"One of the major reasons for bankruptcy is medical bills and one thing you don't want to do is tell people facing the end of their life, 'could you hurry it up because the meter is running,'" Powell said. "The financial element to this is huge and you have to make sure you aren't substituting this for appropriate care."
A much bigger concern for most people, according to the data from Oregon and Washington, is losing their autonomy and dignity and ability to engage in activities they enjoy. Coleman said that wanting to die for those reasons is offensive to the disabled, many of who live for years without being able to walk, bathe or go to the bathroom on their own.
The National Hospice and Palliative Care Organization, an Alexandria, Va.-based group for hospices and their employees, said it opposes expanding the states where physicians-assisted dying is legal. The organization said many of the issues that cause people to want to end their lives, like concerns over pain or being a burden to their families, can be addressed by hospice care and counseling. They would like efforts to be focused on getting more terminally ill patients enrolled in hospice sooner and educating doctors about better pain management.
Burzichelli, who was the founder and executive director of the Center for Effective School Practices at Rutgers University before her illness required her to step down, worries hospice care may not always be enough, and she's determined to prevent herself and others from facing a situation like her father's. Her lung cancer, which is in the advanced stages, has been stable and she recently had one of her kidneys removed to try to stop the cancer's spread. She says she's trying to focus on life and the living. Still, Burzichelli would like the comfort of knowing she has options, including ending her life on her own terms.
"It is helpful to have a process where people are allowed to talk about that with their physicians, if what they are looking at is too bleak to deal with on their own," she said in a telephone interview. "It would make a lot of people's lives more peaceful."