End-of-Life Choice, Death with Dignity, Palliative Care and Counseling

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News Reports Document The Patient End-of-Life Choice Act Working for Vermonters

The newspaper Seven Days has written about two Vermont women known to have accessed Act 39 and self-administered the aid-in-dying prescription it authorizes.  Most recently, they wrote about the woman believed to be the first Vermonter to use the end-of-life law. 

The story explains that Annette Vachon, a retired small business owner, was diagnosed at age 64 with stage IV terminal lung cancer, but radiation treatments did not slow its progress. So Vachon set about obtaining an aid-in-dying prescription from her doctor. He friend, Meg Harris, told Seven Days what happened next:

By October, she knew her time was short, Harris said. Morphine was not controlling the pain and was making her occasionally delusional.

Harris picked up the prescription for her on a Thursday. Just having the drugs in the house, she said, made Vachon feel more at peace. “It was interesting to see how much that changed for her,” Harris said. “Her only goal was to do this with dignity and humor.”

Read the full story here.

Harris came forward with the story of her friend, Annette, after reading the lengthy January profile of another Vermont woman who had accessed Act 39 named Maggie Lake.

After nine years of battling cancer — including two stem-cell transplants, chemotherapy and radiation — Lake had come to the end of her fight.

 Maggie Lake’s story was told by her sister, Katy Lesser.

Lying in bed at her Putney home as day turned to evening, the 60-year-old took the lethal dose of drugs she’d been prescribed weeks earlier. She urged her family to coach her through it as she swallowed the combination of pills and liquids.

“We sat with her. We talked to her. We talked to each other. We reminisced. We laughed. We cried,” Lesser said.

Read the full profile of Maggie Lake and Vermont’s aid-in-dying law here.

More information about Vermont’s End-of-Life Choice Law is available here.


State Health Commissioner Tells Lawmakers Implementation of Act 39 Has Gone Smoothly

In testimony before the Vermont Senate Health and Welfare Committee, the state’s Health Commissioner, Harry Chen, said that implementation of the state’s 2013 death-with-dignity law was going smoothly.  So far, six Vermonters have accessed it.

Read the Times Argus story here.

Chen’s remarks came during a hearing to revisit a provision of the death-with-dignity law which “sunsets” many of its safeguards in 2016. The phasing out of those safeguards – what some call hurdles – was part of a compromise to get the law through the legislature in 2013 as the first aid-in-dying law written and passed by a U.S. legislative body.  A staunch Libertarian Senator who opposed the safeguards agreed to a bill that would phase them out over time. He believed that provisions like two waiting periods and multiple written and oral requests for a prescription would reduce Vermonters’ ability to benefit from the law.

Senators also heard from Oliver Brody, the partner of a woman named Maggie Lake who used the law to end her suffering after a nine-year battle with Leukemia.

“So when the law was passed, I was glad to hear it, never thinking it would be something I would come into contact with,” Brody told the Committee.

Read a synopsis of the hearing from the VT Digger news site here.

The Senate committee hearing, however, is also seen as an opportunity for opponents to move to repeal the law altogether, raising what-if scenarios that have yet to play out in any jurisdiction where aid in dying is authorized. At the hearing, Commissioner Chen assured Senators that, to date, there had been no reports of abuse in Vermont, either.


Bill to Charge Doctors With Homicide for Practicing Aid in Dying Defeated in Montana House

Compassion & Choices Praises Bipartisan Group of Legislators for Rejecting Physician Imprisonment Act

(Helena, MT – Feb. 17, 2015) Compassion & Choices praised the Montana House for rejecting a bill that would have charged a doctor with homicide for writing a prescription for aid-in-dying medication to a terminally ill adult who wants that option to end their suffering. Doctors also would have lost their license to practice medicine under the bill, which would trump a Montana State Supreme Court ruling.

