically able to self-administer the medication. No one else can make the request for you, not through a power of attorney, not through an advance directive, and not through a conservatorship. Age or disability alone does not qualify a person; the terminal diagnosis is what controls eligibility.2California Legislative Information. California Health and Safety Code HSC 443-2
How to Request the Medication
The request process has three parts. You make two oral requests to your attending physician, separated by at least 48 hours, and one written request. 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.3California Legislative Information. California Health and Safety Code HSC 443-3
Not everyone can sign as a witness. Your attending physician, consulting physician, and mental health specialist are all barred from witnessing the written request. No more than one of the two witnesses may be a relative or an employee of the facility where you receive care.3California Legislative Information. California Health and Safety Code HSC 443-3
The 48-hour interval between oral requests is relatively recent. The original statute required 15 days, and the legislature shortened the gap in SB 380 after reports that some patients died or lost capacity during the longer wait and never received the medication they had asked for.4California Legislative Information. SB-380 End of Life
Protections for Patients and Providers
Death from self-administering the prescribed medication is treated under California law as a natural death from the underlying terminal illness, not as suicide. That matters for insurance: life, health, and annuity policies cannot be denied, conditioned, or paid out differently based on whether a person requested or rescinded a request for aid-in-dying medication.5Physician Assistant Board. Information Bulletin – California End of Life Option Act
Physicians who participate in good faith are shielded from civil liability, criminal prosecution, and professional discipline. A doctor cannot lose a license or hospital privileges solely for writing a prescription under the Act. Physicians who choose not to participate are equally protected and cannot be penalized for refusing. People who are present when a patient self-administers face no criminal or civil liability, and they may help prepare the medication, but they cannot assist with the actual ingestion.5Physician Assistant Board. Information Bulletin – California End of Life Option Act
When Hospitals and Clinics Opt Out
Not every California healthcare provider participates. A hospital, hospice, or clinic may prohibit its employees and contractors from taking part in the Act while on its premises or acting within the scope of their employment. To enforce that prohibition, the entity has to give notice of its policy at hire or affiliation, repeat that notice annually, and post the policy on its public website. Without proper notice, the entity cannot discipline an employee who participates.6California Legislative Information. California Health and Safety Code HSC 443-15
The opt-out does not reach beyond the workplace. A healthcare entity cannot stop its physicians from prescribing aid-in-dying medication on their own time, at a different location, or outside the scope of their employment. A doctor working at a hospital that opts out can still prescribe through a separate practice. Entities are also barred from false or misleading statements about whether they will provide aid-in-dying services.6California Legislative Information. California Health and Safety Code HSC 443-15
If your current hospital or hospice has opted out, the practical consequence is that you may need to work with a physician outside that institution. The policy must be posted publicly, so you can check before assuming a given provider will participate.
Who Pays for the Medication
Federal money cannot be used to pay for the prescription. The Assisted Suicide Funding Restriction Act of 1997 blocks federal funds, including Medicare and Medicaid dollars, from covering services that cause or assist in causing death.7Congress.gov. HR 1003 – 105th Congress – Assisted Suicide Funding Restriction Act of 1997 In practice, patients generally pay out of pocket, and the cost can range from several hundred to several thousand dollars depending on the drug regimen. The federal restriction does not override California’s law; it only keeps federal programs from paying.
How Often the Law Is Used
From the Act’s effective date on June 9, 2016, through December 31, 2024, 8,242 people received prescriptions under the law. Of those, 5,423, roughly 66 percent, died after ingesting the medication. In 2024, 1,591 people received prescriptions and 1,032 died following ingestion, with 346 physicians writing prescriptions that year.8California Department of Public Health. California End of Life Option Act 2024 Data Report
About a third of people who obtain the prescription never take it. Some die from their illness first; others keep the medication available without ever using it.
How the Law Became Permanent
The Act was originally passed as AB 2X-15 in 2015, during a special legislative session Governor Jerry Brown had called to address Medi-Cal financing. In 2016, physicians represented by the Life Legal Defense Fund sued, arguing that the Act did not belong in a Medi-Cal special session.
On May 15, 2018, Riverside County Superior Court Judge Daniel A. Ottolla agreed and struck the law down. The ruling turned on procedure, not on the substance of the Act. The California Attorney General’s request for an emergency stay was denied, and the law was briefly suspended.9Institute 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 both its order and its judgment, which restored the law.10Justia Law. California v Superior Court (Ahn) 2018 The legislature followed with AB 282, re-enacting the Act through the regular process so a procedural attack could not succeed again.
SB 380 in 2021 cut the oral-request waiting period from 15 days to 48 hours, added the website-posting and anti-misleading rules for opt-out institutions, and set a January 1, 2031, sunset.4California Legislative Information. SB-380 End of Life SB 403, signed in October 2025 and effective January 1, 2026, repealed that sunset. The Act now has no expiration date.11California Senate District 38. Legislation to Preserve Californias End of Life Option Act Signed by Governor