by Weilin Wang | Mar 12, 2025 | Care Registries
Read Part 1 of My End-of-Life Plan: Create a Comfortable Environment
Every great party needs a pregame. For me, vigil sitting would be the ultimate pregame, before the grand finale – my celebration of life (aka funeral)! It will be exclusive – invitations only, and only best behavior allowed. Joking aside, I view vigil sitting as a precious moment for my dearest family members and friends to gather, share laughter, reminisce about cherished memories, and support one another.
Vigil planning is a natural extension of Part I of my End-Of-Life plan, “Creating a Comfortable Environment”, ensuring continued comfort for the dying person. However, it occurs during the Active Dying phase, which requires some adjustments to the environment, care, and visitors.
Ensure Continued Comfort
From a Buddhist point of view, as one transitions from a physical existence to pure consciousness, all senses will first fade and then heighten, and our ability to tolerate stimuli is challenged. Therefore, I wish for the following:
- No unnecessary physical touch. Only medically necessary or care-related touches are permitted. Even with that, please keep it extremely brief and gentle. I love you all, but let’s not turn this into an unsolicited massage session.
- Quietness is of paramount. Ideally, there should be no talking in my room. If unavoidable, it should be kept to a whisper. The two exceptions are my recorded prayers (kept at a low volume) and the designated person reading Bardo Thodol for me during my last moments.
- Lighting should be minimal. Bedside lamps may be kept at a low level at night or on cloudy days. I might be transitioning, but that doesn’t mean I want to live in a coffin prematurely.
Pain Management
Unless I am in excruciating pain due to my illness, I would prefer low levels of pain medication to keep me comfortable yet conscious. I am not seeking suffering, but I want to maintain as much awareness as I can during this significant life transition. As someone who strongly subscribes to Buddhist beliefs, this is a rare and profound opportunity for me to glimpse into the true nature of my mind. Buddhism teaches that this moment holds the potential for enlightenment, a precious opportunity that exists for only an instant. If that were true, I don’t want to be sedated by morphine while this one-in-a-lifetime opportunity flashes by.
Spiritual and Buddhist Rituals
It is evident that I live by Buddhist principles. Hence, the vigil sitting rituals align with Buddhist beliefs. One book I hold sacred is Bardo Thodol, commonly known as The Tibetan Book of The Dead. It contains an elaborate set of prayers and sacred texts for various dying stages and the journey of the soul. It is my wish that someone read these prayers and sacred texts to me as I progress through the stages.
Final moments:
Bardo Thodol describes the stages of physical dissolution as follows:
- A feeling of sinking, where any movement becomes difficult.
- A feeling of dryness in the mouth.
- A drop in body temperature.
- Difficulty and irregularity in breathing.
As these signs progress, I wish for someone to gently whisper to my ear the six prayers and instructional text for the Death Bardo (documented in my private document to my family).
Final breath:
The 30 minutes after my final breath is the most precious time window in the dying process from a Buddhist point of view. I would like someone to continually whisper the sacred text of Death Bardo to my ear for an hour. If it’s too much burden for one person, I encourage a small rotation of 2-3 people to take turns reading.
Bardo Thodol instructions continue for 49 days after death. Since this document is focused on vigil sitting, I will save further rituals for the next installment “Post Death Care and Rituals”. If you wish to learn more about Bardo Thodol, I recommend the English translations by Chogyam Trungpa, Walter Evans-Wentz, and Robert Thurman (I read this version). For a more modern interpretation, which is also more practical, I also recommend Peaceful Death, Joyful Rebirth.
Ideally I hope my Buddhist teacher and friends will gather by my bedside during this sacred transition. I trust wholeheartedly that they would do the right thing by me. However, in the unforeseen event where they can’t be there, the above instructions can be executed by any member of my family or friends. Sincerity and loving compassion is key in reading these prayers and texts, and no prior experience is required.
