Press Release

Sen. Blakespear Introduces Legislation to Strengthen End-of-Life Care Protections

SB 1088 clarifies end-of-life care directives, so Californians get the medical care they want when they can no longer express their wishes

SACRAMENTO – Sen. Catherine S. Blakespear, D-Encinitas, has introduced legislation to ensure Californians get the end-of-life care they desire.

Specifically, SB 1088 would improve clarity and consistency among the three types of forms that can be used to legally document the type of care and medical treatment a person wants should they become seriously ill or injured and unable to articulate their wishes. 

“SB 1088 makes sure there are no ambiguities or uncertainties about end-of-life care, if a person documents their wishes on an advanced care planning form,” Sen. Blakespear said. “People should have control over the end of their lives and the care they receive, even if they are unconscious, and that’s what this legislation helps provide.”

Californians have three types of advance care planning forms they can use: An advance care directive, a Do Not Resuscitate (DNR) form and a Physician Orders for Life Sustaining Treatment (POLST). Each are different with different requirements.

The legislation makes a number of commonsense changes to ensure consistency and effectiveness for these forms. For instance, it specifies that DNRs and POLSTs could both be signed by a nurse practitioner, physician’s assistant or a doctor, instead of just a physician, as is currently the case for a DNR. 

In addition, POLST forms could be signed electronically, future DNRs and POLSTs would have to be dated and DNRs and POLSTs executed outside of the state would apply in California. 

Summary of advance care planning forms:

  • An advance care directive allows a person to designate someone to make medical decisions on their behalf and to explain what medical treatments should and should not be done if they lose decision-making capacity, among other things.
  • A prehospital DNR form applies when a person stops breathing or their heart stops beating and allows a person to decline resuscitative care orders.
  • A POLST includes a DNR section but has additional sections as well, allowing a person to give medical providers instructions on interventions, such as ventilation, ICU, transport, comfort measures and artificial nutrition by feeding tube.

SB 1088 follows last year’s passage of SB 403, legislation by Sen. Blakespear to continue California’s medical-aid-in-dying law and prevent it from expiring in 2031. The bill eliminated the sunset date for California’s End of Life Option Act, which gives mentally capable, terminally ill adults with a prognosis of six months or less to live the option to request from their doctor a prescription for medication they can decide to self-administer to die peacefully in their sleep.

SB 1088 is sponsored by the Coalition for Compassionate Care of California (CCCC). 

“As the longtime home of the POLST program, the Coalition for Compassionate Care of California appreciates Senator Blakespear’s efforts to bring the legislation up to date and create closer alignment between POLST, the prehospital DNR, and advance directives,” said Jennifer Moore Ballentine, CEO of CCCC. “Californians with serious illness or nearing the end of life need clear and effective ways to express their preferences for medical treatments and have them honored by all healthcare professionals.”

Sen. Blakespear represents Senate District 38, which covers northern San Diego County and southern Orange County. To learn more about the district and Sen. Blakespear, visit her Senate website.