By Guy Page
Senate bill S74 would eliminate several requirements included in Act 39, Vermont’s ‘aid-in-dying’ law, to protect patients against potential mistakes or abuses.
Introduced Tuesday by Sens. Richard McCormack (D-Windsor), Alison Clarkson (D-Windsor), Ginny Lyons (D-Chittenden), and Michael Sirotkin (D-Chittenden), S74 proposes to:
- Eliminate requirement that terminally-ill patients must request death-resulting “medication” in the physical presence of the physician
- Eliminate a requirement that the prescribing physician have conducted a physical examination of the patient in order to determine that the patient was suffering a terminal condition
- Eliminate a requirement that the physician wait at least 48 hours before writing the prescription.
- Provide legal immunity for “any person who acts in good faith compliance with the provisions of Vermont’s patient choice at end of life laws.”
The bill does not explain why patients now would need neither an exam by the prescribing physician, nor direct communication with him or her. When Act 39 was passed, lawmakers were told the direct contact with the physician would minimize the chances of misdiagnosis of terminal condition, or misunderstanding of the patient’s wishes.
The precautionary waiting period, deemed essential in S31 to reduce suicide death by firearms, would be removed from a law created specifically to bring life to an end. Sen. Clarkson is a co-sponsor of both bills.
Providing legal immunity for even non-medical people involved in the aid-in-dying process – including family members and aid-in-dying organizations such as Patient Choices Vermont – would lower the bar of protections against possible abuse of the law. During hearings before Act 39 was passed, opponents expressed concern that family members and others might not share the law’s intent to give the patient complete freedom in the choice to live or die.
S74 has been referred to the Senate Health & Welfare Committee, chaired by co-sponsor Lyons. It would require approval in both Senate and House, and Gov. Scott’s signature (or veto override) before becoming law.
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According to a January, 2020 report on Act 39, Vermont’s 2013 “Aid-in-Dying” law, 34 deaths occurred in connection with the law between July 1, 2017 and June 30, 2019.They fell into the following underlying diagnoses groups:
• 71% were due to cancer (24 total cases);
• 12% were due to ALS (4 total cases);
• 9% were due to Neurodegenerative Diseases (3 total cases from Parkinson’s Disease
and Huntington’s Disease); and
• 9% were due to other events (3 total cases).
The report says all the death certificates listed the “appropriate cause” (the underlying disease) and manner of death (natural). This means that this report will contain no information that could be used to potentially identify any patients or health care providers involved.
Among the 34 confirmed deaths, the mechanism was:
• 28 utilized the patient choice prescription (82%);
• 5 died from the underlying disease (15%);
• 1 unknown (3%).
Since the law took effect in 2013, 87 “events” (as the report describes doctor-prescribed death) have taken place, the report said.
(Full disclosure – the author is a former lobbyist for the Vermont Alliance for Ethical Healthcare, which opposed the passage of Act 39.)