210 Essentials in Hospice and Palliative Care: A Practical Resource for Every Nurse Developing Awareness of the Advance Care Planning Process Nurses who develop their understanding of the ACP process will be better prepared to help others. Experiencing the process is one way to develop understanding. Use this exercise as a starting point. Reflective Activity 1. Reflect on what is important to you as a per- son today, tomorrow, in a year, in 10 years. What gives your life meaning? What gives you joy, strength, and support? 2. Talk with a friend or colleague and share your thoughts on what is important to you now and in the future. 3. Record on paper what values or ideas you want your SDM to consider if you were to be- come unable to speak for yourself. 4. Who would you like to ask to be your SDM? Understanding Physician Assisted Dying and Medical Assistance in Dying Requesting and receiving medical assistance in dying/ physician assisted dying (see definitions in the next sec- tion) raise complex issues for the dying person, the family, and HCPs, and for hospice and palliative care commun- ities. (For the purpose of this text, unless otherwise indi- cated the term “assisted dying” encompasses both med- ical assistance in dying and physician assisted dying.) This section of the book is not intended to be a discussion of whether assisted dying should be legalized. Laws in Can- ada and in certain jurisdictions in the United States have clearly established that assisted dying is a health care ser- vice that is or will be available to certain people at the end of life—people who meet specific criteria and who want to choose their time of death. The focus of this sec- tion is first to clarify terminology and identify hospice and palliative care principles that pertain to assisted dying, and second to provide stimulation that encourages you to consider your beliefs and identify challenges you may face when engaging with the dying person, the family, and your colleagues when assisted dying is being contem- plated or pursued as an end-of-life care practice. It is timely and appropriate to address assisted dying in this text because integrating a palliative approach includes relieving suffering, responding to difficult questions, and helping people explore care options. HCPs can apply their skills learned when responding to other difficult end-of-​ life questions to respond to requests for information about assisted dying. Nurses, as a community and as individuals, need to learn to engage in reflection, dialogue, and ex- ploration to support the dying person and family in their process of considering assisted dying. Terms Relating to Assisted Dying In Canada and in the United States, laws are evolving in response to the requested death movement, a global so- cial movement that is “concerned with the ultimate con- trol of one’s body at life’s end” (McInerney, 2000). This movement seeks to empower people to choose the timing and manner of their own death. Terms relating to assisted dying vary by location and legislation, causing confusion for the dying person and the family, as well as for nurses and other members of the health care team. In the United States, the term “physician assisted dying” refers to the legal practice of deliberately ending a dying person’s life at their request; in Canada, the parallel term is “medical assistance in dying.” As mentioned above, in this text the term “assisted dying” encompasses both medical assistance in dying and physician assisted dying. Physician Assisted Dying In the United States, “physician assisted dying” means: A physician provides, at the patient’s request, a lethal dose of medication that the patient can take by his own hand to end … intolerable suffering. (AAHPM, 2016) In cases of physician assisted dying, the physician pro- vides the prescription and the dying person receives it and self-administers the medication when and where and if