A Connecticut woman who sued the state in August for the right to end her life through Vermont’s medical-aid-in-dying law may not need to wait for her day in court.
Sen. Ginny Lyons, D-Chittenden Southeast, introduced a short bill, S. 26, last month that would strike the residency requirements from Vermont’s 2013 law. On Thursday, Lyons called the amendments a “technical correction” during an initial review by the Senate Health & Welfare Committee, which she chairs.
The federal civil rights lawsuit, brought by Lynda Bluestein, of Bridgeport, Connecticut, and Diana Barnard, a palliative care physician practicing in Middlebury, seeks the same change. Bluestein, 75, a retired public health advocate, has a terminal diagnosis of fallopian tube cancer.
“I’m really hopeful that there will be a legislative fix for this,” Bluestein said in an interview. “We can just say, ‘ Yeah, you can go to Vermont and get care, period.’ That’s all I want.”
Lawyers in her case argue that Barnard would face criminal and civil penalties and potential medical board disciplinary action under the current law for providing medical-aid-in-dying to her patients who live in New York state. The first hearing is scheduled for this summer in U.S. District Court.
“We don’t know which will happen first,” said Betsy Walkerman, president of Patient Choices Vermont, a nonprofit that educates Vermonters about their end of life options. “It’s going in parallel here.”
Vermont was one of the first states in the country to allow medical-aid-in-dying, following Oregon, Washington state and Montana. Vermont’s law, like those now in nine other states and the District of Columbia, protects licensed health care providers from being prosecuted for writing a lethal prescription for a patient. No provider or institution is required to offer this type of care.
The health care provider must follow a multi-step consent procedure and the requesting patient must have a diagnosis of “an incurable and irreversible disease” expected to result in death within six months.
Between May 31, 2013, when the law went into effect and the end of 2022, 173 people completed the process to receive a lethal prescription in Vermont, according to the Vermont Department of Health. Some of those people may still be alive or died instead as a direct result of their underlying condition.
Oregon’s 1997 law, which has a residency requirement, served as a model for other states. Now that limitation is being systematically challenged as unconstitutional by a national nonprofit called Compassion & Choices.
The group’s argument, that three separate clauses in the Constitution prohibit a state from limiting what medical care a person can receive based on where they live, was convincing to Oregon state officials. They settled a similar lawsuit brought by a patient from Washington state and his doctor based in Oregon, agreeing not to enforce the residency requirement. A bill removing it altogether was introduced in January in the Oregon legislature.
Not only would the new Senate bill align Vermont law with constitutional requirements, it is also simply the right thing to do for patients, according to Walkerman.
“I have plenty of friends who have gone to Boston for cancer treatment,” she said. “How would they feel if they were told, ‘Oh no, you can’t come here.’”
But complications do arise due to the unique type of medical care that terminal patients might come to Vermont to seek.
In an informational sheet for non-residents seeking aid-in-dying care in Oregon, Compassion & Choices recommends that people plan to fill the prescription and take it in state, unless their home state also has a parallel law. If part of the process occurs in a state where it is not authorized, “you, the physician and others may face civil or criminal penalties in that jurisdiction,” the sheet warns.
Bluestein said she would plan to come to Vermont to receive aid-in-dying medical care. “The added burden of having to become a resident to make that happen seems a bridge pretty far when you have already been made hospice eligible,” she said. “To have to overturn my whole life and my support system and have to spend time beyond that of getting care.”
Allowing people from outside of Vermont to seek medical-aid-in-dying here also raises other questions. Sen. David Weeks, R-Rutland, asked whether a life insurance policy issued from another state would provide payment in that case.
Lyons responded that testimony on that and other issues would be scheduled in coming weeks. “It’s the sensitive nature of this that introduces the questions that we are asking,” she said.
The committee also should expect to hear from organizations and advocates who “are categorically against the end-of-life choices for patients,” Lyons said. However, “we already have underlying statute, we’re not going to go back there again.”