Do not touch my feet:
OK, I know how this sounds. Especially as a Chinese person who really enjoys reflexology, it is inconceivable that I would have this demand. However, from a Buddhist point of view, it is believed that touching the body draws one’s consciousness to that area. If the consciousness exits through the lower half of the body, it may be drawn to lower, undesirable realms. Conversely, sitting near the head and shoulders and gently touching the crown can help guide the consciousness to exit through the top of the body, leading to higher, heavenly realms. So, please don’t touch my lower half of the body, please sit by my shoulder or head area, and place some sacred objects near the top of my head for good measure. Thank you!
Guest List and Visitor Rules
- Immediate family: My husband, sons, and grandchildren. My sons and grandchildren’s partners are to be determined.
- Buddhist community: My teacher and friends (a name list will be prepared when the time approaches).
Guests are welcome to congregate and interact in the living room, but the volume should be kept low. Inside my “goodbye” room, I prefer no more than two visitors at a time. They are welcome to simply sit with me, and silence is appreciated. Better yet, I would invite them to meditate while visiting me, and if they wish to communicate, they may do so through meditative prayers. Positive vibes only and funny stories welcome! For my Buddhist friends, I would hope that they perform Tonglen meditation on my behalf.
Refreshments
I know it will be hard, but I humbly ask that my dear loved ones maintain a vegetarian diet during this time and minimize alcohol consumption. If they must eat meat, please do so outside of the house and whisper “Om Mani Padme Hum” before consumption. This might sound trivial to non-Buddhists, but during this life transition, positive and negative acts profoundly impact the dying person’s perception, especially among those closely connected to them. So I am deeply grateful if all my dear loved ones can perform this one kind act for me.
Caregiver Rotation
I will strive to take as little time as possible to complete this life transition, as I’m curious to explore existence beyond this physical body. However, for countless reasons, if I take longer than expected, please arrange a rotation schedule in order to reduce the burden on any one particular person. One request, if possible, is that I always have one Buddhist friend available to read the Bardo Thodol to me. If that is not feasible, then please play the recorded prayer on low volume.
Conclusion
As I near the end of my journey, my deepest wish is for my final moments to be filled with love, presence, and the rituals that have guided me throughout life. Whether you are whispering sacred texts, sharing quiet companionship, or simply holding space, know that your kindness means everything to me. This plan reflects my values, my beliefs, and my personality—quirks included.
I hope that in witnessing my transition, you find comfort in knowing that death is not an end, but a transformation. And if you ever feel a soft breeze on a quiet evening, well… maybe I’m just saying hello. Or maybe it’s just the weather. You decide.
A Final Thought
I grappled with how openly to express my Buddhist beliefs in this plan, as I want to make my end-of-life plan widely applicable. Then it dawned on me that it wouldn’t be my plan without thoroughly incorporating rituals and beliefs that I have held near and dear to my heart. They have profoundly transformed my life positively. I encourage you to do the same in creating your own plan – honor the rituals and values that resonate most deeply with you so that your final wishes reflect the life you have lived and the legacy you wish to leave behind.
by Weilin Wang | Jan 21, 2025 | Care Registries
Nothing in life is certain except death and taxes, so goes the saying. We grumble through taxes year after year, because we don’t want to be on the naughty list of the IRS. Death and dying, on the other hand, has no agency of its own. Without its nudging, we find ourselves avoiding all contact at all costs. What if we flip the script? Instead of viewing end-of-life planning as a morbid task, we approach it as a way to honor our lives and beliefs, and to leave behind a legacy for our loved ones?
I have been passionate about conscious death and dying for many years (you can read about my origin story here). Through taking classes, learning from other end-of-life professionals, and volunteering with hospice, I have come to appreciate the complexity of end-of-life planning, even with training. So, I decided to create my own end-of-life plan for two purposes: one, I can finally get it done, and two, I can bring others along the journey to demystify end-of-life planning. By traveling together, I hope to show everyone that this process doesn’t have to be morbid. Instead, it can be an act of love and compassion for ourselves and our loved ones, and—dare I say—sprinkled with fun!
