Vermont Gov. Signs Death with Dignity Bill
Vermont Gov. Peter Shumlin today signed into a law a death with dignity bill that will allow physicians to prescribe medication for terminally sick patients who wish to end their lives.
Shumlin, who promised to push the legislation during his 2010 campaign, said in a statement that he knows “how important it is for those who face terminal illness and tremendous pain to have this choice, in conjunction with their physicians and loved ones, in the final days of their lives.”
Vermont is the fourth state to officially allow doctors to aid patients in dying, and the first to pass a law through the legislature. Oregon and Washington both passed death with dignity measures through popular ballot, while Montana permits the practice via court decision.
The bill had been introduced into the Vermont legislature for nearly 20 years, but only once previously faced a vote, when it was rejected in 2007. This year was different: The state Senate passed it 17-13 earlier this month after numerous false starts and compromises, and the state House approved the final measure last week.
Although the law becomes effective immediately, a number of hospitals have indicated that they aren’t yet prepared to enact policies and participate.
Popular Support and Political Will
Supporters hail the bill as one that could pave the way for other state legislatures. “It’s significant because aid in dying has enjoyed enormous popular support for decades,” says Barbara Coombs Lee, an attorney and president of Compassion and Choices, a group that lobbies for death with dignity laws and other end of life rights.
A 2011 poll found that 70 percent of Americans agreed with the statement, “individuals who are terminally ill, in great pain and who have no chance for recovery, have the right to choose to end their own life.” However, action in state capitols has not kept up with public opinion.
“There has been a real mismatch between popular support and political will,” Coombs Lee says. “People themselves, if allowed the opportunity to vote, can pass legislation in the privacy and anonymity of the voting booth. For elected officials, it’s different. Their votes are very public and they are subject to scrutiny, chastisement and sometimes threats,” particularly if they are members of religions that disapprove of aid in dying.
The Vermont bill is also unique in its attempt to tread the line between the most restrictive and permissive existing laws. Both Oregon and Washington require extensive reporting by doctors, whereas Montana practices a more hands-off model, with few obstacles to patients and doctors as long as the patient has fewer than six months to live and is mentally competent.
In Vermont, for the next three years patients will have to state three times in 15 days that they wish to die as well as get a second opinion about their terminal diagnosis, and doctors must submit to rigorous reporting requirements in what has been described as a “training wheel period.” Afterward, the matter of prescribed death becomes more of a private issue between physicians and patients, similar to the Montana model.
Political Third Rail
Of several other states that have considered death with dignity laws this year, New Jersey looks to have the best chance of passing one. A similar measure in Connecticut got stalled in committee after a filibuster by its opponents, but will likely get another look at the next legislative session.
Additionally, there is a pending lawsuit in New Mexico which could ultimately lead to it joining the other aid in dying states.
“It’s been considered a political third rail for so long,” Coombs Lee says. “I think that [Vermont] will dispel those fears and show that it’s okay to vote in keeping with the desires of your constituents on this, and that the political backlash is more fear than reality.”
“The most important takeaway from working in medicine and in lawmaking is to see how patients in general and dying patients in particular are a missing voice in policy and lawmaking,” says Coombs Lee, who previously worked as a nurse and physician assistant. “When stakeholders gather, they mean insurance carriers, the physicians, the nurses and the institutions. They don’t mean the patients. But the patients actually have the greatest stake of all.”