A contentious end-of-life bill that has ricocheted between the two chambers of the Vermont Legislature since February came to rest Monday when the House voted 75-65 to accept the Senate’s changes to the bill.
The bill now heads to Gov. Peter Shumlin, who supports the end-of-life initiative. Once he signs the legislation, Vermont will become the third state in the nation to allow physician-assisted suicide.
Opponents made one last stand Monday evening against Senate bill 77, which outlines a procedure for terminally ill patients to obtain a lethal dose of medication and gives prescribing physicians legal immunity if they adhere to certain standards. The bill has been debated at length — earlier debates dwarf the three-hour discussion that took place on Monday — and it’s been the springboard for more than 20 amendments, most of which failed, but a few of which dramatically transformed the bill.
The version now agreed to by both the Senate and the House has been billed as a “compromise.” It grants civil and criminal immunity to doctors who prescribe a lethal dose of medication to a patient with a prognosis of less than six months to live. The bill lays out a specific procedure for the first three years that includes safeguards. Starting in 2016, those safeguards are removed and doctors can develop their own standards.
A handful of House lawmakers came armed with amendments — several of them refashioned fragments of previous versions of S.77 — and did their best to show that the most recent iteration of S.77 — which stitches together the original versions passed by the Senate and the House — was a “hodgepodge” piece of legislation that hadn’t been vetted.
None of the amendments passed. Had any of them been successful, they would have killed S.77, since the Senate wouldn’t have had time to review them before session ends Tuesday.
Several amendments sought to reinstate pieces of the House’s version, putting opponents into the odd position of promoting a bill that they had previously spoken out against. An amendment from Rep. Paul Poirier, I-Barre, would have reinstated a form that specified how a patient should make a request for the prescription. S.77 as passed requires patients to make a written request but it does not require a specific template.
Lawmakers opposed to S.77 repeatedly raised the specter of “hidden mistakes,” citing one that was unearthed in the Senate that could have inadvertently jeopardized federal Medicaid and Medicare funding. They speculated on ways the bill could malfunction during “worst-case scenarios.”
“You need to design your law based on preventing the worst-case scenario,” said Rep. Cynthia Browning, D-Arlington.
Rep. Duncan Kilmartin, R-Newport, supplied a steady stream of such scenarios. Kilmartin drafted two amendments, one of which would prohibit anyone who could “profit” from a patient’s death from picking up a prescription requested under the terms of S.77. This would make it harder for people to abuse the law, using it as a way to compel people to end their lives prematurely. Kilmartin invoked the example of a “bookie with a baseball bat,” who could pick up the prescription for a patient who owes them money.
Rep. Paul Ralston, D-Middlebury, said, “Frankly I’m a little freaked out that so much has changed in such a short time,” and Rep. Tom Koch, R-Barre, described the legislation as “cobbled together in a hurry.”
Another objection centered upon a single word. The bill stipulates that the patient must be deemed “capable” in order to request and receive the lethal medication. Lawmakers who oppose the legislation made the case that doctors are more familiar with the term “capacity,” and could be thrown off by the usage of “capable” instead. It threatened to unravel the legislation on the Senate side last week, and on Monday, Poirier offered an amendment that would supplant the term “capable” with the term “capacity.”
Supporters point out that the Oregon law, in place for 15 years, uses the term “capable,” and they say doctors will understand that the two terms are comparable.