Due to the volume of topics and details involved, I will deliver my plan as a four-part series, covering practical, emotional, and spiritual aspects. In my first installment, I will discuss the creation of a comfortable environment for your final days. Then I will dive into vigil planning, after-death care, and the less-fun-but-really-critical documents that make sure our final wishes are honored.
Part I: Create a Comfortable Environment
Would you rather spend your life’s final chapter in a sterile hospital room or “the world’s most inviting blanket fort?” For me, it is that blanket fort, all day, every day! Even when we don’t get a choice on location, with enough creativity and planning, we can transform the blandest room into a cozy hangout.
Picking The Room
I don’t want my husband to think about my death every time he walks into our bedroom—he has good genes and will probably live to 120. So I have chosen the main floor guest bedroom as my “goodbye” room. It has good lighting from two windows that face the sidewalk, perfect for keeping tabs on the neighborhood buzz, and soaking in the joy of watching toddlers and puppies on their way to the nearby park and swimming pool.
Set Up The Scene
Don’t be shy with the details now! Be as specific as you can. Here’s what I want for myself:
Furniture arrangement: I want the bed to face the windows. I would also like the curtains to be open from sunrise to sundown, so I can maximize my “interactions” with the outside world. However, I would like the curtain to be lowered at sunset to avoid blinding glare—squinting while dying is very … undignified.
Seating for visitors: I’d like no more than two chairs by my bed for visitors. I prefer intimate chats over group conferences. If I’m that popular while dying, visitors are welcome to book appointments.
Modern Technology: I would like a 50”-55” TV to watch my curated shows and family photos/videos. I would also like a voice-controlled speaker, quality should be at least on par with a Sonos speaker, that will reliably play my curated playlist on command. Finally, I would like to have an intercom system so I don’t have to holler at my caregivers for some company.
Ambiance: I would also like some green plants and colorful flowers in my room. I don’t mind if they are fake, in fact I prefer them because they are low-maintenance and I feel no guilt towards dying flowers. Please litter the room with warm colored items – blankets, pillows, chairs, rug, flowers, lamps, curtains, etc. Give me my own Lothlórien (LotR), and I will call it Amberville.
Comfort: I would like the room to be a perpetual 74 degrees Fahrenheit as long as the solar panels don’t fail us. In terms of lighting, I prefer – you guessed it – warm lights, 3000-3700 Kelvin to be specific (because yes, I am picky). I prefer bedside lamps over chandeliers. So please use chandeliers sparingly and only when necessary. Let’s keep the drama low.
Scent: I would like the room to be lightly scented with Sandalwood, Myrrh, or Jasmine, ideally through incense, but organic air spray is acceptable.
Welcome Sign
I would like the following message to be posted on the door to my room. A little something to set the mood for the incoming conversation. I have little time left, so please make the chat enjoyable for me (you call it sassy; I call it spirited):
“Come to say hello, come to say goodbye, come to tell me about your life, come to crack some jokes, or come to simply sit with me. Whatever you do, please do not cry to my face; we have a powder room for that. Please treat me as the person you have always known. Know that I have lived a full life, so I’m ready, joyful and excited even for the journey beyond!”
Buddhist Rituals
I prefer not to label myself as a Spiritualist or Buddhist, because our essence transcends all of them. That said, I would like my room to be set up according to the Buddhist traditions:
Music: I will make two playlists on Spotify – “Funky Spiritual Music” for fun, and “Buddhist Mantras” for peace. In my earlier days of the active dying phase, I would play the “Buddhist Mantras” once in the morning, once at noon and once at night (right before bedtime), and play “Funky Spiritual Music” the rest of the day. In my last 3-5 days, I would only play the “Buddhist Mantras” continuously on low volume.
Buddhist Altar: I would like to set up a Buddhist Altar. On it, I would like to place statues or paintings of the Buddhas and Bodhisattvas that I have gathered, stupa, incense, scriptures (Buddhist books), flowers, fresh fruit and food (to be refreshed daily).
