Palliative Care & Oncology
Soon after the passage of the California End of Life Options Act in 2015, President Janet Napolitano of the University of California tasked each of its medical centers with the job of creating policies and procedures to comply with the law. This symposium will compare and contrast how two large tertiary/quaternary centers--UCSF and UCLA--approached the challenge. Likely as a reflection of institutional culture and the differing social fabrics of the cities in which they work, UCSF and UCLA created different policies, most notably regarding how patients were triaged for mental health assessments after initiating a request to their attending physician for aid in dying (PAD). The presenters, two from each institution, will discuss the differing approaches to policy creation and resultant practice, will present salient case examples, and will review ethical and clinical considerations and lessons learned. The moderator will place these developments in the historical context of legalization of PAD. The policies presented here might serve as templates for other health systems. As more states legalize PAD, there will also be opportunities for empirical comparison of outcomes regarding patient, family, and clinician experience.