by Kris Shankar, Volunteer Storyteller
Below is a first-hand account of Anjanette G.’s experience helping her brother, Steve, find a provider.
My brother Steve was a triathlete and loved jazz music. At every opportunity, he would take his three dogs down to the Columbia River near his home in Vancouver, WA, for a swim. Growing up, Steve and I were there for each other through thick and thin.
Over this past Thanksgiving holiday, I went with Steve to see his oncologist in Portland, OR. We listened in silence as the doctor shared that Steve’s melanoma had metastasized. Without immunotherapy, my brother had less than six months to live.
We explored the full range of palliative care and end-of-life options. Given the poor prognosis for remission, Steve saw no point in proceeding with treatment. However, Steve was relieved to hear the doctor mention medical-aid-in-dying (MAiD). We were well aware of this option, and we wanted to be ready to avail ourselves of it when the time came.
Two months later, I received a text from my brother: “Help!” Steve had vomited blood, so I told him to call 911 while I drove down from Seattle to be with him.
At a hospital in Vancouver, an endoscopy revealed that the cancer had spread significantly, so Steve signed up for hospice care. I was concerned when I realized that the hospital and its employees were forbidden to talk about, let alone assist with, MAiD. I contacted Steve’s provider in Oregon only to be told that they could not “cross the river” from Oregon into Washington to assist us. So we had to figure out how to access MAiD on our own.
After Steve returned home, we contacted his primary care provider, a Physician’s Assistant (PA) at Vancouver Clinic, to see if they could help us with MAiD. We learned that PAs could not act as the consulting or the attending physician. We were referred to the doctor on the palliative care team. She was out of town, so we made a telehealth appointment for the following week.
In the interim, we contacted End of Life Washington. After a lengthy phone interview, we were referred to a doctor who agreed to act as our consulting physician. A Volunteer Client Advisor (VCA) at End of Life Washington outlined the MAiD process and legalities, including what would happen on the day of death, which he referred to as the hastening. We now waited for Steve’s telehealth appointment with one piece of the puzzle in place.
When we finally spoke with the doctor from Vancouver Clinic the following week, she inexplicably shared that she could no longer act as an attending physician in a MAiD case. She offered to refer us to another medical institution, but it would be a week before an initial appointment. The palliative care nurse at Vancouver Clinic had given us every indication that the doctor would work with us, and this was a last-minute surprise that we could have done without. I was livid.
We contacted End of Life Washington again and were connected to one of their volunteer doctors, who met us at Steve’s home a few days later. After interviewing and walking us through the process, he agreed to act as Steve’s attending physician. Our team was finally in place.
A week later, Steve called me into his bedroom. As I sat by his bedside, he said, “I am no longer living life.” By this time, he was mostly bedridden, unable to cope with the exhaustion and suffering wrought by the cancer. It broke my heart to see my brother in this state, given his love of life and being outdoors. I asked him if he wanted me to contact our team. He said yes, and we picked a date.
On the selected day, the team arrived at Steve’s home. They compassionately revisited all the options with Steve and then detailed exactly what was about to happen. Finally, at 11 am on Thursday, Feb 17, Steve made the most important decision of his life. Steve’s team stayed with us for several hours, finally confirming that Steve had passed on. The End of Life Washington VCA kept me company until the mortuary came to collect Steve’s body.
It’s deeply concerning to me that close to half of medical services in Washington can bar employees from supporting patients who want to access MAiD.
As a family, we were going through a very difficult time in our lives. Without the support and help of End of Life Washington, Steve and I would have struggled to take the necessary next steps. Words fail me in the attempt to adequately express my gratitude to End of Life Washington.
Note: As of late March 2022, Oregon will no longer enforce the residency requirement, which will allow access to medical aid-in-dying (MAiD) for qualifying non-Oregon residents. Because of this new lawsuit settlement, physicians can care for their non-resident patients, like Steve, who seek to access MAiD.