Though the changes are largely technical, the California Senate overwhelmingly passed a bill recently its author says will help people transition at the end of their lives with more dignity.
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With zero no votes, the bill from Sen. Catherine Blakespear, D-Encinitas, is meant to provide clarity and consistency with advanced care directives and other documents that deal with the type of medical care people receive at the end of their life or if they become seriously ill or injured.
The bill specifies that nurse practitioners and physician assistants can sign off on do-not-resuscitate and POLST forms, as well as doctors.
Completely voluntary, POLST — an acronym for Physician Orders for Life-Sustaining Treatment — lets a seriously ill patient specify the type of medical treatment they wish to receive at the end of life. This can include CPR, intubation and tube feeding, among other interventions. Meanwhile, a DNR form lets emergency medical personnel know not to perform CPR in the event a person stops breathing or their heart stops, but it does not address other medical treatments, according to California’s Emergency Medical Services Authority.
Blakespear’s bill also ensures POLST and DNR forms executed out of state would still be applicable in California and would allow POLST forms to be signed electronically.
“People should get the end-of-life care they want, even if they are incapacitated or can no longer express their wishes,” said Blakespear, who represents communities in southern Orange County. “This bill puts patients first by strengthening continuity on advance care planning forms, so their medical wishes are honored when they matter most.”
Blakespear, an attorney who has worked with estate planning, predicted Senate Bill 1088 will not be quite as controversial as it works its way through the legislative process as her previous effort to expand California’s medical aid in dying law to include more people, such as those who have been diagnosed with Alzheimer’s disease or other forms of dementia.
California is one of only a handful of states that allow people diagnosed with a terminal illness and who meet a tight set of criteria to end their lives with doctor-prescribed drugs. Blakespear’s bill to expand who qualifies did not even receive a committee hearing in 2024.
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This recent effort is really “just a modernization of forms,” Blakespear said in an interview. But it’s still an important tool for people, whether they are healthy or are dealing with a terminal illness, she said.
“I’m interested in helping people at the end of their life transition with as much power as they want,” said Blakespear, who noted she has thought through and discussed end-of-life care not only for her parents but for herself as well. “Inevitably, everyone will die.”
The bill is sponsored by the Coalition for Compassionate Care, an organization that works with healthcare providers, lawmakers and other advocacy organizations to promote high-quality care for those who are seriously ill or nearing the end of their lives. It has support from Alzheimer’s Orange County, the California Academy of Family Physicians and the California Catholic Conference, among others.
It is opposed by the California Clinical Nurse Specialist Association, which said it wanted the bill updated to authorize clinical nurse specialists to sign POLST forms.
The bill heads next to the Assembly.
In other news:
• The California Senate also passed a bill from Sen. Steven Choi, R-Irvine, that provides a process for people who were adopted as children from a foreign country to petition, as adults, for their readoption, the legal process of finalizing an adoption back in California.
“SB 927 restores dignity and legal certainty to individuals who have spent their lives as part of Californian families, yet were left without the documentation needed to prove their status, through no fault of their own,” Choi said. “This bill provides a compassionate and practical solution for adoptees who fell through the cracks of the system decades ago.”
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