Legislative Notebook

This column is about S. 77 "An Act Relating to Patient Control and Choice at the End of Life," which is also known as Physician Assisted Suicide or Death with Dignity. By the time this is in the paper the fate of this legislation may have been determined. But I have heard from so many constituents on this issue that I will provide my perspective on this matter.

Many Vermonters are concerned about the suffering that they may face once they have been given diagnosis of a terminal disease. They want to have control over how and when their lives come to an end through taking a lethal dose of medication prescribed by a doctor. I have great sympathy for those currently in this situation or who anticipate such a situation with dread, or have loved ones in this situation, and I may some day be in such a situation myself. But I have found the legislation under consideration to be problematic.

The version of S. 77 that passed the Senate left the question of prescribing and ingesting lethal medication at the end of life to patients, their doctors, and their families. Those who might provide drugs or participate in acts that could end someone's life were immunized from liability. Some think that this is good in that the government stays out of the situation, but some think that it is dangerous: the state is allowing others to assist a person to end his or her life without oversight or regulation.

The version of S. 77 that has passed the House sets up regulations that are intended to protect against abuse of the authorization to prescribe and to take such drugs. The bill endeavors to ensure that a Vermonter asking for a lethal dose of barbiturates would be of sound mind, have a terminal diagnosis of six months or less to live, and not be influenced by others who might have an interest in their death. However, there is little regulation of how the medication might be taken or the results in terms of complications or mistakes.

It is very clear that many passionately want the option of taking drugs to assure a peaceful death for themselves or their loved ones.

It is also very clear that many believe just as passionately that legalizing such lethal dosage is wrong and may lead to the abuse of vulnerable people. Some also think that it is wrong to ask doctors to participate in their patients' deaths in any way, although this would be voluntary.

I could not support the House version because so often terminal diagnoses are mistaken, and someone might choose death when they might have had years more of life left. I am also concerned about possible effects on those vulnerable to persuasion or who may worry that they are a burden on their families. Since the consequences of mistakes or abuse are irreversible, the regulations would have to be perfect. But they are not and cannot be. We must be compassionate, but we must also have common sense about human nature and the limitations of state regulatory capacity.

I know that regardless of the fate of S. 77 we have more work to do to ensure that all Vermonters have high quality pain management and comfort care when needed. All Vermonters must have access to hospice care when their end is near. At this point negotiations between members of the House and the Senate could result in a compromise version of S. 77 that would pass both chambers. If not, the bill will not become law.


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