A bipartisan group of legislators voted 51 to 49 to reject the bill, HB328, which opponents call “The Physician Imprisonment Act.” The Montana House Judiciary Committee is scheduled to hold a hearing on Wednesday on another draconian bill, HB477, that would imprison a doctor or up to 10 years for writing an aid-in-dying prescription. A 2013 poll showed 69% of Montana voters support authorizing physicians to write prescriptions for aid-in-dying medication.

“We thank the House for rejecting this bill that would have charged physicians who honor a dying patient’s request for medical aid in dying with homicide and take away their medical license.” said Compassion & Choices Montana Campaign Manager Emily Bentley. “Now we urge the House not to reverse course on HB 328 on the final reading of the bill and to reject HB 477 that would put doctors who practice aid in dying in prison for up to 10 years.”

In 2009, the Montana Supreme Court ruled in Baxter v. Montana  that state law authorizes physicians to prescribe aid-in-dying medication to a terminally ill adult who requests it. The Court said: “The Rights of the Terminally Ill Act clearly provides that terminally ill patients are entitled to autonomous end-of-life decisions.” The court required four safeguards: The patient must be 1) terminally ill, 2) mentally competent, 3) over 18 years old, and 4) must self-administer the medication. Five years later, many doctors across Montana have written aid-in-dying prescriptions for terminally ill people who request it.

Compassion & Choices Partners with New York Lawmakers to Introduce End-of-Life Options Act

State Senators Diane Savino and Brad Hoylman Introduce Legislation to Authorize Aid in Dying for Terminally Ill Adults in New York

(New York, NY – Feb. 16, 2015) – Just a few months after 29-year-old Californian Brittany Maynard had to utilize an Oregon law to end her suffering from terminal brain cancer, two New York State senators introduced similar legislation today, referred to as the New York End-of-Life Options Act (S3685).

“The option to end one’s suffering when facing the final stages of a terminal illness should be a basic human right, and not dependent upon one’s zip code,” said Senator Diane Savino (D-23), prime co-sponsor of the New York End-of-Life Options Act. “With solid support for aid in dying across every demographic, I believe there will be strong bipartisan backing for this bill.”

“As a key member of the Independent Democratic Caucus in the New York State Senate, Senator Savino is well positioned to gain bipartisan support for New York’s aid in dying bill,” said Barbara Coombs Lee, President of Compassion & Choices, the nation’s largest organization working to expand end-of-life choices.

In advance of drafting the legislation, Senator Savino met with Dan Diaz, Brittany’s husband, to learn more about Brittany’s experience with her illness and accessing medical aid in dying. Diaz also told Savino that helping lawmakers like her pass death-with-dignity laws was how he could keep a promise to his late wife.

“Having aid in dying as an end-of-life option provided great relief to Brittany,” said Dan Diaz, Brittany’s husband. “It enabled my wife to focus on living her last days to the fullest, rather than living in fear of dying in agony from terminal brain cancer.”

Maynard — who suffered debilitating, painful seizures caused by her terminal brain cancer — had to move to Oregon so she could access its death-with-dignity law because her home state of California does not authorize this end-of-life option. The law gives terminally ill, mentally competent adults the option to request a prescription for life-ending medication that they can choose to self-administer if their suffering becomes unbearable.

“Meeting Mr. Diaz only strengthened my commitment to helping every New Yorker gain access to the option of aid in dying,” said Savino. “I was honored to meet Brittany’s family and to learn how this option improved her well-being during her illness, as well as how having to move to another state only made her final months that much harder.”

Rapid introduction of the bill mirrors the momentum behind similar legislation around the country.

“Since Brittany Maynard’s death, the American public appreciates, like never before, that the option of aid in dying provides peace of mind and comfort to those with a terminal illness,” said Coombs Lee. “We are confident the bill will receive serious consideration in New York under Senator Savino’s and Senator Hoylman’s capable leadership.”

Senator Brad Hoylman said, “We can help alleviate human suffering and provide terminally adults with a modicum of personal control by giving them more choices at the end of their lives.”

