‘Death with dignity’ bill faces key votes, unclear future

A bill that would allow terminally ill patients to take their own lives with lethal doses of prescription drugs sailed smoothly through the liberal-leaning Senate Health and Welfare Committee last Friday, with a unanimous 5-0 vote.

But the legislation — deemed “Death with Dignity” by proponents and “Physician Assisted Suicide” by opponents — is about to hit a steep uphill climb.

Sen. Richard Sears, D-Bennington. VTD/Josh Larkin

Sen. Richard Sears, D-Bennington. VTD/Josh Larkin

On Tuesday, Health and Welfare passed the bill, S.77, over to the Senate Judiciary Committee, where its chair, Sen. Dick Sears, D-Bennington, is a longtime opponent and prepared to vote the bill down.

“I am opposed to the bill — firmly opposed,” Sears said before the Senate Democrats caucused for an hour on how to handle the bill. At the caucus, Sears told his fellow Dems that his committee was poised to vote down the bill 2-3.

Even if this happens, however, Sen. President Pro Tempore John Campbell, D-Windsor, said the bill would still get a fair hearing on the floor, which is an exception from how bills usually proceed when they are voted down in a committee.

Campbell, who also opposes the measure, told VTDigger he hopes Senate Judiciary will vote on the bill by Friday, and he wants the entire Senate to vote on the legislation next week.

House Speaker Shap Smith, D-Morrisville, who supports the bill, said that if the bill dies in Senate, the House would not propose additional legislation.

Senate Judiciary will hear additional testimony on the bill this week, after Health and Welfare heard four days of testimony last week, and both committees held a joint public hearing that drew more than 200 concerned citizens last Tuesday.

The issue has consistently divided Vermonters of all political stripes and proved a topic that stirs strong emotions and convictions on both sides. This year’s legislation is almost identical to a bill proposed last year by a tri-partisan group of senators.

The most prominent change is a shift in palliative care requirements. Under the previous legislation, a participating physician would have needed to refer the terminally ill patient for palliative care consultation. Now, the physician would only need to inform the patient of options for palliative care, which is the providing of holistic care for patients with advanced progressive illness, from pain management to psychological, social and spiritual support and the best quality of life for patients and their families.

A key concern Sears and Campbell have about the legislation is that it allows physicians to report the underlying cause of a patient’s death as the patient’s illness, not the prescription drug overdose that actually kills them.

“One of my major objections is asking doctors to lie,” said Sears. “In the bill, you say the doctor may … call the cause of death as the underlying disease. That is calling the cause of death cancer, for example, when the cause of death is the overdose of a pill.”

Sears also argued that the Vermont Medical Society’s lack of support for the bill is a problem.

Justin Campfield, spokesman for the Vermont Medical Society, said the bill would take attention away from more urgent health care issues.

“We don’t think there should be any legislation one way or another dealing with physician-assisted suicide,” he said. “We feel this is an issue better left to patients and physicians and using the resources currently available,” Campfield said.

“I share the concern of the docs who are going to be complicit in this,” Sears said. “I share the concern of the disability community that this will force people [towards physician-assisted death]. The proponents of the bill I don’t think hold water in terms of the impact this might have on teen suicide, the impact on palliative care, the impact it might have on folks with disabilities.”

Campbell said that although he has religious issues with the bill, he is able to put his personal views aside. His major qualm with the bill, he said, is on a policy level.

“The basic issue, I think, is that the state is getting itself into the doctor-patient relationship, and I find that not only unfortunate but the wrong thing to do,” he said.

 

Follow Andrew on Twitter @andrewcstein

Comments

  1. rosemarie jackowski :

    I don’t always agree with Sen Sears, but I do this time, and I thank him for his well-thought out position.

    I oppose the Bill because it will do exactly what it is designed NOT to do. It will eliminate choice for the most vulnerable.

    Please see
    http://mwcnews.net/focus/analysis/24542-debating-suicide.html

  2. Brian Harwood :

    Eventually the legislature will come its senses and understand that this issue is about quality of life. We are more thoughtful about end of life issues with our pets than we are with our brothers and sisters.

    • Stuart Hill :

      If you dehydrate a pet to death you are arrested for animal cruelty. Dehydration of elderly/disabled people through terminal sedation is common practice and poses zero risk for the perpetrator.

      “A conscious [cognitively disabled] person would feel it just as you or I would. They will go into seizures. Their skin cracks, their tongue cracks, their lips crack. They may have nosebleeds because of the drying of the mucus membranes, and heaving and vomiting might ensue because of the drying out of the stomach lining. They feel the pangs of hunger and thirst. Imagine going one day without a glass of water! Death by dehydration takes ten to fourteen days. It is an extremely agonizing death.”

      http://www.chninternational.com/A_Painless_Death.html

      I do realize that many view the elderly and disabled as a nuisance or even just horribly “icky” for a young healthy person to have to look at.

