[T]he Vermont House gave preliminary approval Wednesday to a bill that retains patient protections in the state’s physician-assisted suicide law that were set to expire July 1, 2016.
In 2013, the Legislature passed Act 39, which supporters sometimes call the “death with dignity law.” Under the law, a physician may prescribe a lethal dose of medication to patients with a terminal illness.
The patient, after going through a lengthy process, may self-administer the medication to end his or her life. Under Act 39, a doctor must determine that a patient is “capable” of making “an informed decision” and certify that the patient has a diagnosed, “incurable” terminal illness.
An attempt by lawmakers who oppose the law to repeal Act 39 failed by a vote of 60-83.
Rep. Paul Poirier, I-Barre, a co-sponsor of the repeal amendment, objected to the role it creates for the state in “sanctioning the end of a life,” and the law has the potential to be abused, he said.
“We don’t live in a perfect world,” Poirier said, and in some instances family members may encourage someone to end their life “based on greed.”
The repeal amendment’s other sponsor, Rep. Anne Donahue, R-Northfield, said there is a persistent misunderstanding that Vermont’s law contains the same protections and reporting requirements as Oregon’s law, which has been in place for close to two decades.
Donahue says Vermont’s law does not require patients to self-administer the lethal medication. The Vermont version also allows people to qualify based on age or disability, she says. That’s not the case for the Oregon law, Donahue said.
Vermont’s law, unlike Oregon’s, doesn’t require reporting on what type of health insurance patients have, their diagnosis or whether they are in hospice care, Donahue said.
Rep. Sandy Haas, P-Rochester, noted that Donahue is mistaken that the Vermont law allows qualification by age or disability. The law only qualifies patients with the diagnosis of a terminal illness with six months’ life expectancy.
Much of what is known about the law’s use in Vermont is anecdotal, according to health department officials. At this point, they’re only able to report that doctors have written seven prescriptions for life-ending medication since the law took effect. However, Linda Waite-Simpson, state director of Compassion & Choices — which advocated for the law’s passage — has said in media accounts that three people used the medication to end their lives.
Given the lack of official reporting, Donahue questioned the assertion by the law’s supporters that “it’s working as intended,” adding that she has collected anecdotal reports of potential abuses of the program.
Haas responded that physicians are only afforded immunity if they determine the patient is able to self-administer the dose. Not doing so could result in the loss of their license and a prison sentence, she said. In addition, neither the attorney general nor the Department of Health has received a complaint about Act 39, she added, signaling that problems have not occurred.
Haas and the Committee on Human Services offered an amendment to allow the Health Department to better track who is filling and using these prescriptions, which they believe will “increase public confidence” that the law is working as intended.
The amendment, which was approved, requires the health department to release a statistical report on the use of the law, beginning in 2018.
The bill, S.108 has passed the Senate, but the upper chamber will need to approve the House amendment to the reporting procedures before it lands on the governor’s desk.
Some of provisions that will be preserved if S.108 becomes law are:
• A patient must make two oral requests, 15 days apart, and then a written request for a lethal prescription.
• The doctor has to offer the patient the option to rescind the second verbal request.
• The doctor has to verify the patient either did not have impaired judgment or refer a patient with impaired judgment to a mental health provider.
• The doctor must determine that the patient was “making an informed decision” and inform the patient verbally and in writing the range of treatment options.
• A second doctor must confirm that the patient was acting voluntarily when requesting the lethal prescription.
• The patient’s original doctor must document all the requests in the patient’s medical record.
• “Promptly” after writing the prescription, the patient’s original doctor must submit a report to the Vermont Department of Health documenting that the doctor and patient followed the appropriate legal procedure.
CLARIFICATION: This story was updated with an explanation of key elements of Act 39.
Correction: Rep. Anne Donahue’s statement that people can qualify to obtain lethal prescriptions based on age or disability is incorrect. A clarification by Rep. Sandy Haas was added to the story at 9:50 April 30.
