As we enter 2025, several people have asked how the new administration and its policies might affect FEN and its services. Will we have to make any changes to our current services? Will we eliminate some states that we currently serve, like West Virginia which just passed a constitutional amendment to ensure they will not have medical aid in dying laws?

First, we will not panic. We will continue to provide our services in all states. The need for our services will not change because a new administration is in charge. In fact, the need may be more important with the possibility of cuts in social services like Medicare and Medicaid. Our population is ageing, and the price of care is rising. One out of three people over 85 has some level of dementia and the cost of memory care can be more than $10,000 per month, which few Americans can afford. And it is important to remember that the work of caregiving falls disproportionately on women. More importantly, for individuals who do not want to live in a demented condition, it is galling to think of the inheritance they had hoped to leave their family drained by for-profit facilities that keep them alive against their wishes. People need reasonable, affordable, and comfortable choices for how they want to manage their end days.

Second, I want to remind everyone that what FEN does is legal, safe, and peaceful. It is legal for a person to hasten their death and for their family to know they are going to do it. It is not legal to provide the means or physical assistance, neither of which FEN guides do. Our guides are trained to follow the policies and procedures outlined in the guide program handbook, which is reviewed annually by the Board. We provide information that allows people a choice in how and when they die. West Virginians can deny themselves the right to medical aid in dying—though why they would deny themselves a basic civil liberty is a mystery to us—but the First Amendment to the US Constitution protects Final Exit Network’s right to speak and educate our clients and the public.

We will continue to be diligent and thorough in our application and guide processes. We will make sure that clients know their safe and legal options, including medical aid in dying laws, going to Switzerland, and voluntarily stopping eating and drinking. We will make sure that clients are having those difficult conversations with their close loved ones. And we will continue to value both personal autonomy and the social fabric of relationships, while protecting our organization for the long term.

Finally, we will spend more time on podcasts, at conferences, and in association meetings educating people on the legality and importance of choice in dying. People should understand their options, regardless of what they finally choose to do. Most people today will let nature—or, more accurately, the medical system—take its course, and die in a hospital or in their residence with hospice care. But some of us will choose to die on our own terms. Final Exit Network will be there for those people who make that choice and qualify for our services.