JUANA SUMMERS, HOST:
Vermont is one of nearly a dozen states with medical aid in dying. That means doctors can prescribe lethal medication to terminally ill patients who want to hasten their deaths. For the first decade the law was on the books, only residents of Vermont could use it. Then, last year, lawmakers opened the program to people from out of state. As Vermont Public's Mikaela Lefrak reports, the changes brought an influx of interest to the small state.
SUMMERS: Vermont is one of nearly a dozen states with medical aid in dying. That means doctors can prescribe lethal medication to terminally ill patients who want to hasten their deaths. For the first decade the law was on the books, only residents of Vermont could use it. Then, last year, lawmakers opened the program to people from out of state. As Vermont Public's Mikaela Lefrak reports, the changes brought an influx of interest to the small state.
MIKAELA LEFRAK, BYLINE: Ever since Vermont removed its residency requirement for medical aid in dying, Diana Barnard hasn't been able to keep up with the phone calls from would-be patients. She's a palliative care physician in the town of Middlebury.
DIANA BARNARD: Yeah, it can be hard. I have, like, three calls sitting on my phone right now, but building capacity is important.
LEFRAK: Patients have to be in Vermont for two required appointments and to take the medication. Barnard hopes more local doctors will join her in helping them.
BARNARD: Mentoring them through learning how to do it so that they can feel comfortable doing it on their own.
LEFRAK: Barnard was able to take on Rita Mannebach of Florida. Barnard confirmed her patient had terminal lung disease and prescribed the drugs. During a recent phone call from a rented house in Burlington, Mannebach described her plans for her last day alive.
RITA MANNEBACH: On Thursday morning we'll have a little program at 10 o'clock that we just put together ourself. There'll be a symbolic ceremony of letting go, me letting go of them, them letting go of me, and then I'll just have some last words that I say. May you be peaceful, may you be happy. That's the kind of thing.
LEFRAK: She had no doubts about what she wanted to come next.
MANNEBACH: It's all about quality of life for me. It results in less suffering.
LEFRAK: Only Oregon and Vermont allow nonresidents to use medical aid in dying. When Vermont opened up the program last year, it changed a lot for prescribing doctors and hospice workers. Every new patient requires significant paperwork, multiple medical consultations and emotional support.
TIM SCHAFER: The floodgates opened, and suddenly we were receiving these calls.
LEFRAK: Dr. Tim Schafer is a family physician in southern Vermont.
SCHAFER: It has profoundly changed my life, our clinic function. We just had a lot to learn about how to pull this off logistically.
LEFRAK: Schafer feels a deep calling to help his patients who are suffering. He feels privileged to be a prescribing doctor. He's had to come to terms with not being able to help everyone.
SCHAFER: And we finally agreed we have to limit new consults to one per week.
LEFRAK: To help with logistics, Schafer and other doctors rely on a new network of volunteers called Wayfinders. It's made up of retired hospice nurses, social workers and death doulas. They support families and patients navigating medical aid in dying. Suzanne Baxtresser is a Wayfinder in southern Vermont. For her, the biggest challenge is finding housing where patients and their families can stay.
SUZANNE BAXTRESSER: We want people to take the medicine in a safe place. We want people to know that nobody's going to come knocking on the door saying, what's happening?
LEFRAK: Vermont faces a severe housing shortage. It's also a popular tourist destination, which makes short-term rentals even harder to come by than doctors.
BAXTRESSER: We have had some Airbnb owners who have been supportive, and they've offered their places. But then when summer comes, everything gets rented.
LEFRAK: One family with an unused property has essentially donated it to the cause, and a local nonprofit, Patient Choices Vermont, is trying to figure out a longer-term housing solution. With the help of Wayfinders, Rita Mannebach was able to find a place to stay for the weeks before her death. Her years volunteering as a hospice worker herself helped her feel ready for what was to come.
MANNEBACH: I'm 84, and I'm very - I'm at peace with the whole thing. I mean, to me, what happens after is totally unknown. I don't know what's going to happen, but I don't have any fear. So I feel perfectly at ease about the whole thing.
LEFRAK: Two days after our interview, she followed her plan. Rita Mannebach of Florida died in Vermont. After she passed, her family made plans for her ashes to be shipped back to Florida. Then, they tidied up the rental, drove to the airport and went home. For NPR News in Burlington, I'm Mikaela Lefrak.
(SOUNDBITE OF KACEY MUSGRAVES SONG, "SLOW BURN") Transcript provided by NPR, Copyright NPR.
NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.