Patient to End-Of-Life Doula or Bedside Attendant Intake Form
Submitted by Death Dying and... on Mar 15, 2025 - 12:27pm CDT
Over the many years that the Academy for Medical Aid in Dying and its clinicians have been providing aid-in-dying care, we have found that having an experienced attendant at the bedside, in the days before and during the aid-in-dying procedure, is crucial.
Patients who have a knowledgeable attendant, such as a nurse, doctor, doula, or volunteer, have more peaceful deaths, and their loved ones have less complicated grief. The preparations and procedures for aid in dying can be complex and more easily managed by a knowledgeable clinician than a stressed-out but well-intentioned loved one. Well-supported loved ones who don’t have to manage medications or make clinical decisions can focus more on each other during these tender moments.
If you are planning an oral self-administration, and your hospice staff or other providers cannot attend to your aid-in-dying day, or if you feel you need further bedside support, please fill out this form for a referral to an Academy-trained doula or verified bedside attendant.
If you need a referral to an attending/prescriber, please click here
About the organization: The American Clinicians Academy on Medical Aid in Dying grew from the remarkably successful 2020 National Clinicians Conference on Medical Aid in Dying at UC Berkeley, and the 2023 National Clinicians Conference on Medical Aid in Dying, in Portland, Oregon. The Academy extends the work of these conferences, informing and educating clinicians about medical aid in dying, from clinical discussions to evidence-based knowledge, from nursing care to the work of volunteers at the bedside, from medical ethics to pharmacology, and more.
Unlike many medical academies, the American Clinicians Academy on Medical Aid in Dying does not have specially-privileged members. We advocate open and accessible information, so all clinicians and interested parties are welcome to every aspect of the Academy’s work.
Keywords: Death, Dying, Euthenasia, Planning for Death, End of Life Doula, Grief Support
Start the Conversation
Every registered user can comment on website content.
Please login or register to comment