Part One: Dying with dignity

When it comes to end-of-life care, is there a right answer?

Living in a state with the oldest population in the nation, many Mainers and their families are currently, or soon will be, looking at their options.

A controversial topic and one that narrowly failed in the latest legislative session is physician-assisted death.

Mary Rustin says a lot of things make her lucky, including her home, her family, her love of singing, and her work as a hospice volunteer, which she's been doing for the last ten years.

"We will sing songs while we're there. We might be there one hour. We might be there three. I sat with one of my patients for almost two weeks just saying the Rosary for her every day because she was failing and that was all she wanted."

Hospice and palliative care generally comes highly suggested by medical professionals.

Dr. James VanKirk says hospice is when the patient is no longer pursuing aggressive treatments and regimens.

"The focus of their care is simply to control quality of life. Maintain things for as good as possible for as long as possible."

Palliative care is when they work with patients who have terminal diagnoses who may or may not still be pursuing aggressive treatment.

"A lot of our work in palliative care is working with people to help them tolerate their chemotherapy better, to get through radiation."

Another highly controversial option is physician-assisted death, or dying with dignity, where a terminally-ill patient would make a request through their doctor for a prescription that would end their life.

"Death with dignity for individuals who are competent, they are in charge with their mental facilities."

Dr. Geoffrey Gratwick is a rheumatologist and a lawmaker.

"I believe very strongly about this. I was a proponent of the two bills that came forward in the session and my perspective is both based on my personal work as a physician and I will simply say that I've seen, and 40 years as a doctor I've seen three instances where patients really wanted this,” says Gratwick.

Dr. VanKirk says he understands why someone looking at a painful death would want to seek out the physician-assisted option, but he doesn't think the state is ready until everyone has access to every option.

"I won't argue with that person. What I will argue with is that if that person still has their spouse, and is living north of Jackman, and now has cancer and can't get pain meds and can't have visiting nurses or hospice and can't make the trip to the physician's office in Augusta, really the only option we are going to give that person is really whether you want it or not. You can either be miserable where you are, or you can take this prescription. The other thing we've seen is patients graduate with what we think is a condition that's going to end their life and days two weeks and for amazing reasons things stabilize,” says VanKirk.

Like his miracle-patient, Mary, who went into hospice after suffering a major tear in an aortic valve.

"And, they say 'you have three months to live.' And I just looked at them and I said, 'guess what? You're not in charge. God is in charge. And, I'm going by him.' The doctor said to me, 'well I think that's called faith.'

That was almost nine years ago. Mary just celebrated her 88th birthday and says after 18 months in hospice, she was able to see things from the receiving end.

"I am blessed and I'm so lucky to be able to do this. God is in charge and when he's ready, I'm ready."