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The Best Sort of Goodbyes

Many people concern themselves with the here and now, but Law Professor Valerie Vollmar has devoted her professional life to helping people deal with the future. For more than a decade, she has crusaded for the rights of terminally ill patients to decide when and how they will die.

Oregon's Death with Dignity Act was the first legislation in the United States to give terminally ill patients - rather than medical professionals - the ultimate right to make their own end-of-life decisions. Vollmar's user-friendly website about physician-assisted death has been significant in furthering national and international discussion about the issue, providing information about legislative and medical developments. The site has received heavy traffic from doctors, lawyers and patients, and Vollmar has been interviewed on TV and radio broadcasts and quoted in newspapers across the country.

Many terminally ill patients prefer to die at home, Vollmar says. They want to be surrounded by loved ones and avoid the numbing pain that often accompanies terminal illness, and they don't want to leave their families with crushing medical bills in order to prolong an existence of questionable quality. In short, they want to choose the moment for goodbyes and to be fully conscious -- rather than adrift in a morphine haze -- so they can share the process with those they love.

Oregon's law allows doctors to prescribe -- but not administer -- the medication that will end life. "That action is left to the patient," Vollmar says. "If you know something about the dying process, you know that pain management is not always possible. We have more people living longer, and living with chronic pain, and our medical system is overly technological. Many patients don't want every single measure to be taken. This legislation gives patients more choice.

"It's been interesting to see who chooses to use the Death with Dignity Act," the law professor says. "In most cases, the patients are older, highly educated people who are used to being in control of their lives. Many obtain prescriptions without ever using them. They just want that backup in case they decide they're ready to die."

Vollmar's website data shows that the Oregon law has been implemented with proper safeguards, and well received. Surveys show that the public, here and abroad, supports death with dignity measures by 60 to 80 percent or higher.

Many states are looking at the issue now, Vollmar says, and several countries have adopted physician-assisted death laws, but Oregon was the first U.S. state to push the idea forward. The state is now a leader in end-of-life care, with hospitals like Oregon Health and Science University allowing terminally ill patients to designate only comfort care rather than extreme and costly measures. "Oregon has always been a pioneer in grassroots efforts," she says. "We're good at coming up with original ideas.

"For me, there's satisfaction in seeing society evolve to the point where we are addressing end-of-life issues," says Vollmar, who has been active on other fronts as well.

In 1984, in what was almost an act of revolution, Vollmar drafted new will and trust forms using readable language, so people can actually understand the legal documents they sign. Numerous Oregon lawyers use the forms, which she continues to update. She also took on an ambitious revision of the state's trust laws that led to the 2005 adoption of the Oregon Uniform Trust Code by a near-unanimous vote of the legislature ("I decided no one but an academic was going to have the time or inclination to tackle it!"), and she co-authored a book that provides law students with a plain-speaking introduction to trusts and estates.

"This is not just a scholarly occupation, but also a personal one," Vollmar says. "I care about people who are going through the final stages of their lives."

She cares about her students too. Sitting in her fourth-floor office overlooking the maples along Winter Street, she says, "This is the perfect job for me. It's incredibly rewarding to mentor professionals in training. I've never taught in an abstract or theoretical way. I feel strongly that I need to equip students with the kind of expertise they'll really need to help their clients."

Good to know, since there are at least 3,000 lawyers, at last count, who have been introduced to trusts and estates by Professor Vollmar. We're in good hands.