Long after the sun set on the Statehouse on Tuesday, House lawmakers were still inside the capitol debating a bill that sets up a process for a terminally ill person to request a lethal dose of medicine from a physician.

A little before midnight, the House voted 80-57 to approve S.77. It is up for final vote Wednesday. The bill underwent a radical reshaping in the Senate, but House Human Services Committee restored the original legislation, which is what was presented for debate on the House floor.

The House version of S.77 faced a frontal attack right off the bat, when Rep. Tom Koch, R-Barre Town, made a move to postpone the bill indefinitely. Kochโ€™s motion was rejected 51-90.

For awhile, the challenges were more oblique, made in the form of amendments to the bill, all of which were definitively squashed.

The debate was philosophy-heavy at times โ€” whether or not a person should have complete autonomy to end their life on their own terms โ€” and data-heavy โ€” what percentage of Vermont doctors favor the legislation โ€” at other moments.

Emotions ran high throughout, and the discussion frequently veered into very personal territory, with lawmakers recalling the deaths of loved ones and their own brushes with suicide.

As the clock struck 10 p.m., Rep. Anne Donahue, R-Northfield, handed out the final amendment of the day, launching another attempt to overhaul the bill. Very similar to the amendment that unraveled the same bill in the Senate, it replaces the bill with a provision that simply gives immunity from prosecution to doctors and family members for supplying a potentially lethal medication.

S. 77 in its current form โ€œtreads on ground where we donโ€™t belong,โ€ Donahue said. Her amendment, she said, would negate the need for a โ€œgovernment constructed process.โ€

The House rejected Donahueโ€™s amendment, 44-94, opting for the original version, which details a procedure for patients to legally obtain and self-administer a lethal prescription if they have less than six months to live.

Rep. Sandy Haas, P-Rochester, who sits on the Human Services Committee, urged the chamber to reject Donahueโ€™s amendment because the approach it takes โ€œdoesnโ€™t work. โ€ฆ Itโ€™s not easy to die from opiates.โ€

A sampling of the other amendments are described below:

โ€ข An amendment from Rep. Doug Gage, R-Rutland, would have, among a number of other obligations, required physicians to record the amount of time that elapses between when a patient takes the lethal dose and when they lose consciousness.

Rep. Linda Waites-Simpson, D-Essex, a member of the Judicary Committee, said requiring a physician to โ€œstand there and start countingโ€ would be an โ€œunnecessary intrusion into a very private and sad time for the family.โ€

โ€ข Rep. Mary Morrissey, R-Bennington, offered an amendment to require that death certificates specify if the cause of death is due to the lethal prescription.

โ€ข Rep. Paul Poirer, I- Barre City, proposed a change that would prohibit the coverage of this end-of-life procedure under health care insurance plans. Poirer voiced a concern common among opponents to the bill โ€” that people will feel financial pressure to end their lives in order to relieve their families โ€” and he said lethal prescriptions shouldnโ€™t constitute medical treatment.

โ€œThis is not health care. โ€ฆ This is providing a service that helps someone die,โ€ Poirer said.

โ€ข Rep. George Till, D-Jericho, posed an amendment that would allow physicians who wish to distance themselves from physician-assisted death to differentiate themselves from those who support it. Doctors could choose whether or not their medical licenses would include a notation indicating that they would consider prescribing lethal medicine through the process outlined in the bill.

โ€ข Rep. Duncan Kilmartin, R-Newport, proposed to devote a full-time deputy stateโ€™s attorney and forensic investigator to monitor potential misuse of the legislation.

In a statement, Dick Walters, president of Patient Choices Vermont, commended lawmakers for preliminary approval of the end-of-life choice legislation.

โ€œItโ€™s been a long day in the Vermont House of Representatives, and we are pleased with the outcome of the debate,” Walters said. “The preliminary passage of the End of Life Choice bill in the House takes us another step closer to the governorโ€™s desk. We thank the legislators who have voted to give Vermonters this important choice.โ€

The legislation, which will be on third reading in the House Wednesday, faces a potential fight in conference committee with the Senate panel. The Senate version of the bill is similar to Donahue’s proposal, and quite different from the House plan, which resembles the Oregon law.

Gov. Peter Shumlin has said he would sign a bill that gives terminally ill Vermonters access to the same options now available in Oregon.

Previously VTDigger's deputy managing editor.

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