The Spirit of Dirigo: Celebrating One Year of Implementation in Maine

Republished from Death with Dignity National Center.

One year ago, on September 19, 2019, the Maine Death with Dignity Act went into effect and implementation of the law began. Many years of grassroots organizing and legislative partnerships paved the way for passage of the law. But the success of implementation thus far has been made possible by the willingness of patients and healthcare providers to navigate a new process. 

“They took the bull by the horns,” said Val Lovelace, chair of Maine Death with Dignity, who led the on-the-ground campaign to pass Maine’s law and now supports Death with Dignity’s implementation efforts in her state. Their approach embodies the spirit of Maine’s fierce independence and openness to blazing new trails. 

“This isn’t going against the grain; it’s pioneering a whole new grain,” Val added.

How Implementation Works

Maine’s largest healthcare network, MaineHealth with Midcoast-Parkview, announced support for patient decisions on day one, implementing internal policies in January 2020. Since then, two other provider networks have implemented similar policies, smoothing the way for physicians wanting to support their patients who qualify.

If needed, patients and providers contact Maine Death with Dignity for information. “We provide clarity on the process and how the law works, and do our best to answer complex questions as they arise,” Val explained.

“We also encourage patients to have open, honest dialogue with their providers to determine whether there is support for their decisions, and to ask for a referral to a supporting physician if there is not.”

Two patients are known to have died using the medication, and a number of others qualified for prescriptions. 

Implementation’s Impact

The true impact of the Maine Death with Dignity Act is best understood through personal stories.

One of the law’s legislative champions, Representative Michele Meyer of Eliot, Maine, serves on the state legislature’s Joint Committee on Health and Human Services, which held hearings on the Maine Death with Dignity Act. She also is a registered nurse by profession and has worked with many dying patients. Representative Meyer knows too well the pain and loss of control experienced by those with few legal options to ease suffering at the end of life. 

“Born of Love and Compassion”

The most courageous people I have known are those battling terminal illness,” Rep. Meyer shared with us. “I have been deeply moved by the calls and letters I have received from many in the last year. While the circumstances differ in specifics, each has described the simple knowledge of autonomy now available at the end of life as relieving the anguish of the unknown and bringing peace of mind and empowerment to these Mainers who feel little of either.   

The option for a serene, dignified death was legislation born of love and compassion – and I am proud to have worked for its passage.  

— Maine State Representative Michele Meyer (D-Eliot, Kittery, and South Berwick District #2)

“It’s a blessing”

The Reverend Marvin Ellison, PhD, a Presbyterian minister and former Willard S. Bass professor of Christian ethics at the Bangor Theological Seminary in Portland, Maine, said his Christian beliefs inform his support for Maine’s law.

As a Christian theologian, I can state unequivocally that Maine’s Death with Dignity law is a blessing.

— Reverend Marvin Ellison, PhD

 

It’s a blessing to those at the end of life who are ready to die, but for a variety of reasons are not able to die,” Marvin shared with us. “It’s a blessing to their family and friends, who pray that their loved one will not be forced, against their will, to experience a meaningless and protracted death but rather will have the means, when and if they so wish, to exit more gracefully.

“It takes spiritual maturity to discern when death is no longer the enemy to resist, but rather has become the friend to welcome,” he added. “I thank God for the gift of our moral freedom to make these very tender, very principled decisions for ourselves.  We honor God and each other when we adopt a “hands on” rather than “hands off” response to dying, especially when we act with care, compassion, and respect for one another at our ending no less than at our beginning.” 

“If There Was a Good Way to Go, This Was It”

Ronald Deprez, a 75-year-old Maine resident living with a degenerative illness, was one of the first individuals to use Maine’s law. The Portland Press-Herald penned a moving story about Deprez and his decision alongside an eloquent tribute to him on the paper’s obituaries page written by his daughter, Esmé.

“It was peaceful. He wasn’t in any pain,” said Esmé of her father’s death. “If there was a good way to go, this was it.”

“Making Peace with Life Through Death”

In July, we published online a three-part series featuring an essay by Karen Wentworth, a Maine resident with terminal cancer who plans to use the Maine Death with Dignity Act to die on her own terms. 

“As I approach my final days, I am making peace with life,” Karen wrote.  “I want to live, but am content to die. Terminal cancer has determined my fate, but I still can control how I choose to leave this Earth. The Maine Death with Dignity Act makes this possible.”

Sharing—and—celebrating—Karen’s story is a fitting way to commemorate the first year of implementing Maine’s law. 

As with many others who have chosen to access medical aid in dying in states with such laws, Karen’s decision to do so was driven by her desire for autonomy and peace at the end of life. Having this option allows Karen, in her words, to “pass in the warm comfort of compassion with peace and love in my heart.”

 

The Spirit of Dirigo

Maine’s state motto, “Dirigo,” translates as “I lead.” In the years-long campaign to pass the Maine Death with Dignity Act, citizens of all stripes across the state stepped up to lead grassroots efforts to build support in their cities and towns. In the first phase of implementation, patients and providers are leading by example, working together to ensure patient access. And Maine’s adoption of the law has established the Pine Tree State as a leader in the Northeast’s death with dignity movement. 

“I don’t have the words to easily describe what it feels like to be a part of something so good,” Val said. “This truly is a blessing born of compassion, and it is already bringing such deep meaning and relief for people in my state. I’m so grateful. It just doesn’t get better than this.”