• Psychosomatics · Sep 2018

    Physician-Assisted Death Psychiatric Assessment: A Standardized Protocol to Conform to the California End of Life Option Act.

    • James A Bourgeois, Maria Theresa Mariano, James M Wilkins, Rebecca Weintraub Brendel, Lawrence Kaplan, and Linda Ganzini.
    • Baylor Scott and White Health Central Texas Division, Psychiatry; Texas A&M Health Science Center School of Medicine, Psychiatry, Temple, TX. Electronic address: james.bourgeois@bswhealth.org.
    • Psychosomatics. 2018 Sep 1; 59 (5): 441-451.

    BackgroundThe California End of Life Option Act (EOLOA), which legalized physician-assisted death (PAD), became effective in 2016. The EOLOA does not require a mental health consultation in all cases nor does it state the standards for the mental health assessment. University of California, San Francisco Medical Center (UCSFMC) policy makers decided to require a mental health assessment of all patients seeking PAD under the EOLOA.ObjectivesThe Department of Psychiatry was tasked with developing a standard protocol for the mental health assessment of patients seeking PAD.MethodsMembers of the consultation-liaison (C-L) service developed a document to guide members in completing the mental health evaluations for patients requesting PAD.ResultsA committee at UCSFMC developed a clinical protocol informed by the law with an additional local expectation of an evaluation by a psychiatrist or clinical psychologist. The C-L psychiatry group at UCSF developed a standard protocol for the psychiatric assessment for use by clinicians performing these assessments. Attention to the cognitive, mood, and decisional capacity status pertinent to choosing PAD is required under the clinical guidance document. Case vignettes of 6 patients evaluated for PAD are presented.ConclusionsThe local adoption of the California EOLOA by UCSFMC requires a mental health assessment of all patients requesting EOL services at UCSF. The clinical guideline for these assessments was locally developed, informed by the literature on EOL in other jurisdictions where it has already been available.Copyright © 2018 Academy of Consultation-Liaison Psychiatry. All rights reserved.

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