      So like a dog that is not longer fun to play with and that may require a bit more care they see it as a great kindness to put mom out of her misery if if mater feels she is still enjoying life.

      Yeah I am being a little flip about a serious matter but it helps to deaden the pain of injustice. Ask Bill Sorrell if you want the details of the case.

  3. Peter Liston :

    I hope that this legislation passes. People should have the power to make their own choice.

    It’s silly to argue about the language of the death certificate.

  4. Pat McDonald :

    Looking Beyond the “Sound Bite”

    We live in a “sound bite” world and perhaps to many “death with dignity” sounds like something we would all hope to experience. But what does it really mean? I was a member of the House of Representatives when the bill was first voted on years ago. I still remember some of the debate. I was particularly concerned with the discussion about the actual technical details of the process. From what I remember, there are many pills that the individual needs to take. What happens if not all pills are able to be consumed? What happens after the individual dies? Is there any verification of whether the individual actually took the pills? Does the death certificate just reflect the known condition without any additional investigation?

    Another issue which continues to baffle me is the fact that this State always supports those individuals with disabilities – as we should. We try as much as possible to provide opportunities to make their lives easier, productive and rewarding. I applaud this approach. But in this instance, representatives from disability and independent living entities and numerous individuals with disabilities are pleading with the Legislature not to pass this bill. The Legislature seems almost dismissive of their pleas. I don’t understand why.

    When this bill came to the House floor years ago, I was on the fence with how I was going to vote. I had just undergone my second cancer surgery so the thought of what could happen was clearly on my mind and I kept thinking about the “sound bite”. But a lobbyist for Independent Living whom I served with on the Governors Affirmative Action Council talked to me about the bill. I have a great deal of respect for this woman. She was amazing and never let her disability interfere with her life and with her desire to get involved. She convinced me that passing this bill was a bad idea for her and for those in the disability and independent living communities. And so I went beyond the “sound bite” and voted no.

    I strongly believe that right up until the moment life ends and beyond, there are opportunities to have an impact on others and in some cases to surprise even doctors about how long ones strength and determination can keep life going. I would hope our elected officials would look beyond the “sound bite” and vote no for this bill.

  5. Dave Gram :

    Mixed metaphor alert! Do you have to put a boat that’s sailing smoothly on a trailer before it faces its steep uphill climb?

  6. Bob Orleck :

    Senator Sears is absolutely right on this issue. And the matter should die in his committee. The proponents of this bill over and over, year after year, will not let it die. Why not go along with Senator Sears and let the bill die with “dignity! I know there are Senators who have grave reservations about this bill. It will be hard for them to say no to it, but they will be doing the right thing if they do.

  7. People with disabilities and chronic conditions live on the front lines of the health care system that serves (and too often underserves) dying people. One might view us as the proverbial “canaries in the coal mine” who are alerting others to dangers we see first.

    It’s good to see legislators looking carefully at the problems with assisted suicide legislation. Hopefully the majority will recognize that:
    • Predictions that someone will die in six months are often wrong;
    • People who want to die usually have treatable depression and/or need better palliative care;
    • Pressures to cut health care costs in the current political climate make this the wrong time to add doctor prescribed suicide to the options;
    • Abuse of elders and people with disabilities is a growing but often undetected problem, making coercion virtually impossible to identify or prevent.
    It’s not the proponents’ good intentions but the language and implementation of assisted suicide laws that legislators need to consider.

  8. Dave Bellini :

    If this bill passes, next, there will be some state certification course in assisted suicide. After that, the state will authorize Nurse Practitioners and physicians assistants to perform the procedure. Maybe legalize a mail order home drug kit. ($19.95 plus shipping and handling) I don’t think Doctors should help kill patients. Even if the patient will eventually die, everyone will eventually die.

  9. John Kelly :

    When Massachusetts voters rejected legalization last November, it was because a broad coalition of medical professionals, the disability community, and liberals exposed the shoddy science and lack of compassion behind the bill. It is impossible to build a social policy upon mere guesswork, which is how doctors characterize a terminal diagnosis. Many people have themselves or know longtime survivors of a doctor’s wrong prediction. The late Senator Ted Kennedy’s wife Victoria wrote that Teddy was given 2-4 months to live, but enjoyed “15 more productive months.” Obamacare architect Dr. Ezekiel Emanuel warned of the likely abuse of “the poor, poorly educated, dying patients who pose a burden to their relatives.” Vermont should instead ensure that everyone receives social supports, good home care, and all the comfort care currently available.

