Vermont Approves Physician-Assisted Suicide

May 14, 2013

Vermont is a governor's signature away from becoming the third state to explicitly legalize physician-assisted suicide, after a final vote by lawmakers yesterday to approve the controversial practice.

The bill is modeled after "death-with-dignity" laws in Oregon and Washington that allow physicians to prescribe a lethal dose of narcotic to a terminally ill patient who requests it. The Vermont bill went through various iterations before the Vermont Senate passed a final version last week, followed by a 75-65 vote last night in the state House. Vermont Governor Peter Shumlin has said he will sign the measure into law.

'I am...proud that we will now offer Vermonters who face terminal illness at the end of life a choice to control their destiny and avoid unnecessary suffering," Shumlin said in a press statement. "I believe this is the right thing to do."

In addition to Oregon and Washington, physician-assisted suicide is technically legal in Montana, where that state's supreme court declared in 2009 that existing state law and public policy do not prohibit physicians from helping terminally ill patients die. A bill passed by the Montana House would have outlawed the practice and imprisoned cooperating physicians for up to 10 years, but the state Senate voted it down last month.

The victory for physician-assisted suicide in Vermont comes shortly after a defeat in Massachusetts, where voters in a November 2012 referendum defeated the same bill that voters in Oregon and Washington had approved. The measure legalizing physician-assisted suicide was running ahead in the polls until a last-minute advertising campaign by opponents appeared to turn the tide. Critics have said that physician-assisted suicide will create a slippery slope leading to euthanasia and expose ailing individuals to pressure or coercion to take their lives from greedy relatives eager for an inheritance.

Opponents to the Massachusetts ballot measure included the Massachusetts Medical Society, which called physician-assisted suicide "fundamentally incompatible with the physician's role as healer."

The Vermont Medical Society opposed the bill in Vermont, but for a different reason. In 2003, the society took the position that there should be no law either for or against physician-assisted suicide. Legalizing the practice "might prevent or circumvent good palliative care," but laws to the contrary might "chill the use of medications needed to control symptoms" in the care of the dying, according to a recent issue of the society news bulletin.

Under the bill awaiting the governor's signature in Vermont, a physician can order a lethal dose of narcotic requested by a dying patient only after a number of conditions are met. For one thing, the physician must counsel the patient about alternative end-of-life services, including palliative and hospice care. In addition, the prescribing physician and a consulting physician must concur that the patient:

  • has most likely only 6 months to live,

  • is voluntarily requesting physician-assisted suicide, and

  • is competent and making an informed decision.

The patient must request the medication twice, with a span of 15 days in between. The prescribing physician cannot administer the drug; the patient does.

The template for the Vermont bill — the 1994 Oregon law that took effect in 1998 and that Washington approved 10 years later — earned high marks in a recent study in the New England Journal of Medicine. Researchers looking at the implementation of the Washington law at a Seattle cancer treatment center found that it was "well accepted by patients, families, and staff."

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