Since Brittany Maynard’s story broke on Oct. 6, lawmakers have introduced similar bills, or pledged to so, in Washington, D.C. and at least 13 states, including California, ColoradoFlorida, Indiana, Maryland, Minnesota, Missouri, New Hampshire, Pennsylvania, Wisconsin, and Wyoming.

Brittany’s story also is galvanizing Compassion & Choices campaigns to pass bills authorizing aid in dying in New Jersey, Connecticut, Massachusetts, Colorado and California and to defend this legally recognized option in Montana, New Mexico and Vermont.

National and state polls consistently show the vast majority of Americans across the demographic and political spectrum want to maintain their right to choose their medical treatment at the end of their life. A 2014 Harris Interactive poll puts nationwide support for aid in dying at 74 percent.

“This is a deeply personal decision, one which mentally competent, terminally ill New Yorkers should be able to make only for themselves,” said Hoylman. “I look forward to working alongside Senator Savino and my colleagues to pass New York’s version of “death-with-dignity” legislation.”

The New York End-of-Life Options Act is modeled after legislation in Oregon and other states where aid in dying has been proven to be good policy and medical practice.

  • It allows only qualified, terminally ill and mentally competent adults to request and obtain a prescription from their physician for medication that the patient can self-administer to bring about a peaceful and humane death.  Two physicians must confirm the prognosis is terminal.
  • It requires two witnesses to attest that the request is voluntary.
  • It protects physicians from civil or criminal liability, and from professional disciplinary action, if they fulfill an eligible individual’s request. Participation by doctors is fully voluntary.
  • It provides safeguards against any coercion of patients: It establishes felony penalties for coercing or forging a request; and it honors a patient’s right to rescind the request.
  • It states that any action taken in accordance with the bill will not constitute “suicide” or “assisted suicide.”

Besides Oregon, aid in dying is authorized in Washington, Montana, Vermont and New Mexico.

Compassion & Choices, the oldest and largest national non-profit organization committed to improving care and expanding choice at the end of life, is a leading advocate of aid-in-dying legislation in New York and around the country.


C&C Honors Black History Month

Dr. Michael Eric Dyson

Nationally recognized thought leaders in the fields of theology, medicine and financial planning will join Compassion & Choices during Black History Month to discuss the effects the lack of end-of-life planning has on the African American community — and what can be done to address the issue.

Along with the National Caucus and Center on Black Aged, Inc., C&C will host “The Journey Home: An African American Conversation” on Feb. 24 in Washington, D.C. Studies show the timeliness of the discussion:

  • Only 13 percent of blacks in home healthcare have an end-of-life plan in place, compared with 32 percent of whites.
  • In the nursing home setting, only 35 percent of blacks have a plan compared with 70 percent of whites.
  • Whites are 2.4 times and 3.4 times as likely as blacks to have a living will and a durable power of attorney for healthcare, respectively.

The event follows the success of an intimate November conversation among African Americans in Chicago that featured Aris T. Allen Jr., son of the first African-American chair of the Maryland Republican party who ended his life after being diagnosed with terminal cancer in 1991. Allen and other experts will join keynote speaker Dr. Michael Eric Dyson, best-selling author and Georgetown University sociology professor, in a discussion on the social, cultural and religious reasons African Americans often don’t make end-of-life plans and how it hurts their families and communities. “It’s going to be a good intersection between the religious and cultural practicalities African Americans look at in the death and dying process, “ said C&C National and Federal Programs Director Daniel Wilson.

C&C will continue this dialogue on a national level among influential groups such as the Congressional Black Caucus, NOBEL (National Organization of Black Legislative Elected) Women, African American sororities and fraternities, community leaders, and physicians regarding the importance of discussing end-of-life priorities. Attendees at these events receive planning resources such as Compassion & Choices’ Good-to-Go Toolkit and information on the End-of-Life Consultation service.