Cindy L. Cain, PhDAssistant ProfessorDepartment of SociologyUniversity of Alabama at BirminghamBirmingham, AL 35233 

Majority of Surveyed Hospitals Prohibit Physician Participation in End of Life Option Act Interview with:

Cindy L. Cain, PhDAssistant ProfessorDepartment of SociologyUniversity of Alabama at BirminghamBirmingham, AL 35233 

Dr. Cain

Cindy L. Cain, PhD
Assistant Professor
Department of Sociology
University of Alabama at Birmingham
Birmingham, AL 35233 What is the background for this study? What are the main findings?

Response: The End of Life Option Act permits terminally ill Californians to request a prescription for medications that would hasten death, providing they meet all requirements of the law and follow the steps outlined by their health care provider.

However, the law also allows health care providers and organizations to opt out of participating. Until now, we did not know how common it was for entire health care organizations to opt out.

In this study, we found that 61% of the surveyed hospitals prohibited physician participation in the End of Life Option Act. Thirty-nine percent of hospitals did allow participation in the law; these participating hospitals were less likely to be religiously affiliated and more likely to be nonprofit. What should readers take away from your report? 

Response: Policies set by health care organizations affect patient access to the End of Life Option Act. What recommendations do you have for future research as a result of this work?

Response: Much of the care for people at end of life happens outside hospital settings, so more research is needed on the policies of these other settings. We also need more research on physicians’ willingness to participate in the End of Life Option Act. Is there anything else you would like to add? 

Response: This research was funded by the California Health Care Foundation and the Stupski Foundation. 


Cain CL, Koenig BA, Starks H, et al. Hospital Responses to the End of Life Option ActImplementation of Aid in Dying in CaliforniaJAMA Intern Med. Published online April 08, 2019. doi:10.1001/jamainternmed.2018.8690


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Last Updated on April 8, 2019 by Marie Benz MD FAAD