    • krister adams :

      are you going to pay for this?

  10. Kristin Sohlstrom :

    Please familiarize yourselves with the Liverpool Care Pathway. It’s meant to be a caring way to end the lives of people but because it’s a matter of policy versus personal choice, it has turned into a way to kill people and get them off the public health dole.

    As VT’s policy-makers including and especially VPIRG talk about the importance of “reducing the cost of end of life care” this “death with diginity” bill takes on a whole new meaning. There is nothing about this subject that should be a matter of policy on any level at any time. The unintended consequences of such a decision especially when there is no confirmed way of raising money for VT’s new SHARED health care funding system is a red flag.

    Note the language used in this simple explanation of the Liverpool Care Pathway in Wikipedia…sound familiar? That’s not a mistake.

    http://en.wikipedia.org/wiki/Liverpool_Care_Pathway_for_the_Dying_Patient

    “Liverpool Care Pathway: More than 10,000 patients placed on plan”

    http://www.bbc.co.uk/news/uk-england-21141281

    Here’s a high level overview – yes, it says people’s homes.

    http://www.liv.ac.uk/mcpcil/liverpool-care-pathway/

    But look – half of the people placed on this “pathway” aren’t notified.

    http://www.telegraph.co.uk/health/healthnews/9716418/Half-of-those-on-Liverpool-Care-Pathway-never-told.html

    This is what it looks like when things start to go horribly wrong even when a plan has the best of intentions.

    http://www.dailymail.co.uk/news/article-2240075/Now-sick-babies-death-pathway-Doctors-haunting-testimony-reveals-children-end-life-plan.html

    http://www.dailymail.co.uk/news/article-2217061/Liverpool-Care-Pathway-Family-revive-man-doctors-wasnt-worth-saving.html

    http://www.dailymail.co.uk/news/article-2223836/I-survived-death-pathway-Patricia-82-given-days-live-family-defied-doctors-gave-water-straw–shes-planning-world-cruise.html

    http://www.dailymail.co.uk/health/article-2267922/One-6-patients-controversial-care-pathway-year-dementia.html

    Learn from what’s going on in the world today. Look outside the box of VT. Whether or not it’s an intended consequence a lot of people in VT are asking for an NHS-style health care system in VT saying it’s a model we should be following. The Liverpool Care Pathway was only intended to be put into place the last 72 hours of a person’s life…but who foresaw those last 72 hours as defined by the government?

    Tread lightly with this subject and don’t tread on me.

  11. Chuck Kletecka :

    I don’t understand the opposition to this bill coming from the disability community. Individuals and advocates have demonstrated that what we call “disability” is not the same as illness. Evoking the stereotype that the disabled are somehow “sick” undermines the fact that individual dignity is not dependent on ones level of ability and is not something that needs to be cured.

    Equating disability with terminal illness is disgusting and offensive. One issue has nothing to do with the other. It’s a shame disability “advocates” are acting as if they were.

    • Zachary Schmoll :

      Let me try to answer your question.

      I do not think that disability rights advocates are arguing that disability and illness are the same thing. On the contrary, the general motivation for a bill such as this actually brings a blow to the dignity of individuals with disabilities.

      In Oregon, if you look at the actual numbers that were published in the New England Journal of Medicine, the reason that many individuals decided to go through with physician-assisted suicide came from an imminent loss of independence rather than an immense amount of pain. These individuals decided that they did not want to live like an individual with a disability. I am not saying that terminal illness and disability are the same thing whatsoever, but I am saying that they do share symptoms such as the loss of independence.

      These people apparently did not believe their lives were worth living in that condition. Another way of saying that is that they did not believe that their lives had any value remaining.

      By having the government approve of this action, it would be saying that as a people, we understand that there are certain conditions that cause people to believe that their lives have no more value and they should be allowed to terminate their lives. To again refer to the example of Oregon, this condition was almost always brought on by a loss of independence.

      Then, it is not hard to logically deduce that by passing this bill we understand that because of a perceived loss of physical independence, it is reasonable to want to kill yourself and we condone that.

      That is where one of the main problems lies. This bill reinforces the perception that physical independence is the most important value in determining self-worth, and if you do not have that physical independence anymore, we understand and accept as a society that it is perfectly reasonable to perceive that your life has no more value and you might as well end it.

      That is what is insulting about this legislation. It implies that a lack of physical independence can reasonably be synonymous with having no value. Is that the image that the state of Vermont would want to project? I would certainly hope not.

