(Jay Niver is a retired journalist who works with the FEN team that produces this blog. His work with the right-to-die movement stems from his father’s own planned exit, told in an award-winning documentary film: Live and Let Go – An American Death.)
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The US right-to-die landscape shifted dramatically in summer of 2023. That’s when two states, Vermont and Oregon, removed their residency requirements to provide medical aid in dying (MAiD) to qualifying persons. It didn’t matter if they lived there or not.
Pundits speculated about two possible outcomes. One was that other states where MAiD is legal would follow suit and drop their own residency mandates.
That hasn’t happened.
The other thought was that Vermont and Oregon would be awash in “suicide tourism,” with hundreds of dying visitors using the states as a “death destination.”
That hasn’t happened either.
In the first year after non-residents were eligible, Oregon enabled 23 visitors to die peacefully with dignity – fewer than 7% of those who used MAiD. In Vermont, the number was about 26 – roughly 25% of those who used the law to exit on their own terms.
Desperate, suffering people are not flocking to those states. There are many reasons why. But, regardless of the hurdles, traveling hundreds of miles within the US would seem like a more practical, feasible solution than flying to Switzerland and taking loved ones to be at your side.
At least here, in Burlington or Portland, putting family up in a Days Inn is far less burdensome. Data and research consistently show that most people want to die at home with those they love, and letting that happen closer to home is better for folks who aren’t wealthy enough to jet to Europe. Making it even easier now is a small but growing number of end-of-life hosts who open their doors to those who go to Vermont and Oregon to die.
Trail Angels
Those who trek the Pacific Crest Trail, Mexico to Canada, have “Trail Angels” help them along the way. Now there are end-of-life (EOL) Trail Angels in New England and the Northwest, helping people on a life-ending journey perhaps as challenging as a 2,600-mile backpack.
Debby Waldman and the Washington Post reported on them last year. A variety of property owners with varied accommodations – from extra rooms or suites to apartments and second homes – share at least one thing in common: They support the right-to-die cause. And the thought of someone near death having to say goodbye in a motel room offends them.
Walderman spoke with Wayfinders Network, a group of independent EOL doulas, hospice nurses, and case managers who work with Patient Choices Vermont (PCV), which helped get the state’s assisted-dying law enacted. Wayfinders reaches out to healthcare providers to let them “know we exist,” network member Kasey March told Walderman.
Patients ending their lives prefer comfort and privacy, according to March: “You want somewhere that no one is going to knock on your door and ask what’s going on …”
Mobility issues are a factor for many terminally ill patients, so accessibility is a concern for those who accommodate them. Being close to urban areas also makes it easier on their failing-health clients.
Reporter Walderman talked to EOL lodging providers and a family who used a Vermont site for the father’s assisted death. In each case, the hosts and client requested privacy – no last names.
While all are committed to death with dignity, there’s no reason to shout it publicly. That’s a job for advocacy groups like PCV and other state RTD organizations.
Though the number MAiD states continue to grow, it is still an uphill slog for those who wish to plan their exit.
Seeking aid in Vermont or Oregon isn’t as easy as just showing up. All the usual US safeguards are required, including having a six-month-terminal illness diagnosed, being mentally competent, meeting a waiting period – and being able to ingest life-ending drugs without assistance.
Non-residents must find an in-state physician to approve them, and they must “exit” in the state where they’ve been okayed. Finding a doctor is sometimes hard enough for locals who want routine healthcare, let alone for an outsider who wants to die as they’ve arranged it.
It can be hard to sell a house where someone has died. So, it’s not hard to imagine the difficulty of renting a VRBO or Airbnb if applicants know it’s where some people exit. It’s problematic to call an agent and say, “I need a place for Mom to die.”
Fortunately, for non-resident MAiD patients who need a welcoming, comfortable, private setting in Vermont or Oregon, some angels are providing such a place to say their final goodbye.
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Final Exit Network (FEN) is a network of dedicated professionals and caring, trained volunteers who support mentally competent adults as they navigate their end-of-life journey. Established in 2004, FEN seeks to educate qualified individuals in practical, peaceful ways to end their lives, offer a compassionate bedside presence and defend a person’s right to choose. For more information, go to www.finalexitnetwork.org.
Payments and donations are tax deductible to the full extent allowed by law. Final Exit Network is a 501(c)3 nonprofit organization.
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Thank you, Jay.
A nice reminder that “regular” people are out there helping others who are suffering at the end of life.
Thank you, Jay, for this enlightening article. I watched Live and Let Go – An American Death and thought it was excellent and touching. To those who welcome individuals and families seeking MAID far from home: thank you.