1) What are the costs of Medical Aid in Dying in Vermont?

There are several costs associated with pursuing Medical Aid in Dying in Vermont. The expenses listed below are separate from, and not included in, The Comfort Project's service fees.

Required, Fixed Costs:

• Prescription Medication: $700

• After-death arrangements: Cremation services average $1,325, plus an optional $250 for shipment of cremated remains. If you choose to have the body transported, costs depend on distance and weight. Copies of the death certificate sent by the funeral home typically cost $95.

Variable Costs:

• Medical Appointments: These appointments are often covered by insurance. If insurance does not cover the consultations, the cost for the three required appointments is $1,309 total.

• Travel & Accommodations: Depends on your travel distance, mode of transportation, number of people in your party, and the scheduling of your medical appointments.

The Comfort Project's Service Fees:

Our fees for non-medical coordination and support are separate from all the expenses listed above. Please visit the Costs section of our website for information about our services and fees.

2) Where does someone take the medication?

The Comfort Project strongly recommends a private home specifically designed and thoughtfully furnished for people pursuing Medical Aid in Dying with our support. Conveniently located near the physicians we work with, the home offers a peaceful, comfortable setting surrounded by natural beauty.

Features include an ADA-compliant access ramp, lovely views of nature, and beds that can accommodate taking the medication either indoors or outdoors. With six beds available, there is also room for family, friends, and caregivers to stay comfortably.

If you prefer another setting, The Comfort Project can help you identify other dependable locations where you may take the medication. These options are listed in our Client Portal, which you'll have access to once we begin working together.

3) What if my doctor does not support my desire to pursue Medical Aid in Dying?

If you receive a terminal diagnosis and wish to pursue Medical Aid in Dying, it is important to know whether or not your physician would support your choice. Read more information about how to talk with your doctor about this choice here, on the website of Patient Choices Vermont.

4) Does the medication ever not work?

The compounded formula has been carefully tested and refined over twenty years. It is the standard formula used by all states where Medical Aid in Dying is legal. The medication is effective when taken as directed. The Comfort Project team and your medical team will review in advance how to prepare and what to expect, so you feel confident and supported.

5) Why do I need to be enrolled in hospice both at home and in Vermont? 

Most doctors require patients to be enrolled in hospice in their home state. This ensures comfort, safety, and compassionate care before you go through the steps to come to Vermont. When you arrive in Vermont, your hospice care will be transferred to our local hospice. This coordination ensures continuity of medical and emotional support across locations.

6) What if I lose the ability to take the medication myself?

Vermont law requires that you be physically capable of self-administering the medication. If you lose that ability, you would no longer qualify for Medical Aid in Dying. We can help you explore timing and options in advance to honor your wishes within the legal guidelines.

7) Can I schedule the date and time I wish to take the medication?

Leading up to the day the medication is taken, many logistics require finalizing, for which we request two weeks advance notice. In that time:

• Our local hospice (Bayada) needs advance notice to plan staffing

• The compounding pharmacist must prepare the medication

• The Comfort Project must ensure two of our staff (“Wayfinders”) are available for the process

8) What if I don't want to take the medication right away after my final doctor appointment?

If there is a significant gap between your final doctor appointment and the date you wish to take the medication, your doctor may want to see you one more time for a brief follow-up visit to ensure you still meet all criteria for Medical Aid in Dying. This is something you will discuss with your prescribing doctor. If you receive “green lights” at all doctor visits, the decision if and when to take the medication ultimately rests with you. There is never any pressure to follow through with taking it.

9) Can I take the medication back home with me? 

Federal law prohibits transporting the medication for Medical Aid in Dying across state lines. The medication must remain in Vermont and can only be used in Vermont, in accordance with Vermont's Medical Aid in Dying law. All steps of the process must take place in Vermont.

10) What funeral arrangements are available?

Information on our Client Portal (which we make available to you when we are working together) covers different funeral arrangements, including transporting a body back to your home location, green burial in Vermont, or three types of cremation that are available in southern Vermont: flame cremation, water cremation and terramation.

11) Will my death certificate reflect that I used Medical Aid in Dying?

No. The death certificate lists the underlying terminal illness as the cause of death, without mention of the medication that was taken. This is consistent with Vermont's Act 39 and helps preserve privacy for you and your family.

12) How will I get the death certificate and from whom?

The Death Certificate is filed with the state of Vermont and Social Security is notified as part of the cremation fee. It takes 2-4 business days.  There is more information on the Client Portal, which we make available to you when we are working together.

13) What support is available to my survivors?

You can access bereavement support services by contacting your local hospice organization. The Comfort Project also provides resources on our Client Portal about online grief support groups for people living with loss related to Medical Aid in Dying. Again, the Client Portal is available to you when we are working together.