In 1993, at the peak of the AIDS epidemic, a small group of dedicated individuals who had seen too many violent, lonely, and agonized deaths vowed to make a difference. Staying within the law, they provided information and emotional support to mentally competent, terminally-ill individuals who sought a peaceful, humane death. We distinguish ourselves from other “right-to-die” advocacy groups by providing counseling, and by working with the healthcare community for changes in medical care for the terminally ill. Yet, unlike every other mainstream organization, we insist that meaningful reform must include legalization of assisted dying and increased pain management.

EDUCATION:
Compassion and Choices urges vigorous communication about end-of-life choices and care. We provide information, consultation, and emotional support to individuals for all end-of-life choices. We counsel patients and their families about how to obtain effective pain and symptom management and hospice care. 

As appropriate, we also talk about legal, effective methods for assisted dying. We bring all options to the discussion, including methods of administering high-dose pain medication, withdrawing medical treatment, stopping eating and drinking, and inducing total sedation. We facilitate discussions between patients and their doctors about how patients might choose their time and manner of death. We help doctors talk with one another about ethical, effective means to help their patients achieve a peaceful death.

Compassion and Choices’ educational efforts are firmly rooted in hope and choice. Knowledge about the option of aid-in-dying often allows terminally-ill individuals to find peace of mind and end their anxieties about the circumstances of their deaths. Clients can turn their attention to their last few days with family and resolve any final concerns. In most cases, death overtakes our clients before they ever feel the need to exercise an aid-in-dying option. All requests for information, and the identities of patients, loved ones, and healthcare providers, are held in the strictest confidence.

ADVOCACY:
Many patients with terminal illnesses, including cancer, suffer needlessly because they do not receive medications that could relieve their pain. Sometimes an unfounded concern about addiction prevents patients from asking for stronger medication. Yet there is widespread agreement among experts that fear of addiction should play no role in treating the pain of the terminally ill. The correct amount of medication is whatever is required for relief. Some physicians, in addition, fear they could lose their licenses if the Drug Enforcement Agency becomes aware that they prescribe large amounts of pain medications.

In 2001, Compassion and Choices successfully argued, under elder abuse statutes, a case involving an elderly California man who had suffered needlessly from under-treated pain during his dying days. As a direct result of that groundbreaking case, the California Legislature passed a law requiring physicians to complete twelve hours of continuing education in pain management and end-of-life choices in order to maintain their California license to practice medicine.

Compassion and Choices is also closely involved in the legislation to support assisted dying. In 2005, the national organization was involved in the Supreme Court decision, Oregon vs. Gonzales, upholding Oregon’s Death with Dignity Act. In 2006, we advocated in support of AB 651, California’s Compassionate Choices Act.  We are currently involved in advocating for AB 374, California's new Compassionate Choices Act.

SERVICES:
Compassion and Choices staff and volunteers:
• Provide support and consultation about end-of-life options to patients and their families.
• See clients through the journey, helping them access the best care and gentlest death possible.
• Advocate for improved end-of-life care.
• Advocate for legalization of assisted dying.


Read "Conversations 101: How to Talk With Patients Who Are Facing Death,"
by Fran Johns

Read "Helping My Mother Die with Dignity and Compassion,"
by Stewart Florsheim