by Edward J. Mahoney
Vermont legislators should be mortified that they have enacted a law to allow and promote “aid-in-dying” with virtually no protections for vulnerable patients. One might contend that they have committed legislative malpractice by cutting-and-pasting together a law that (a) has great potential to be injurious to one group of people and (b) violates the rights of conscience of another group — clear violations of their legislative oath.
S-77 (now Act 39), “An Act Relating to Patient Choices and Control at the End of Life,” raises serious problems for hospitals and other health care facilities as well as physicians and health care professionals. A close reading of the statute reveals that Act 39:
- Requires that the patient requesting hastened death be “capable” at the time of the request; however it allows someone other than the patient to interpret a patient’s request if the patient is unable to be understood by the physician.
- Does not require that the patient be “capable” at the time of the lethal ingestion.
- Requires that the patient request a lethal drug for self-administration, however it does not require that the patient actually self-administer the drug.
- Requires that physicians inform all terminally ill patients about all available treatment options (including a drug to hasten death) even if the patient does not ask about it.
- States that physicians are legally obligated to answer any specific questions about treatment options without withholding any requested information. There is no exemption for a physician who believes the request is premature, clinically inappropriate, or unethical.
- The prescribing physician may not contact the patient’s primary physician unless the patient consents, possibly obscuring pertinent history such as prior incapacity, depression, suicidal statements or attempts.
- Provides legal immunity for physicians, but not for nurses, pharmacists or other involved professionals.
- Does not establish any oversight at all. The physician is only required to report to the Department of Health that he or she has written a lethal prescription (no patient name required) and has followed the procedure set forth in Act 39. The pharmacist is not required to report filling the prescription. There is no prescription tracking. No data is collected. No annual reports. The state and the public will have no idea how often this practice is occurring.
- The Department of Health is required to adopt rules about the safe disposal of unused lethal prescriptions, but there is no way for them (or anyone) to know who has these lethal doses in their possession.
- In addition — unbelievably — the legislature has declared an automatic repeal of all procedural steps as of July 1, 2016. After that date, hastening a patient’s death will be as simple as treating bronchitis.
Act 39 should be a national embarrassment to Compassion and Choices, the out-of-state organization that lobbied so hard to convince our legislature that legalization of “aid-in-dying” would be good for Vermonters.
One has to wonder how carefully Governor Shumlin read this bill with such glaring errors and omissions before he signed it.
Act 39 is so egregious we cannot delay until the 2014 legislature to try to “fix” it. The legislature should be called into special session to re-address this dereliction of their sworn duty.
Edward J. Mahoney
Vermont Alliance for Ethical Healthcare
Residence: Essex Junction, VT