As a hospice and palliative medicine physician, I agree there are not nearly enough resources available to prioritize the needs of terminally ill patients. We can and should do much better. Unfortunately, even with the most skilled interdisciplinary team and endless resources, the multi-dimensional suffering experienced by patients in the final weeks and days of life cannot always be managed adequately. Despite the best palliative and hospice care, some patients continue to suffer. I practice in Vermont where medical aid in dying has been legal for more than 10 years. Vermont Department of Health reports reveal that our law is working as intended without a single instance of abuse. Our law offers immense peace of mind to those managing end-of-life suffering.

For those small number of patients whose suffering is unmanageable, medical aid in dying can offer the option of a peaceful death, when death is certain to happen. Most importantly, the patient maintains control throughout the process, pausing or stopping it at any time. There are several layers of best practice in place for managing the safety, storage and disposal of medications in the home of those who are dying. In Vermont, when the pharmacist delivers the aid-in-dying medications, they also deliver a pouch to destroy and send back any unused medication. A well-informed patient and an attentive medical team help to minimize any risks and to support the patient and family through the deeply personal process of dying with the freedom and control that many of us want and deserve.

Diana Barnard

Middlebury, VT