Today we are recognizing National Healthcare Decisions Day, intended to empower and inspire people to prepare or review their advance directives. An advance directive, sometimes called a living will, is a legal document that outlines your health care preferences in the event that you become unable to make or communicate those choices. As part of the document, you choose a person, your “health care agent,” who will advocate for you during times when you so not have decision-making capacity.
We frequently receive questions about advance care planning and Act 39 (Medical Aid in Dying) in the context of dementia or severe cognitive decline. People ask us whether they can direct the use of medical aid in dying in advance, specifically in the case of dementia. The short answer is no. However there are steps you can take to help avoid prolonged life with severe dementia.
PCV Welcomes New Jersey
New Jersey Governor Murphy last week signed New Jersey’s medical aid in dying law, which is similar to Vermont’s Act 39. New Jersey is now the eighth State and ninth jurisdiction to authorize medical aid in dying. Momentum is building in large part because of successful experience in Vermont and the other states that allow medical aid in dying. When populous states like New Jersey are added to the list, we get a step closer to aid in dying and end-of-life discussions becoming a normal part of end-of-life care. More doctors will learn to guide patients through these decisions, and medical curriculum will increasingly address the training needs of medical professionals. Every time we in Vermont talk to our doctors, our neighbors, to friends in other states, we advance acceptance of end-of-life choice.
We receive a variety of messages from our supporters that let us know our work has had a significant impact on their lives. Here's a recent example:
"I watched every video on the PCV website. It gave me great comfort and knowledge about what to expect as my husband and I navigated the Act 39 process." ...from a recent thank-you note.
One of the most-watched videos (with over 500 views) is that of Peggy and Samantha Stevens in our Living While Leaving series, sharing their loving memories of Eric Stevens during his journey using medical aid in dying.
On Sunday, April 7, Peggy Stevens spoke at the Universalist Unitarian Congregation in St. Johnsbury. A warm and engaging speaker, Peggy shared her personal experience during the time when her husband Eric's health was declining from a neurological disease. She discussed how they had to make a transition from looking for cures to planning what they hoped would be a peaceful death. Peggy's story is about living life fully while accepting the inevitable end of life.
Report from the Field:
During this past week, PCV representatives Dr. Diana Barnard, Betsy Walkerman, Francesca Arnoldy and Marnie Wood led and participated in discussions at two public forums. Dr. Barnard discussed hospice and palliative care at the Gerontology Symposium hosted by the Center on Aging at the University of Vermont. Francesca Arnoldy led breakout sessions on the role of an end-of-life doula.
"I was able to discuss the process of Act 39 as I described the kind of emotional support a doula can offer," says Francesca. "Focusing on individual choice is paramount as a doula assists with gathering information so clients can make their best decisions."
Marnie Wood reported that attendees appreciated the PCV brochures and the chance to talk with people who have been through medical aid in dying with a family member. In the circle I led, as part of Death Talks during Public Philosophy Week, a major topic raised by attendees was how to support people who do not want to linger with severe cognitive decline. We will be posting more information about that on the PCV website soon.
Our Upcoming Work:
PCV speakers will be leading two discussions in the next month. One will be at the Caldwell Law Group in Lebanon, NH, which serves Vermont and New Hampshire clients with estate and end-of-life planning services. The other event is intended to provide information on Act 39 to the Brown Alumni Association of the Upper Valley. Sorry, but both of these are private engagements.
If you are connected with an organization that would like to have a discussion about medical aid in dying, please contact us. These discussions are about life, making decisions, establishing connections, and about personal autonomy in navigating the challenges to your fundamental civil liberties. Every person who learns about end-of-life choice and talks about it with their doctor, helps to anchor this civil liberty firmly in our Vermont community.