Patient Choice at End of Life

The following is an article that I wrote a couple weeks ago. I should have sent it to iBrattleboro immediately but didn’t. My apologies for that. But here it is.

This week (the week of Feb 16) the Senate passed what is referred to s.77. Make no mistake – what we passed was not S.77. S.77 was a well thought out bill modeled after the Oregon law that allows a competent adult with a terminal illness the ability to have control at the end of his life. Many objected because they felt that no one should take his own life and this was condoning suicide. Some objected because they felt there were not enough safeguards for the disability community, that it discriminated against those who had lost the ability to self-administer the drug, and that it did not put enough emphasis on palliative care.

At the last minute, with no testimony, an amendment was introduced that struck all the language in S.77 and replaced it with a bill that now does not satisfy either. What was passed grants immunity to a doctor who prescribes a medicine for symptom relief of a terminal illness if the patient overdoses and dies. It also provides immunity for anyone present at the death. Both of these immunities were in the original bill.

This has no safeguards – there is no requirement for competency, no age requirement, no requirement that the doctor advise you of the availability of palliative care, no requirement that the doctor even advise you of what might be a lethal dose (in not knowing, one could take just enough to put them in a coma), no requirement that the patient ask for the drug or suggest his intentions.

This bill gives physicians immunity with no protection for patients. According to the Attorney General’s office it seems to be so broad as to cover any form of professional discipline or tort liability even for misconduct or gross negligence. And because it is all wink wink, there is no ability for an after the fact review.

I spoke with the Attorney General’s office, a state’s attorney, a former AG, a medical attorney, the palliative care specialist at Fletcher Allen, and two M.D.s – all agreed it was an ill conceived idea.

Unlike the under lying bill, there was no testimony on this and it was written at the last minute. The supporters of this argue that this gets government out of our death. It does not – it provides immunity with no protections. Some say there were too many hoops to go through with the original S.77. I would say there is a difference between hoops and good care.

What we have done is passed a bill that legalizes physician assisted suicide, not a patient choice or death with dignity bill. Both sides of this issue have lost.

So you might ask, why did we pass it? Some voted for it because they saw it as a way to kill the original S.77, some because they just did not want to have to vote on this highly charged issue, some because they believed it provided a good answer to a thorny issue, some to at least keep something alive that might have the chance to be improved on by the House.

At the end of the alphabet I had the luxury of being able to vote against it yet knowing it would remain alive to continue to be worked on. My hope is that the House will take it up and do its best to improve this bill.

– Jeanette White
Windham County Senator

Comments | 2

  • It's nobody's business if you do, unless...

    “What was passed grants immunity to a doctor who prescribes a medicine for symptom relief of a terminal illness if the patient overdoses and dies. It also provides immunity for anyone present at the death. Both of these immunities were in the original bill…”

    Suicide is a decision that is an intensely and entirely person decision that each individual has the right to make at anytime in their life. It is not and never will be a decision that should be rightfully regulated by the state and should not be interfered with by any individual or group. Once a person has decided on suicide, it is up to them to act alone or bring in advice and support people, groups or agencies into their decision-making process. Interference or intervention of any kind should be prohibited.

    In the matter of people being judged mentally-incompetent or mentally-ill falls into shades of gray that cannot offer clear guidelines. Having a “specialist” declare someone mentally-challenged can never be an exact science but there may be cases where family, friends, agencies and the state might be appropriately allowed to step-in to monitor and advise, and in some case, prevent the intended suicide.

    However, the fact that anyone has a personal opinion that suicide is wrong is equally wrong themselves when they speak for other people and then turn their opinion into a law that’s binding for everyone. And, that is a significant problem with society’s laws – people too often use their own moral standards and opinions to control and regulate the activities and behavior of other people.

    Intentional suicide is a victimless crime. Barring what few extenuating circumstances may be part of an intended suicide, physicians and interested parties who have been requested to assist in a suicide is solely the business between a person wanting to die and the people they ask to get involved, if they so chose.

  • Thanks Jeanette

    Thanks for that excellently written article, and for your work on this topic.

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