January 2, 2021 An interview with Janell Jones, PharmD by Martha Turner
If you are in need of filling your prescription for Medical Aid in Dying medications, Janell Jones, PharmD, at Gold Country Compounding in Auburn California, is an extraordinary pharmacist to work with. She has been offering this service since California’s End of Life Options Act came in to law in 2016 and she received her first request soon after that. She provides heart-felt, respectful and thorough counseling for the dying patient and family members, in person or over the phone. She deeply believes that a person with a terminal illness has the right to make this decision. Her first patient taught her that he was not “choosing to die” as the cancer had made that decision for him. He was, however, choosing WHEN he would die. Janell can be reached at (530) 368-2103 for any questions you may have about this essential end of life service.
Full Circle of Living and Dying first learned about Janell Jones, PharmD in 2019, when we heard there was a pharmacist, just down the road in Auburn, who was able to fill a prescription for Medical Aid in Dying (MAID).
Janell has been a pharmacist since 2011 and her undergraduate degree was in chemistry. Early on she became interested in the art of compounding medications and took additional elective classes in this specialized practice. In 2016, soon after California’s End of Life Options Act was made into law, a patient approached her to fill his prescription for his Medical Aid in Dying medications. Janell explored the ethical, legal and practical aspects of providing this service with her pharmacy team and all agreed with and supported the concept. This first patient had a profound effect on Janell when he told her he was not “choosing to die” as the cancer had made that decision for him. He was, however, choosing when he would die. She believes, as do we at Full Circle of Living and Dying, that a person has the right to make this decision.
Janell explained why this medication has to be “made from scratch” which essentially is what compounding medication is about. It requires special licensing for the pharmacy for the handing of the raw material. It is not possible to simply use the tablet forms of the medications. This is because the number of pills needed to reach the needed dosage would be enormous because of the large amount of fillers and binders that tablets are made with.
The formula used for MAID continues to evolve as time goes by. The original medication was a lethal dose of Seconal which required 70+ tablets! This was very hard for a person to take and the cost became exorbitant, up to $4000! (The medication combinations continue to change over time.) MAID medications are currently not covered by Medi-Care or most private insurance companies. The current cost is between $400-$500.
The person taking the medication goes into a deep and peaceful coma prior to the heart slowing, finally stopping, and the transition to the other side is complete. It is important that the GI tract is functioning in order for the medications to be absorbed. However, for a person unable to swallow, there is a formula that can be administered rectally.
Currently it is not lawful to receive medications for MAID by the IV route. The future holds hope for this as it would be more humane for some persons, however this is not expected anytime soon. Janell explained that additional licensing is required for a pharmacy to be “sterile” in order to mix IV medications of any type. There is more work to be done as our society evolves around the matter of death and we give thanks for the work Janell does.
Additional information about Medical Aid in Dying can be found elsewhere on the Full Circle of Living and Dying website under the tab End of Life Plan of Care and then the tab California End of Life Options Act.
The trail blazers for the legislative efforts nationwide are the dedicated people working with Compassion and Choices whose website is: https://compassionandchoices.org/ California specific information and support can be found at https://endoflifechoicesca.org/