Monique Van de Ven died peacefully in Vermont on January 27, 2016, at the age of 56 after taking a medical aid-in-dying prescription obtained through her doctor under the Vermont Patient Choice and Control at End of Life Act (Act 39).
In 2006 she was diagnosed with adenoid cystic carcinoma, a rare but aggressive head and neck cancer. Monique’s journey was not easy by anyone’s estimation. Over a ten year period, she had numerous surgeries including the removal of her right sinus and her right eye, followed by debilitating radiation therapy. When it was clear to her physicians that there were few options left, Monique sought relief through palliative care, wanting to know all of her options. She was very clear that she had had a good life and wanted a good death. She believed very deeply that it is beautiful on the other side and that there is no merit in suffering.
Monique tried to find a physician who would support her choice to use Vermont’s Act 39 but most of her medical care was provided by Dartmouth Hitchcock Medical Center and her physicians weren’t forthcoming with information that would have allowed her to access the law. It was very stressful dealing with her terminal diagnosis but struggling to find a new physician who would support her choice was difficult and disheartening. “People are so desperate to have this information and physicians who discourage their patients from considering aid in dying are providing poor quality medical care.”
Monique was grateful to eventually find a new primary care physician who would support her choice. Her struggle to get information and support led her to want to help other terminally ill Vermonters have a more open process. One of her final acts was to help Compassion & Choices intervene in a federal lawsuit filed by opponents of the law that requires doctors, regardless of their personal feelings, to inform terminal patients in Vermont that they have the option of choosing to end their lives when their quality of life falls below what they can tolerate. Her story is now part of the federal record.
Her friend, Linda Galvao, said of Monique, “her careful planning ahead and making clear to loved ones exactly what she wants near the end is a huge gift. None of us who are trying to help need to worry or guess whether we’re doing what she’d want. I think this is one of the greatest gifts any of us can give our families and loved ones. Yes, it has to be done ahead of time and it means having real, sometimes awkward conversations about the culturally taboo subject of death. But everyone’s peace of mind as we near this inevitability is so very worth it. “
Three days before her death Monique posted this message to friends and family:
This painting is showing me the way home.
I am so grateful that I can make the journey soon, with so much love surrounding me.
I have been so blessed in my life, and I want you all to know how much I love you!
After Monique died, surrounded by loved ones, her friend Linda shared this final remembrance
Yesterday went beautifully, peacefully, even better than anticipated. Monique continued her brief respite of feeling energetic and nearly pain-free, able to say the goodbyes she most wanted to. She felt totally supported and also absolutely, totally ready to leave her body behind. She knew she was loved and kept saying how lucky she was to have had such a good life.
She sat in her favorite recliner in her comfortable living room. The precious meds that had been locked in the safe were painstakingly prepared — the dozens of capsules opened and emptied into homemade applesauce sprinkled with cinnamon. Surrounded by four friends and so ready to “go home,” Monique scooped out every bit and licked the spoon, chasing it with a sip of fine red wine at 2:30 p.m. After a minute she said, surprised, that she didn’t feel sleepy — and then quietly went to sleep.
We all held her until her breathing and pulse stopped at 3:30. It couldn’t have been more peaceful. There was the contagiousness of feeling our own breathing grow shallow as her sleeping body struggled with its last hold on life. The lightness and relief when it was over, feeling our own muscles relax, our own inhalations fill our lungs deeply once again and our exhalations release tension we hadn’t recognized before.
And then the perfectness of old customs practiced mainly by women forever — jointly carrying her to a table centered in the room, laying her out and staying with the body, now totally relaxed and out of pain. Flowers and candles and meaningful tokens of love filling the rooms. Sharing the task of calling family and dear friends. Holding and washing and dressing the body of a loved one as part of the “saying goodbye” rather than having strangers do it. Stroking her hair, holding her hands and kissing her cheeks as they cool. Toasting her life with champagne and later sharing a meal in the next room. More people are coming — squeeze in more tables and chairs, fit everyone in. Everyone belongs and is made to feel welcome. The lasagna made for the occasion feeds eight of us, several of whom barely ate during the long, intense day. Still half of it left in the large pan for the days to come. The whole day is filled with laughter and tears and stories, hugs and mutual appreciation all around. No one doubts that this is a happy day for Monique nor that her strong, vibrant essence is joyful and quite free of the shell of her body. Yet the tasks of caring for the body — the only place we have known her to be until now — are honored and carried out with love and reverence.
For more information on the Vermont lawsuit: https://www.compassionandchoices.org/compassion-choices-and-patient-choices-vermont-intervene-to-protect-vt-aid-in-law/