Abstract
Death with Dignity, i.e. Medical Aid in Dying, in the U.S. is defined as a death when
someone takes medications prescribed by a physician in compliance with State Law. The
terminal patients decide the day and the time when they will take the lethal medications. In
these cases, it is important to provide support for these patients. Since the Death with Dignity
Act is enforced only in some U.S. states and is dependent on State Law, the support system is
also different in each state.
This paper explores the structures and conditions of these support systems and how
they engage with terminal patients through a comparative investigation of the local support
organizations in Oregon, Washington and Vermont.
Firstly, the commonality of the above three states was that the “minimizing” of national
support organizations brought difficulties for local support organizations. Without financial
support from national organizations, local support organizations had to become financially
independent and needed to raise funds. Thus, they felt that if they engaged in activities to
educate people about the philosophy of Death with Dignity, this would get more supporters
involved and will bring not only more donations but also stable management of the local
support organizations, thereby creating a “Positive Cycle.”
Secondly, the difference among these three states was the organizational type of the local
support organizations. Specifically, Oregon has a satellite network that is divided into four
areas, while Washington has a centralized organization structure that covers the whole area,
and Vermont has a centralized network that covers the whole area. These kinds of
differences affected the ways in which they perceived the challenges brought by the
minimizing of national support organizations, and how they coped with them.
