What do advocates for legalizing assisted suicide do when they cannot get enough legislators, or the public, to support their policy goals? In the past, they created euphemisms (e.g., “aid in dying,” death with dignity,” and “patient-directed dying”) to mask the true nature of assisted suicide. But many people saw through that strategy, so they are trying new legislative tricks— a covert assisted suicide bill in Vermont.
Vermont Senate Bill 77 masquerades as mere liability protection for doctors and family members of terminally ill patients. However, a close look at the bill demonstrates that no matter what you call it, the end result is death.
Vermont Senate Bill 77 (SB 77) was originally introduced as Oregon-style legislation (i.e., legalizing assisted suicide with “safeguards”). However, in February the original language was replaced with something even worse, masquerading as a “compromise.”
The new language provides:
. . . A health care professional who has a bona fide health care professional-patient relationship with a patient with a terminal condition and who prescribes medication to that patient for the relief of symptoms associated with or caused by the terminal condition shall not be subject to criminal or civil liability or professional disciplinary action if the patient self-administers more than a prescribed dosage of the medication and dies as a result. A person shall not be subject to criminal or civil liability solely for being present when a patient self-administers a lethal dose of a medication that has been prescribed for that patient by a health care professional (emphasis added).
No one wants to prosecute doctors who prescribe medication to alleviate pain for suffering, terminally ill patients—as they do every day—even if the medication could unintentionally accelerate a person’s death. In fact, there is little excuse for patients to suffer today.
With the advanced pain medications, antidepressants, anti-anxiety medications, implantable devices for pain management, improved surgical procedures, relaxation techniques, and counseling that are available today, “it is believed that nearly 98 percent of all pain in the terminally ill can be properly managed.”[i]
However, SB 77 will permit a physician who has only seen a terminally ill patient once to receive full immunity. In other words, if a doctor prescribes a powerful pain medication to a very sick and potentially depressed patient whom he just met, and the patient then takes an overdose to commit suicide, (a) the state cannot consider whether a criminal prosecution is warranted, (b) the patient’s family is barred from seeking civil relief from the physician, and (c) the physician’s medical license cannot be challenged. This explicit and unqualified immunity invites abuse.
Importantly, doctors do not need this protection—there are no reports of widespread prosecutions of, or lawsuits against, doctors for prescribing pain medications. SB 77 provides a solution in search of a problem.
No one wants to prosecute loving family members who are at the bedside of a suffering person when that person unexpectedly takes his or her own life. However, the law shields any person from criminal or civil liability for being present when a person “self-administers” a life-ending dose of medicine.
The circumstances are not even limited to when the patient is “terminally ill.” This level of immunity is indefensible when you consider the potential for abuse—how can investigators know that a patient voluntarily took a lethal dose of medication? By discouraging investigations in suspicious situations, this provision immunizes anyone from responsibility regardless of the drug-taker’s health conditions or prognosis, or the circumstances surrounding the shielded person’s presence. Effectively, this provision might even immunize acts of murder.
No, SB 77 is not a traditional assisted suicide bill. It is potentially worse. There is no mechanism for tracking how many terminally-ill patients are given a powerful medication to “control their pain” with a wink from a doctor who knows that the patients intend to end their lives. In fact, its enactment might have the unintended effect of causing ethical doctors to prescribe less needed pain medication out of fear that patients may use it to commit suicide.
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Despite its mask as a “compromise,” SB 77 is dangerous and deadly. The Vermont House of Representatives should reject it as such.
[i] C.M. Scaduto, Terminal Sedation Can be Licit, Ethics & Medics 35.6 (June 2010) (citing American Pain Foundation, End of Life (updated July 16, 2009)).