Prayers: understanding that I am (and likely will be) the only one practicing Buddhism in the family, I will record the prayers beforehand. When I can no longer perform the prayers myself or have become unconscious, I’d like the recorded prayers to be played on low and gentle volume continuously (all mantra music can stop now).
The Buddhist rituals will continue on after dying, but I will save that for a later installment.
Conclusion
The end-of-life plan is a living and breathing document (yes, I see the irony). As our life experiences evolve, so should our documents. To me, this is an act of love—for myself and my family. Not only does it fulfill my final wishes, but also it creates an opportunity for my loved ones to express their love and care.
As you create your own plan, be as specific and quirky as you want. At the very least, your loved ones might be momentarily relieved from intense grief as they hunt for the lamp with just the right Kelvins or embark on a shopping spree to create your Amberville. More importantly, knowing that they have brought me comfort, eased my suffering, and helped me transition with peace, it will hopefully bring the same qualities right back to their lives. I sincerely hope this plan serves as a solid foundation for my loved ones to accept, heal and grow. One day, I hope they will learn to embrace their own impermanence with grace and even a little excitement (I can dream).
I hope this first installment inspires you to begin your own journey towards a thoughtful, compassionate, loving and FUN end-of-life plan. For further resources, please visit Create a Comfortable Environment, and the End of Life Planning page to access a worksheet (click on the “End Of LIfe Checklist” button and download the “Create a Comfortable Environment” PDF). The worksheet is packed with ALL the details you will ever need. If you think I’m picky, just wait until you meet the worksheet. Until next time.
Read Part 2 of My End-of-Life Plan: Vigil Planning
by Weilin Wang | Jan 13, 2025 | Care Registries
My father is 75. Despite his decent genetics, growing up in 1950s China wasn’t exactly a health retreat. Famine, political movements, and poverty took their toll before he even turned 18. But to his credit, he spent the rest of his life trying to compensate—regular exercise, a balanced diet, and an unwaveringly positive attitude. I always thought he’d live well into his 80s or 90s, gracefully defying the odds.
That all changed this year. He fell three times due to sudden dizzy spells, fracturing his right wrist, his back, and then his left wrist. He was bedridden for months, needing frequent care. The kicker? He was in China, and I—his only child—was in the US with my own family. I couldn’t be there to help, and my dad, in his infinite wisdom, decided it was best to spare me the worry by keeping the situation a secret. (My parents divorced when I was 15, but somehow, they still teamed up on this one—teamwork makes the dream work, right?)
One day, though, it hit him. He realized he was staring at his own mortality and decided it was time to come clean. When he finally did, I booked my flight to China right away. It took two conversations before he could open up and share his final wishes. After a few long moments of silence, he just said it, no sugarcoating: “When I die, I want to be cremated. No one can take my ashes. No funeral, memorial, or burial. I lived, I died, and that’s that. I don’t have much to leave behind, but I know you don’t care about that. I don’t want you to have to travel back to China every year to tend to my grave. So, that’s what I want.”
Now, let me introduce myself a bit. I grew up in 1980s China, a time when life was improving, and I had a solid foundation of love from my parents. Death rituals felt normal in my childhood—nothing to fear, no mystery. The body of the deceased loved ones would be on display in narrow alleyways for family, friends, neighbors, and passersby to say goodbyes and pay respect. There were tears, sure, but also celebration—after all, life was meant to be lived fully. I grew up without any fear of death, at least the ones from natural causes, because it was simply part of life – we live, we die, and we live on in our loved ones’ memories.
As I grew older, I realized that not everyone shared this view. In fact, death and dying were often seen as taboo, wrapped in fear, anxiety, and even denial. As I embarked on my spiritual journey, I realized what a gift it was to be fearless and accepting of death and dying. So, I took death and dying classes, and eventually built a website, Care Registries, to help families with end-of-life planning and care because I wanted to show people that a “good death” was possible, one that’s as peaceful and meaningful as life itself.
