Introduction

Introduction

Volunteers are at the heart of Compassion & Choices’ advocacy, education and outreach efforts, paving the way for a full range of end-of-life options nationwide. Our success hinges on the generous participation of supporters like you — volunteers from around the country who contribute their skills and time to make a difference.

The guidance provided in the following chapters will help you match your interests and talents with the most impactful actions you can take as a Compassion & Choices volunteer. Particular attention has been given to resources to help you engage with your state and local governments and elected officials. Our step-by-step instructions take the guesswork out of what can be a complicated system and helps you make a direct impact. Read on for information, guidance, best practices and tips to help you engage the media, hold fundraising events and even host movie screenings!

Support for the End-of-Life Options Movement

It’s important that your local officials, media and potential supporters understand that medical aid in dying commands long-term, bipartisan majority support among voters nationwide. In 2017, a Gallup poll put national support for medical aid in dying at 73%, which is consistent with other recent national and state results such as a 2016 LifeWay Research online survey that put medical aid in dying at 67% support.

Majority support for medical aid in dying has been broadly reliable across a range of questions and demographics. Among California voters, significant majorities support medical aid in dying in every subgroup, including 72% among Hispanics, 60% among African-Americans and 74% among Asian-Pacific Islanders. In 2015, a poll of voters across New York state found support for the option of medical aid in dying was 77% (and 75% among Catholics); when more details of pending legislation in the state were provided, support went up to 4 out of 5 voters wanting that legislation to succeed (including 81% of self-identified conservatives).

How to Talk About Medical Aid in Dying

This section contains some important facts and examples of how best to answer some common questions about medical aid in dying. Pay close attention to the language that is being used. Compassion & Choices has found over many years that the way you talk about medical aid in dying makes a big difference in how well the listener understands and reacts to the issue.

Majority of Doctors Support Medical Aid in Dying

Many leading national professional medical associations support medical aid in dying because it empowers physicians to respect their patients’ wishes. The American Public Health Association, the American College of Legal Medicine, the American Medical Women’s Association and the American Medical Student Association support open access to medical aid in dying. Also, a highly reliable Medscape poll of U.S. physicians in December 2016 found a majority (57%) of doctors now support medical aid in dying.

Significantly, after reviewing the California End of Life Option Act, the state’s medical association (the largest in the nation) decided to take a neutral position on medical aid-in-dying legislation. In a press release the California Medical Association said, “We believe it is up to the individual physician and their patient to decide voluntarily whether the End of Life Option Act is something in which they want to engage. Protecting that physician-patient relationship is essential.”

Medical Aid in Dying Is Not Suicide or Assisted Suicide

Factually and legally, medical aid in dying is not suicide or assisted suicide. It is critical to accurately describe medical aid in dying as one end-of-life option that dying people can access to end their suffering. People who use medical aid in dying are of sound mind and want to live, but a terminal disease is killing them; they use medical aid in dying to end an unbearable and inevitable dying process.

Many have publicly expressed that the term is hurtful and derogatory to them and their loved ones. Many medical groups agree and have adopted the more accurate and neutral term medical aid in dying.

State legislatures and courts in states where the practice is authorized recognize medical aid in dying as differing from suicide, assisted suicide or euthanasia. Euthanasia and assisted suicide are both illegal in jurisdictions where medical aid in dying is authorized. Medical aid-in-dying laws on the books in California, Colorado, the District of Columbia, Hawai‘i, Oregon, Vermont and Washington expressly state: “Actions taken in accordance with [the Act] shall not, for any purpose, constitute suicide, assisted suicide, mercy killing or homicide.”

Faith

The choice of whether to pursue medical aid in dying is an intensely personal decision, and one individual’s beliefs or faith should not limit another’s right to choose the end-of-life medical option best for them and their families. As such, no faith leader will ever be required to participate in the medical aid-in-dying process. A faith leader may be asked for spiritual or emotional support, but this medical practice involves a dying person and their healthcare providers only. Freedom of religion as it relates to medical aid in dying means that everyone should be allowed to make their own decisions about end-of-life care grounded in their own faith and beliefs.

Notable religious leaders have spoken out in favor of medical aid in dying. Their advocacy demonstrates that their support is rooted in their faith and not in spite of it.

Archbishop Desmond Tutu expounded, “I have been fortunate to spend my life working for dignity for the living. Now I wish to apply my mind to the issue of dignity for the dying. I revere the sanctity of life — but not at any cost … People should die a decent death. For me that means having had the conversations with those I have crossed with in life and being at peace.

It means being able to say goodbye to loved ones — if possible, at home.”

Similarly, retired Episcopal Bishop Gene Robinson reasoned, “There is nothing innately good about allowing ‘nature’ to take its course in a prolonged and painful journey to an inevitable death. It doesn’t make you a better person because you endured the indignity and trauma of it. You don’t get extra stars for it … Shouldn’t the right to end one’s life also be provided for those [terminally ill people] who would choose it?”

Many dying people who consider using the option say that praying about the decision brought them closer to God, just as conversations about the decision brought them together as a family, and they view that intimacy as a miracle in and of itself. Remember, an inclusive approach is always best. Our country is built on respect for religious diversity. You should never be dismissive of or combative with faith communities.

Protecting People Who Are Vulnerable

There is simply no evidence or data to support any claim that medical aid-in-dying laws are subject to abuse. A report published in the Journal of Medical Ethics about the Oregon Death With Dignity Act concluded: “Rates of assisted dying in Oregon showed no evidence of heightened risk for … the physically disabled or chronically ill.” In fact, there has not been a single documented case of abuse or misuse related to existing medical aid-in-dying laws, and no one has ever been charged with a crime.

Since the implementation of the law in 1997, the Oregon Health Authority has collected comprehensive data about the implementation of the Death With Dignity Act. Two decades of annual reports, as well as a host of medical articles and other resources, are posted online.

Gene Hughes, a disability rights advocate from New York, sums up his support of medical aid in dying thusly, “We cannot advocate for the rights of people living with disabilities to be able to make their own choices and healthcare decisions during life, only to deny those freedoms at the end of life. I believe much of the objection to medical aid in dying is driven by fear and misunderstanding. Dying is a part of living.”

Respecting the Wishes of Others

Medical aid-in-dying legislation is about bringing options to people at the end of life. Many people support medical aid in dying without knowing whether they would use it for themselves because they feel it is right to respect the wishes of others.

California Governor Jerry Brown, a Jesuit Catholic who in 2015 signed the state’s medical aid-in-dying bill into law, said in a memo, “I do not know what I would do if I were dying in prolonged and excruciating pain. I am certain, however, that it would be a comfort to be able to consider the options afforded by the bill. And I wouldn’t deny that right to others.”