TY - JOUR
T1 - Physician-Assisted Death Psychiatric Assessment
T2 - A Standardized Protocol to Conform to the California End of Life Option Act
AU - Bourgeois, James A.
AU - Mariano, Maria Theresa
AU - Wilkins, James M.
AU - Brendel, Rebecca Weintraub
AU - Kaplan, Lawrence
AU - Ganzini, Linda
N1 - Publisher Copyright:
© 2018 Academy of Consultation-Liaison Psychiatry
PY - 2018/9/1
Y1 - 2018/9/1
N2 - Background: The 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. Objectives: The Department of Psychiatry was tasked with developing a standard protocol for the mental health assessment of patients seeking PAD. Methods: Members of the consultation-liaison (C-L) service developed a document to guide members in completing the mental health evaluations for patients requesting PAD. Results: A 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. Conclusions: The 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.
AB - Background: The 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. Objectives: The Department of Psychiatry was tasked with developing a standard protocol for the mental health assessment of patients seeking PAD. Methods: Members of the consultation-liaison (C-L) service developed a document to guide members in completing the mental health evaluations for patients requesting PAD. Results: A 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. Conclusions: The 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.
KW - decisional capacity assessment
KW - end of life
KW - neurocognitive disorders.
KW - physician-assisted death
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U2 - 10.1016/j.psym.2018.02.003
DO - 10.1016/j.psym.2018.02.003
M3 - Article
C2 - 29653821
AN - SCOPUS:85045103325
SN - 0033-3182
VL - 59
SP - 441
EP - 451
JO - Psychosomatics
JF - Psychosomatics
IS - 5
ER -