Now, back to my dad. You’d think my parents would naturally share my views, right? After all, I’m their daughter. But, surprise! Death is a taboo topic in China too. Even saying the word “death” could invite misfortune—or worse, a curse to speed up someone’s departure. This fear of death only deepened as China modernized. Paradoxically, the spiritual wisdom of Taoism and Buddhism embraces death, but it never quite made it into mainstream thinking.
So, my dad’s final wishes took me by surprise. I wondered: Is he too accepting of death? Was he disillusioned with life? Did his final wish reflect bitterness, or disappointment in how things turned out? After a few moments of trying to find the right words, I said, “Dad, if you’re so open to discussing death, how about we work on a Legacy Project together?”
He looked at me, puzzled, and asked, “What’s a Legacy Project?”
I took a deep breath. “What means the world to me isn’t materialistic possessions, but the life experiences you have lived and are willing to share with me. When you told me about your childhood, I was too young to appreciate it. Also, there were always lessons in your stories so I didn’t really truly listen. Now I’m older and realize that is the biggest treasure you could have possibly left behind – for me, your grandsons and their children. I will respect all your final wishes, but I don’t want to lose your life experiences or your legacy.”
At that, both of us were fighting tears. My dad hesitated. “But I made a lot of mistakes in life…” I knew what he referred to. My parents’ divorce because of my dad’s infidelity, his prison sentence from bribery, and his attempts to get money out of me after prison – had all left scars. Yet, there was also so much more to him. His resilience, his generosity, his determination to survive through the Great Famine, and how he forgave and cared for his father.
My grandmother died at 36 during the great famine in China, and my grandfather became absent because of his deep grief. My dad, 10 years of age, left to fend for his own survival and his little brother’s. He would wake up early and hungry to wait for coal trucks, then carry two buckets of coal across mountain peaks, just to earn a few coins to feed himself and his little brother. When coal trucks became rare, he begged, borrowed, and stole food. Many kids his age died during that time, but through his hard work, resilience, and resourcefulness, he and his brother survived. Despite my grandfather’s absence, my father never faltered on his responsibility as a son. He treated my grandfather with respect, invited him to live with us, and took care of him till his last days. His actions reflected the importance of funeral planning not just in the ceremonial sense, but in how we care for one another while we’re alive.
My father lived a complicated life, through which I realized that we all have dualities – kindness and mistakes, strength and vulnerability, light and darkness. When there was duality inside of each of us, there would be duality in life. What was important was the learning and the growth from those life experiences. Like a rainbow, life is a spectrum of colors. We label them good and bad, and we have preferences of one over the other. However, when colors are missing, we would have no rainbow. Life too comprises many “good” and “bad” experiences, but without the “bad”, the “good” wouldn’t shine as brightly.
I responded to my father “When I was young, I saw things in black and white, and I blamed you for breaking up the family. I was ashamed of your prison sentence. I was furious when I found out you tried to steal from me. Now that I’m older, I have learned to accept you as a whole person – flaws and merits. We are all imperfect, so why judge each other? All I want is to preserve all your life experiences – ‘good’ and ‘bad’ – so your grandsons and their kids will get to know you as a real person, not a perfect, fictional character.”
We cried together, not in sadness, but in joy and release of pent up emotions. Our relationship, once marked by ups and downs, was now built on a foundation of mutual understanding, respect, and forgiveness. It wasn’t an easy journey, but we had grown together, creating a beautiful rainbow of our shared experiences.
We agreed to add Legacy Project as part of his final wishes – an embrace of life’s impermanence, while preserving the richness of his life story. In my 45 years, I had never felt closer to my father. And I’m pretty sure he’d say the same.
Dear readers, I encourage you to have an open conversation about end-of-life planning, final wishes, and legacy projects with your loved ones. Yes, it may be difficult, but it can also bring clarity and peace. Most importantly, this co-creation will bring you closer together.
