Dan Diaz Advocate for End of Life Options

Husband to Brittany Maynard.

- Brittany suffered from aggressive brain cancer.
o At first, she was given an estimate of five years.
o She underwent an 8-hour surgery just to shrink the tumor and remove
her severe headaches.
o The brain cancer grew even more aggressive, leaving her with an
estimate of six months.
- However, she was not afraid of death but of suffering, especially since she
would die anyway.

Program for death with dignity

- In this program, simply being old/disabled is not a qualification; these people
can go on living albeit with an ailment.
- However, Brittany was told that she would die in six months, that it would be
very painful, and it was obvious that she had an aggressive brain tumor that
had no cure.
o She was told that she risked losing the ability to speak and read, the
ability to see, and the ability to control her mood.
- There are also many provisions in the program specifically designed to
protect the patient:
o The patient must be declared to be of sound mind.
o Two separate doctors (which the patient consults voluntarily) must
both agree.
o There are multiple break periods between stages of the process
(more time to think it through)
- After all these steps, the patient finally receives the pill.
- However, CA does not offer this option, so Brittany and Dan had to move from
California to Oregon in order to apply for medical options.
- In this respect, California is twenty years behind Oregon, which has had this
program for the past 20 years.

Whats in the prescription?

- The pill is a dose of sleeping medicine. (It existed before Ambien)
o Unlike the rumors, it is not a mythical black pill or a needle (thats
euthanasia, which is illegal)
- The biggest safeguard of all is that the patient must be able to consume the
pill herself.
- Within five minutes of taking the medicine, Brittany began to sleep.
- After 30 minutes she died gently.
Empowerment:
- Just by having the pill and knowing she could make that decision, Brittany felt
relieved.
- She was able to regain control over at least this aspect of her life.
- Much of the fear comes from so many things being out of the patients
control.
- The gentle death Brittany had was vastly different from the death she would
have had from cancer.
- I want to be done with cancer before cancer is done with me.

Jennifer Glass
- Jennifer was diagnosed with advanced lung cancer.
o By the time she was diagnosed, it had spread too far for surgery to be
an option.
o She was going through aggressive chemotherapy to extend her life,
which had hard side effects.
- Unlike Brittany, who moved to Oregon for the end of life program, the only
option available to Jennifer was terminal sedation.
- Terminal sedation entails inducing a coma and withholding food and water
from the patient until the patient wastes away from the effects of starvation,
dehydration, and progression of cancer.
o It is possible for the patient to come out of the sedation during the
process, which takes five days.
o For Jennifer, there were two instances in which she almost came out of
sedation, causing her extreme discomfort until she was sedated again.
- Terminal sedation is the only option available to terminally ill patients in all
fifty states.
- If Brittany and Jennifer both made the decision to die and chose to follow
through, why did Jennifer have to suffer five days?

End of Life Options Act

- Jennifer delivered a speech pushing for the passage of Californias End of Life
Options Act during its consideration.
o This was finally passed in 2015.
- A similar program was recently passed in Colorado, from a voter initiative
which was later supported by campaign funding.
- The program in DC faced repeal due to DCs unique legal status; its laws can
be revoked by Congress.
- In Oregons program, based on data collected over twenty years, the
percentage of patients out of all total patients who actually use medical aid in
dying is just 0.3%.
- Nearly 70% of all Americans agree that terminally ill patients should have
access to a medically aided death.
 - Since Brittanys death, 25 states have passed end of life options and
assistance for terminally ill patients.

Terminology
- It is important to note the difference between medically aided death and
euthanasia.
o Euthanasia involves a third party administering the lethal dose to the
patient.
o Since it is not done by the patient himself or herself, euthanasia is
illegal.
- There is also a difference between medically assisted death and
suicide/physician-assisted suicide.
o Suicide/physician-assisted suicide are simply not applicable terms.
o Suicidal people want to die. Brittany and Jennifer wanted to live.
Brittany received the pill in May. If she were suicidal, she would
have taken it immediately.
Brittany took the pill in November, when she could no longer
endure the suffering from the cancer.
o Suicide is more of a pejorative term, usually meant to instill fear.
- Medically aided death and end of life options result not in more people dying,
but fewer people suffering.