    • Stuart Hill :

      A quick FYI. Most of those disability advocates you are scolding are disabled. They are speaking from experience.

      Perhaps you would do better to listen to them than to scold them for not agreeing with your perspective.

  12. Judith Kniffin :

    I would add to the mix of responses here: As our legal policy now stands, those individuals who have plenty of money and influence can, and not infrequently do, arrange for their own “death with dignity”. The rest of us with fewer resources are often captive to a medical industry that keeps us alive far longer than nature would have intended. Our life:death ratio is out of balance, with some dire population and economic implications. And our attitude about death is seriously skewed. What’s wrong with death, after all? It’s natural and actively contributes to more life!

  13. Jessica Butterfield :

    The “Death With Dignity” bill needs to die in the senat. They say there are safeguards in place to prevent misuse of this option, but I don’t believe it. It’s very easy for a family member to pressure their elderly, disabled, or sick family member into taking this option. Besides, doctors aren’t always right when they diagnose a terminal illness.

  14. Kathy Callaghan :

    I totally agree with Pat McDonald.

  15. Chuck Kletecka :

    The operative concept here is terminal illness. This is only for folks who have a prognosis of not more that 6 months to live, not those who are otherwise healthy irregardless of their disability.

    Doctors who participate will be risking their medical license, and possible criminal charges, if they misrepresent the facts. Will the timeline be exact in all cases, of course not. But they know how to diagnosis of a terminal illness as opposed to a chronic, but not life threatening condition.

    I’m sorry to say this but I think the “slippery slope” argument towards euthanasia of the disabled boarders on delusional. Quite the opposite; our society has demonstrated an ongoing commitment toward protecting individual rights. Far from perfect, but we are going in the right direction.

    To suggest that all that could be reversed and descend to killing is just not going to happen. I am a gay man and I know something about feeling marginalized. However, at some point you’ve got to trust in the basic decency of the folks around you if you see yourself as a true member of society.

    Denying an option for a terminally ill person based such unlikely grounds is simply unfair. Those with any sort of “difference” should know how unfair being unfair is.

    • Zachary Schmoll :

      Through the two responses you have posted so far, fairness seems like a primary concern. From what I can gather, you seem to be making the case that anybody who has a terminal illness should have access to these prescriptions to end his or her life in what you think of as a more peaceful manner.

      I don’t know how you can make that argument and still support this particular version of the bill.

      I encourage you to look at the actual bill if you have not already just to verify that what I am about to say is accurate (http://www.leg.state.vt.us/docs/2014/bills/Intro/S-077.pdf).

      If we are talking about fairness for all people, which is exactly what you’re advocating, and this bill in its current form would not do that for individuals with disabilities even if you do not have any moral opposition to physician-assisted suicide.

      First, in order to be eligible for this procedure, you need to not have any type of depression or other disorder that could cause impaired judgment (page 3). It that not discriminating against those individuals? Anybody who has ever suffered from depression is not eligible? That is not fair whatsoever, and it is not like we are only talking about a few people. Thousands of people suffer from depression and other types of mental illness.

      Then, it specifies on page 5 that the medicine needs to be self-administered. Again, what if I do not have the ability to open my own pills? What if I cannot reach my mouth because my muscles have deteriorated? What if I am not capable of swallowing? Legally, I would be prevented from the same right that everyone else would have through this bill. Again, if fairness is the reason to legalize physician-assisted suicide, this bill does not do that whatsoever.

      As you probably can tell, I would not be in favor of this legislation even if they addressed these two issues, but I felt like I needed to respond to your statement about fairness. It is rather obvious in the text of this bill that it is implicitly not fair, and supporting it while saying that it creates a more fair situation is contradictory.

  16. I find this entire controversy very sad. Some of us can see both sides of this issue. As a former nursing home social worker I saw patients kept alive for 7 to 10 years in a semivegetative state and tube fed. I found it utterly disgusting.
    Also, I have seen folks with Advance Directives choose Paliative care and sign statements saying just what they want when life becomes intolerable due to pain due to terminal conditions. This is what I have done and it is what I suggest to anyone who believes that Death with Dignity is their only option. Death should never be sanctioned by others except when an AD is in effect stating the patients wishes, which should be followed explicitly, even if it hastens death. By putting words in statute you are starting down a very slippery slope for medical practitioners. The only clear direction in this matter should be a well executed AD and a DNR order, if theindividual so wishes. All of this is permitted under current legally binding documents.

Comments

*

Comment policy Privacy policy
Thanks for reporting an error with the story, "‘Death with dignity’ bill faces key votes, unclear future"