Don’t wait for the “right” moment—take the first step now. Sit down with your aging parents, listen to their stories, and share your own. Together, you can honor their wishes and preserve their legacy for future generations.
For resources and tools to guide these conversations, visit Care Registries. Start today and make a lasting impact.
by Weilin Wang | Dec 18, 2024 | Care Registries
Ryan was 17 when he was diagnosed with cancer.
It would have been devastating to anyone at any age, let alone a senior in high school, full of hopes and dreams for the future. The days following the news, Ryan and his parents waited for biopsy results in agony. Then one night, Ryan woke up in cold sweat, yet felt an overwhelming sense of calmness. An inner voice whispered – “Life is fleeting and precious. There is no point in wasting time by worrying about something you have no control over.” For Ryan, this inner voice was God reminding him to live life to the fullest.
Ryan recognized that little voice – it was the same one that told him to get a second opinion when his first doctor dismissed his symptoms. Ryan had learned to trust that little voice; it saved his life once already. Suddenly, as if a huge weight fell off his shoulders, he felt free for the first time since hearing the devastating news.
In the days that followed, Ryan transformed. He became carefree, present and joyful. It was as if he were living his best life! Ryan’s parents believed that he was in denial, because what else could it be? How could anyone behave so calmly and joyfully when faced with the possibility of death? Yet, they accepted Ryan’s new approach to life, recognizing this was better than succumbing to despair.
Finally the results came back: it was a benign tumor, and because they caught it early (thank you, little inner voice), Ryan made a full recovery following a timely surgery.
Let me briefly share how Ryan and I met. Earlier this year, after being laid off from my job, Ryan was assigned to me as my outplacement coach. While discussing my career change to pursue my passion for conscious death and dying, Ryan shared his near-death experience with me. I was blown away by his story, and felt compelled to share it with others, hoping the wisdom of his experience might inspire others as it inspired me.
Today Ryan is a husband and father of two lovely children. When asked about the life lessons from his near death experience, he shared the following insights with me.
Open To Your Intuition
Modern science often emphasizes the idea that “what we can’t prove doesn’t exist”. Yet many of us have had our “sixth sense” moments to question that. Ryan’s inner voices saved his life twice – first by prompting him to get a second opinion, and then helping him find emotional peace in such adversity. His story reminded us to honor our intuition as a powerful guide.
Living Authentically and Pursue Your Dreams
Buddhism talks about Discerning Wisdom, a mental clarity that allows us to distinguish between:
- The truth of life versus the conventional appearances of the world.
- Making ethical decisions that leads to one’s liberation from suffering.
- Seeing through the delusions created by our mind.
In a way, Ryan embodied this principle – live authentically vs. subscribing to social expectations.
Quoting Ryan, “Life is fleeting, you have no time to waste on playing games”. He focused on what gave his life meaning – family, relationships, dreams and passions. Travel had been a passion of his since he was a child, so in the past 20+ years Ryan had visited almost all of the 50 states of the US, exploring the various subcultures within the country, weaving these experiences into the fabric of his life.
When we live authentically, we no longer burden ourselves with others’ opinions of us. Instead we beat our own drums, live our personal truths, even if it goes against the societal tide.
Read about Life Review and Legacy Project
There Is Sacredness Behind Every Adversity
Years ago, I read A New Earth by the spiritual teacher Eckhart Tolle, who shared with the world his teachings on mindfulness, acceptance and transcending the egoic mind. I found one of his many insightful teachings really resonated with Ryan’s experience: “There is sacredness behind every adversity”.
Ryan brought up another perspective from Steve Colbert’s 2015 interview with GQ, where Steve reflected upon his loss of his father and two brothers at the age of 10:
“It’s a gift to exist, and with existence comes suffering. There’s no escaping that. I guess I’m either a Catholic or a Buddhist when I say those things because I’ve heard those from both traditions. But I didn’t learn it that way. I learned it by experiencing loss. That loss is a gift. My mother knew that was true. She had to know it, or she could not live. So, she experienced an almost stoic acceptance of her suffering, and I think I got that from her.”
