Studies show Americans overwhelmingly support legal aid-in-dying, yet end-of-life choice joins civil rights, racial justice, gay and lesbian rights, equality for women and reproductive choice as a controversial topic of our times. Well-financed sources of traditional authority limit legislators from supporting the freedom their constituents desire. Compassion & Choices reflects the majority viewpoint that the personal wishes and healthcare needs of the patient — not the religious or moral beliefs of the legislature or caregivers — should guide health-related decisions made between a doctor and patient. The only national organization committed to this issue, Compassion & Choices upholds the right of patients and their families to make end-of-life decisions according to their own moral and religious constructs. Compassion & Choices can build the movement that shifts the standard of medical practice and makes excellent palliative care and broad end-of-life choices the norm. The dream of a day when patient-centered care and choice is provided at the end of life drives the mission and vision of Compassion & Choices. Compassion & Choices promotes and enforces advance directives for health care, provides free end-of-life consultation, and presses for state-of-the-art pain and palliative care. We advocate for improved physician-patient communication and a full range of legal end-of-life choices, with careful safeguards, for those who are terminally ill. We work in the policy arena, in the courts, at state legislatures and at the grassroots level to build support for changes in end-of-life care. With more than 300,000 supporters, and a well-developed coalition of allied organizations, we speak with a singular, powerful voice for improving the quality of life during the dying process.

Compassion & Choices employs a multi-pronged approach to achieve victory and visibility in the courts, in the legislature, in the media and at the grassroots. Our strategies in each arena intertwine, allowing us to maximize our staff resources and [maintain consistent messaging/unify our messaging with supporters and in media outlets/across our campaigns]. We devote significant resources toward achieving victory in current cases and pursuing litigation that could have permanent effects without being subject to legislative or other prohibition. We have found through our work in a number of states that a carefully thought out litigation strategy can support or speed up efforts that are taking place in the legislature. Our legal and legislative teams coordinate and consult about every major decision, increasing the effectiveness of our campaigns in both arenas, while our media team has a rapid-response plan in place for every possible outcome. Last fall (2014), Compassion & Choices introduced the world to Brittany Maynard, a 29-year-old woman suffering from terminal brain cancer who made the decision to move from California to Oregon to take advantage of that state's death-with-dignity law. Working closely with Brittany, her family, and her husband, we produced a six-minute video that told Brittany's story in their own words. The stunning success of our media campaign with Brittany during the last months of her life and following her death in late 2014 led to increased public awareness and support of death with dignity, and inspired lawmakers to introduce death-with-dignity legislation in 25 states and Washington, D. C. We will continue to pursue our long-term strategy of making aid in dying legal in 20 jurisdictions by 2020 through dedicating significant resources to hiring on-the-ground community organizers in campaign states; developing digital marketing and fundraising strategies to reach more supporters and move them to action; recruiting world-class talent to advance our legal and legislative work; and building partnerships with influential healthcare organizations.

As the only national organization of its kind serving the advocacy and direct healthcare needs of the terminally ill, Compassion & Choices draws on the expertise of staff with a wide variety of legal, healthcare and communications backgrounds. We have over 90 staff in Washington, DC, Portland, Oregon, and Denver with extensive policy, legal and legislative experience. Through their advocacy, education, and outreach, our staff are national leaders in creatively and effectively promoting improved pain care for seriously ill and dying patients. Our state organizers are experienced campaign professionals who know how to build grassroots support to affect legislation. From New York and New Jersey to California and Colorado, Compassion & Choices has boots on the ground recruiting volunteers to testify, speak up at town halls and put a human face on legislation to show the positive impact expanding end-of-life care will have on families. Their efforts have helped Compassion & Choices build a network of over 400,000 supporters. Many of our End-of-Life Consultation staff have legal, medical, or life experiences that equip them to work comfortably with dying clients and their families and help them navigate the health care system; gain access to effective palliative and hospice care; complete advance medical directives; and stay in charge of their own dying. Compassion & Choices has earned its seat at the table with top policymakers and healthcare providers. We forge alliances and partnerships with influential medical organizations that lend us credibility and expertise, including the Leadership Council of Aging Organizations; the American Academy of Hospice and Palliative Medicine; and the American Public Health Association.

Compassion & Choices employs a system to track and manage accomplishments and better coordinate all activities. We also employ tools that measure advocacy effectiveness; the effectiveness of legislative battles and strategies; constituency- and ally-building work; and whether targets are met. We will use the above strategies to measure progress against our long-term objectives, which include: - Aid in dying is open, accessible and a legitimate medical practice in 10 jurisdictions. - End-of-life choice has a consumer movement identity, and C&C is the recognized movement leader, as measured by media recognition of a movement being underway. - The field of medicine recognizes intentional, medically managed death as an ethically defensible end-of-life choice, as reflected by: o The consensus of bioethics journals and curriculum. o The promotion and marketing of peaceful, family-centered dying (analogous to the emergence of birthing centers). - Passage of at least one federal law or major policy change ensuring full information and access to all end-of-life care options.

Compassion & Choices has spent decades laying the foundation for transformational change in the medical establishment around end-of-life care. Because of our efforts, the pace of change in the policy arena and in the courts has accelerated dramatically. In the past two years, we have achieved victory on many fronts, with astonishing speed. Below is a brief overview of our recent accomplishments: • Secured passage of the End of Life Option Act by the California legislature in October 2015, accomplishing in two years what we aimed to achieve in five. • Launched a national call to action on November 30, 2014, which would have been Brittany Maynard's 30th birthday. A terminally ill California woman who used her final months to speak out for end-of-life choice, Brittany drew national and even international attention to Compassion & Choices and this movement. Just months after our call-to-action campaign, bills to authorize aid in dying were introduced in 28 legislatures (including the Washington, DC, city council) in every region, with 217 elected officials sponsoring these bills. • In 2013, pushed for passage of the nation's first death-with-dignity bill approved by a state legislature in Vermont • Played a major role in the May 2014 dismissal of charges against Barbara Mancini, a Pennsylvania woman charged with assisted suicide in the death of her terminally ill 93-year-old father. Barbara Mancini now actively advocates for change, including giving legislative testimony. • Formed the Campaign to End Unwanted Medical Treatment in December 2013, formalizing years of C&C consumer advocacy. Tools include www. EndUMT. org, where supporters can learn more and take action. Policy papers and briefings routinely draw elite audiences of thought-leaders in policy circles. • Worked with the Washington, DC city council and the Hawai'i state legislature to successfully pass laws that authorize medical aid in dying in those jurisdictions. Compassion & Choices sets ambitious goals grounded in methodical strategic planning. We will not rest until all Americans have access to a variety of options for end-of-life care and planning, including aid in dying. The following is a sampling of short-term objectives we are working to achieve: • Amend and enforce the Federal Patient Self-Determination Act to increase provider accountability. • Encourage professional organizations to adopt policy supportive of aid in dying. • Model aid in dying practice for integration into medical care and education.