RIGHTS WATCH : To Choose to Die

Making a conscious, informed decision to forgo emergency medical care in certain circumstances--choosing someone to implement that decision and putting it in writing--is a soul-searching process that can take months.

But that wrenching decision can be undone in a few minutes. In a moment of crisis, a well-intentioned family member can panic and call 911. In most circumstances and in most counties in California, paramedics must try to resuscitate a patient even if he or she is terminally ill and wants to die.

That’s changing. Within a few weeks San Diego and Orange counties will implement policies allowing paramedics to withhold resuscitation in some cases. (Los Angeles County is months away from a new policy.)

In both Orange and San Diego counties, patients and doctors sign a simple, one-page consent form. The San Diego policy is broader; doctors must only attest that the decision is “medically appropriate.” In Orange County, the “do-not-resuscitate” policy is restricted to the terminally ill. But the Orange County policy has a very practical component. Instead of having to produce the consent form, patients can opt to wear a special green leg or arm band to indicate their wishes. San Diego officials worry about the social stigma of the bands.

Regardless of the specifics, San Diego and Orange counties and four others around the state are making it easier, in life-or-death situations, to choose death when it is the better alternative. And they are making tough policies easier for other counties to adopt.