Translator: Ellen Maloney Reviewer: Denise RQ Thank you very much. As a nurse, and a physician assistant, and as an attorney, I work to expand choice and improve care at the end of life. In 1994, I was one of the authors of the Oregon Death With Dignity Act, and I have championed that ever since. Well, my life's work changed last year when a young woman named Brittany Maynard joined our movement. In theological terms, I would call Brittany Maynard a 'prophetic witness'. That's a person with vision, and deeply held values and beliefs, who speaks about justice and mercy. Brittany did that. Brittany put in place a chain of events that led to passage of a Death With Dignity bill in the California legislature, less than one year after she died. We had been trying to do that since 1991. But in September of 2012, Brittany's life was in full bloom. That's when she married Dan Diaz, they moved to a new home, and they started talking about a family. But she started having headaches, and the headaches got worse. During a holiday trip to the wine country, she had rapidly escalating pain, she had a crisis. She went to the doctor, and she learned, on New Year's Day, 2014, that she had a brain tumor. The doctors told her that she might live as long as 10 years. She opted for aggressive treatment, and she hoped that her surgery would add years to her life. This is Brittany's pre-operative MRI. You can see the tumor extending it's tentacles into healthy tissue. Well, in a cruel, cruel stroke, the tumor actually got more aggressive after her surgery. 70 days after surgery, doctors told her that they were upgrading her tumor to a grade 4 glioblastoma; the deadliest form of brain cancer. Brittany was terminally ill. Her tumor was so large, her doctors told her they were amazed that she was able to walk and talk. What happened to Brittany happens to thousands of people everyday. She learned she had cancer, and she learned it would kill her. And like those thousands, she felt shock, and denial, and grief. And she focused all of her attention on addressing the disease, on curing her disease. But she was different from the thousands in her reaction when her cancer did not respond to treatment, and it continued to grow aggressively in spite of everything medicine could do. Brittany was brave enough to ask her doctors to tell her the truth. She wanted to know what this tumor would do to her before it killed her. She learned about seizures, escalating headaches, loss of vision and speech, and movement, and consciousness itself, perhaps for days or weeks, before she died. Brittany vowed that the tumor was not going to do that to her. So she moved her family to Oregon, where aid-in-dying is an authorized medical practice. She went through the process of becoming eligible to receive life-ending medication. Once she had the means for a peaceful death in hand, she decided to be an advocate. She contacted my organization Compassion & Choices and asked us to help her raise her voice. We planned a campaign together, and this is the video clip that we posted on People.com, first thing in the morning, October 6th, 2014. (video) Brittany: I don't wake up everyday and look at it. It's in a safe spot, and I know that it's there when I need it. I plan to be surrounded by my immediate family, which is my husband and my mother and my step-father, and my best friend who is also a physician, and probably not much more people. And I will die upstairs in my bedroom that I share with my husband. With my mother and my husband by my side. Pass peacefully with some music that I like in the background. Dan: Between suffering or being allowed to decide when enough is enough, it just, to me, makes-- provides a lot of relief and comfort [to know] that, OK, that option is there, if and when we decide or she decides it's time. Brittany: I can't even tell you the amount of relief it provides me to know that I don't have to die the way that it's been described to me that my brain tumor would take me on its own. Dan: "Death With Dignity" allows people who are in the predicament of facing a lot of suffering, that they can decide when enough is enough. Brittany: Since becoming ill, I have traveled and continued. My husband and I took a beautiful trip to Yellowstone. It was exquisite, and then I went with my best friend to Alaska. We went to Denali National Park, and we went to Seward, and Kenai Fjords, and kayaked up to the glaciers, and then I met my mother in Juneau, and we took this spectacular boat trip. Before I pass, I am hoping to make it to the Grand Canyon because I've never been. That's all I can do, is set little goals like that, and all those things make every day worthwhile. Mother: My hope right now is that my daughter can live her life the way she wants to, that she can make the decisions that she wants to, that she can be who she is, which is this very autonomous, bright, well-read, well-traveled person, who loves adventure. Brittany: I hope to enjoy however many days I have left on this beautiful Earth, and spend as much of it outside as I can, surrounded by those I love. I hope to pass in peace. The reason to consider life, and what's of value, is to make sure you're not missing out. Seize the day; what's important to you, what do you care about, what matters? Pursue that, forget the rest. Barbara Coombs Lee: Brittany wanted to impact the world, and indeed, she did. By that afternoon, that video had been watched by 16 million people. We reached 54 million people on Facebook. By the time she died, one month later, 100 million people worldwide knew who she was and knew her cause. She wanted to impact public policy, and she was successful. Over 200 legislatures from 25 states introduced Brittany's Death With Dignity bills in their states. Now, compare that with 2014 when there were four states in play. Four days before Brittany died, she talked with Governor Jerry Brown and asked him to support aid-in-dying so people in California who are dying wouldn't have to move to Oregon in order to achieve the peace of mind she did. I told Brittany that after she was gone we would carry on her vision, we would be her good and faithful servants. Why was she so effective? Brittany provided that aha-moment when people recognize an injustice that too many people suffer needlessly in their death, people accept tests and treatments that increase their agony, and do nothing to prolong their life. People suffer with breathlessness and pain that is unbearable. Or they are medicated into a stupor or delirium, and can be that way for days or weeks. People wouldn't choose this if they knew about their treatment and their illness. People would make the same choices doctors make for themselves; comfort care only, when death is inevitable. If people had the truth in their treatment, they would make better choices. Brittany galvanized a movement that is much better than aid-in-dying. This is a consumer movement to transform the way Americans approach the end of life. Aid-in-dying is key to this movement simply because it demonstrates and establishes who is in charge; whose values and priorities really matter. Only one person's values and priorities really matter at the end of life; the person who is dying. But that's not what happens. Right now, a medical industrial imperative takes over and overwhelms the person's decision-making duties. Right now, the priorities of intensive medicine escalate, and people die in places and in ways they would not choose, if they knew what was happening. Brittany energized a campaign for aid-in-dying, and aid-in-dying is the energy behind a campaign to transfer authority and power from providers to patients, so people can make decisions that are right for them. Because what do people want at the end of life? They want the things Brittany wanted, three things; they want to live well as long as possible; Brittany didn't stop living because she knew she was dying. She made a lovely home in Portland, she walked in the woods nearby, she continued to travel to nature's splendors. She did visit the Grand Canyon. Second, people want to show love. Brittany said, "The thoughts that go through your mind when you know you have so little time left are the things you need to say to the people you love." And third, people want to be true to themselves. For Brittany, that meant not allowing her tumor to deprive her of every function of her mind and her body before she died. So when her seizures escalated, and when one left her unable to speak Dan's name, her husband's name, she decided it was time to take her medication, while she could still do it herself, as the law requires in Oregon. When Brittany died, other voices continued her campaign. This is Jennifer Glass, she was 49 years old with lung cancer when she told the Senate, "I am doing everything possible to extend my life. No one should have the right to prolong my death". This is Christy O'Donnell. Christy fought on two fronts; she testified and lobbied for legislature, and she is also asking the courts to give her doctors permission to write her a prescription for life-ending medication that she can take if the law is not in time for her. Well, if you ever doubted that one person can change the world, Brittany should disavow you of that belief. Brittany lived her values, she spoke her truth, and she gave us the hope that when death comes, it can come gently. For you, and me, and the millions of people who will inevitably follow her, So, may it be so. (Applause)