Ryan saw the same truth from his own near death experience. His acceptance of potential death, his insights and subsequent decisions to pursue his passion, and his determination to live authentically. He is a living testament to the sacredness hidden within our most challenging moments.
Acceptance of Death And Dying
When we accept death, we accept life holistically. I believe that the fear of death is the root of many phobias, irrational fears and moral diseases. When we muster the courage to accept that one day we all will die, we can then face it head on, research the topic, gather resources and plan a good death. With death being a faithful and compelling reminder of the preciousness of life, how else would we live our life other than fully?
Having come close to death’s door, Ryan has fully embraced life’s impermanence and feels grateful for every moment he has. His experience also influenced his family to be open to the topics of death and dying, which is a gift of its own.
Read about Death Philosophies and Spiritual Beliefs
Conclusion
I hope you find Ryan’s story as inspiring as I do. At 17, Ryan faced what many would consider a crushing death sentence, yet he miraculously found peace by accepting life’s impermanence. He embraced every moment and found sacredness even in adversity. While some fear death even after a long and full life, Ryan used his experience as a reminder to live in the NOW.
May his story inspire you to listen to your intuition, live authentically, and find the sacredness in every challenge.
by Weilin Wang | Dec 11, 2024 | Care Registries
Imagine facing terminal cancer and being forced to live through unbearable pain every day. But instead of praying for your suffering to end soon, you can reclaim your final days – deciding when and how to die with dignity and peace, and to spare your family from unnecessary emotional pain as well.
For Dr. Barbara Morris, this was not a philosophical debate but a basic human right that she made her life’s mission to fight for. Her journey from a geriatrician to a whistleblower, and ultimately to becoming a strong voice advocating for Medical Aid In Dying (MAID) was nothing short of legendary. She faced heartbreak, personal risks and institutional barriers, in pursuit of a powerful question: How can we ensure that everyone has the right to a compassionate and dignified end of life?
Dr. Barbara Morris, Neil Mahoney, and Centura Health
Dr. Barbara Morris was a Colorado based physician specializing in geriatrics. In 2019, her patient, Neil Mahoney, was diagnosed with terminal gastrointestinal cancer, and suffering unbearable pain. He sought Dr. Morris’s assistance in assessing MAID, which was passed as Colorado’s End of Life Options Act (EOLA) in 2016, allowing terminally ill patients to seek MAID. For Neil, choosing MAID was not about giving up, but about taking control. He wanted agency over his own life, and to decide for himself when and how to live his final days with dignity, while sparing his family from unnecessary suffering. The problem was, Dr. Morris’s employer, Centura, a faith-based healthcare system, prohibited her from discussing MAID with Neil.
When faced with an impossible choice between following institutional rules or supporting her patient in his end of life choices, Dr. Morris’s decision was clear – she needed to honor Neil’s final wishes, because it was the right thing to do both as a doctor and as a fellow human. She filed a lawsuit against Centura, seeking clarity on whether a healthcare system had the authority to restrict a physician’s ability to participate in MAID. Five days later, she was fired, abruptly ending her professional relationships with Neil and hundreds of other patients.
Though Dr. Morris could no longer serve as Neil’s attending physician, she kept in contact with him and his families until the end. Ultimately, Neil was able to fulfill his final wishes and access MAID despite the obstacles. Neil’s journey had inspired Dr. Morris and set an example for others who face similar barriers in the future. While the legal case was long and stressful, Dr. Morris thought it was worth it in a way. It really shed some light on the potential conflicts between healthcare institutions and the rights of patients and healthcare providers. Though it would still be a long road ahead, this legal battle had set a foundation for future progress with persistent effort on Dr. Morris’s part.
