Advance Directive – Includes a person’s living will and medical durable power of attorney. Called “advance” because it is prepared prior to a health crisis in which it would guide medical care. Advance directives vary by state and can include other documents, such as a dementia provision. See also “living will” below.
Aid in Dying – A medical practice that allows mentally capable, terminally ill adults to request a prescription for life-ending medication from their physician, which the person may self-administer if and when s/he chooses. Where medical aid in dying is currently authorized—Oregon, Washington, Montana, Vermont, California, Washington, D.C., Hawai‘i, New Jersey and Maine—doctors are required to confirm that a patient is fully informed and provide the patient with information about additional end-of-life options, including comfort care, hospice and pain control before providing a prescription. Aid in dying is the preferred terminology of several healthcare organizations. Terms like “assisted suicide” do not accurately describe aid in dying (see below).
Death with Dignity – The freedom to die peacefully and in control. It is also the name given to aid-in-dying laws that have advanced in a number of states over the years. Oregon’s landmark aid-in-dying law, enacted in 1997, is called the Oregon Death With Dignity Act. Washington state’s 2008 law is the Death With Dignity Act.
DNR – Stands for “do not resuscitate,” a medical order making clear an individual’s request that no measures be taken to resuscitate them if their heart or breathing stops. The order is made while the individual is mentally capable and conscious, or by that individual’s healthcare proxy if he or she is not.
End-of-life choice or end-of-life options – Describes the overarching goals of Compassion & Choices. The mission of Compassion & Choices is to improve care and expand options, and empower everyone to chart their end-of-life journey. Compassion & Choices’ vision is a society that affirms life and accepts the inevitability of death, embraces expanded options for compassionate dying, and empowers everyone to choose end-of-life care that reflects their values, priorities, and beliefs.
Euthanasia – Also known as “mercy killing.” In the act of euthanasia, the physician – not the dying person – chooses and acts to cause the death of the patient. Euthanasia, like assisted suicide, is a criminal act in the United States. Compassion & Choices does not support euthanasia or assisted suicide.
End-of-Life Information Center and Consultation Program – Free online resources at http://www.compassionandchoices.org/end-of-life-planning/ and a free consultation service from Compassion & Choices that provides clients with expert consultation in navigating the healthcare system and understanding end-of-life choices available in each state. Trained professionals offer assistance in completing advance directives, make referrals to local services, provide information on end-of-life options, and educate clients, their loved ones and healthcare professionals about patient-centered end-of-life care.
Hospice – A program in which an interdisciplinary team of caregivers provides comfort, support and dignity to terminally ill people when medical treatment is no longer expected to cure the disease or prolong life. Hospice service is provided wherever the person resides, most often at home. It is voluntary and also involves and supports the individual’s family and/or loved ones.
Living will – A document that expresses a person’s end-of-life preferences if they become unable to speak for themselves. A living will is just one component of an advance directive (see “advance directive,” above).
MOLST/POLST – Stands for Medical (or Physician) Orders for Life Sustaining Treatment. A form available in a growing number of states providing detailed guidance about an individual’s wishes for end-of-life medical care. The order is part of advance healthcare planning and is prepared by a medical professional. It is often printed on brightly colored paper and placed on a refrigerator so it can easily be found during an emergency.
Palliative/total sedation – Also referred to as terminal sedation. The continuous administration of medication to relieve severe, intractable symptoms that cannot be controlled while keeping the person conscious. This state is maintained until death occurs.
Physician-assisted suicide – Or simply “assisted suicide,” is an inaccurate description of the medical practice of aid in dying, which is currently available in a growing number of states to mentally capable adults who are terminally ill. See Compassion & Choices’ Medical Aid in Dying is not Assisted Suicide resource explaining how a request for medication to shorten a difficult dying process by an adult facing an imminent death is different from a person who is considering suicide and has no such prognosis. According to the American Psychological Association, aid in dying and suicide have “profound psychological differences.”
Refusing medical treatment – A legal right to refuse medical treatment even if that treatment is necessary to sustain life. These life sustaining interventions can include ventilators, feeding tubes and pacemakers.
VSED – Stands for “voluntarily stopping eating and drinking,” a legal right for any individual who wishes to shorten their dying process by refusing nourishment orally or through a tube.
Terminal prognosis, terminally ill – An illness for which the medical expectation is death within a few months. Aid-in-dying laws typically define terminal as a life expectancy of six months or less.