Founding End of Life Options Colorado
Inspired by Neil’s courage and determination, Dr. Morris and a group of pioneers channeled their passion for end-of-life choice into advocacy and education. They founded End of Life Options Colorado, a nonprofit organization dedicated to increasing awareness and understanding of the ELOA among patients, families, and healthcare providers. The nonprofit’s mission is simple yet significant: to ensure everyone facing a terminal illness has access to accurate information, compassionate care and agency over their final days.
Mentoring Healthcare Colleagues
Dr. Morris quickly observed that the barrier to offering MAID was both practical and emotional for many healthcare providers. MAID was a time consuming process that involved lengthy evaluations, conversations and ongoing emotional resilience. Physicians already faced immense time pressures and were challenged in dedicating the necessary attention to MAID. To support that, Dr. Morris began coaching and mentoring clinicians on their first MAID cases. She found these interactions deeply rewarding, as she observed her colleagues gain confidence and clarity while ensuring patients receive compassionate care.
Over the years, Dr. Morris witnessed a cultural shift among healthcare providers toward MAID. What began as a taboo practice, shrouded in secrecy, had grown into a more accepted and transparent part of end-of-life care. Providers who once hesitated to associate with MAID were now listing their services publicly, thanks in part to Dr. Morris’s tireless advocacy.
ELOA Evolution and Further Improvement
The ELOA has evolved since its passage. Recently, Colorado Governor Jared Polis has signed amendments to shorten the waiting period from 14 to 7 days, and to allow advanced practice nurses with prescriptive authority to serve as attending or consulting clinicians. To outsiders these changes might seem minor, but to patients with rapidly progressing illnesses who do not have the luxury of time, this could make a life changing impact.
Looking into the future, Dr. Morris identifies further areas for improvements.
Allow non-resident patients access MAID in Colorado. To date, there are only 11 states that allow MAID, leaving the majority of the terminally ill patients without access to MAID. For these individuals, relocation to one of the eleven states (state residency is a prerequisite to access MAID in most of the 11 states) is rarely feasible, considering their health conditions and the seismic effort to uproot their entire lives and families. Dr. Morris has been advocating for removing the residency requirement in Colorado, emphasizing that compassionate and accessible end-of-life choices is a basic human right.
Combat systematic inequalities of MAID access. Another maybe not-so-surprising observation was that MAID participants skewed towards highly educated middle-to-upper class individuals. This was because this demographic group likely had better access to information about MAID, in-person medical consultation from their physicians, and more financial resources to take actions. It is important to call out the financial disparity, because Medicare and Medicaid do not cover MAID-related services due to federal restrictions. To make matters worse, the cost of medications has risen rapidly, causing MAID to be even more difficult to access. With this inequality top of mind, Dr. Morris and her nonprofit team have been working tirelessly to reach underserved communities, provide education to raise awareness, and explore ways to provide financial assistance. They are doing everything within their power to promote equal access regardless of socioeconomic status.
Navigating Ethical Concerns
As with any progress throughout history, there were always controversies and debates, and MAID is no different. In one such debate, the disability rights advocates were concerned that MAID could devalue the lives of people with disabilities. While their fears are understandable, Dr. Morris highlighted robust safeguards built into ELOA, which were designed to protect vulnerable populations. She also shared her personal experiences – both hers and her colleagues, where she had observed all such cases being handled with the utmost care, respect and integrity.
A Mission of Compassion
Reflecting upon her journey, Dr. Morris found her transformation to a non-profit leader unexpected yet fulfilling. She has embraced her role as an educator and advocate for end of life choices, and views it as her way to honor Neil and other patients’ courage. Looking into the future, Dr. Morris envisions a society where MAID is normalized, widely accepted, and seamlessly integrated into our healthcare system. Dr. Morris’s journey is a true embodiment of honoring the end of life care with compassion, and the fight for everyone’s right to die with dignity and grace.
Resources
Visit please https://endoflifeoptionscolorado.org/ to further explore Dr. Morris and her organization’s amazing contribution.
Visit Care Registries to further understand MAID (and VSED).
