Vermont Officials Continue Study on End of Life Medical Care

Bioethics   |   Steven Ertelt   |   Jul 6, 2004   |   9:00AM   |   WASHINGTON, DC

Vermont Officials Continue Study on End of Life Medical Care

by Paul Nowak Staff Writer
July 6, 2004

Montpelier, VT ( — In response to a 2002 study revealing that Vermont’s care for the terminally ill was lacking, Attorney General William Sorrell launched an initiative to improve the situation. Two committees have been working on separate issues — pain and symptom management and decision making — and public hearings of their draft reports are now being held.

As the committees are focusing on improving palliative care, or treatment to provide comfort rather than a cure, they have not included assisted suicide in their studies, despite last year’s battle in the public forum over the issue.

When asked about assisted suicide at a hearing in Brattleboro, Sorrell said “the topic that … will be discussed in this state and other states in the months and years to come.”

Committee member Dr. Francis Brokaw gave an example of the shortcomings in palliative care training, by pointing out that while medical students spend hours being trained in obstetrics even though a majority of them will not be dealing with pregnant women in their practice, relatively few hours are spent learning about palliative care.

Judith Kinley, a consulting clinical ethicist at Brattleboro Memorial Hospital who testified about advance care directives, told the Brattleboro Reformer that lack of education is the root of failures to provide palliative care.

"There’s really advanced knowledge out there that’s not disseminated," said Kinley.

During the last legislative session, Vermont has been the latest target by organizations promoting assisted suicide.

The Vermont legislative research office has been asked by 78 state legislators to investigate the impact of Oregon’s assisted suicide law, and research the arguments for and against the legalization of the practice before the next legislative session.

At a meeting of the American Psychiatric Association in May, members were told of a recent case in Oregon in which guidelines were not followed, and a patient who was not terminally ill received a prescription for a lethal overdose of medication from his doctor, despite the fact that the doctor said he was not competent enough to make major medical decisions. Other abuses are possible due to loopholes in the law, agree other physicians monitoring end-of-life issues.

The Oregon law passed in 1994 requires that the patient be terminally ill and that two doctors agree that they have six months or less to live, and that they be deemed mentally competent to make their decision.

Vermont Governor Jim Douglas (R) made it clear he does not support the legislation, and the chairman of the Senate Judiciary Committee stated earlier this year he does not want to take up such a controversial issue if it’s not likely to become law.

Several different organizations banded together to oppose the assisted suicide proposal.

The Vermont Alliance for Ethical Healthcare, was joined by several groups, including the Vermont Medical Society, the Vermont Center for Independent Living, the Vermont Right to Life Committee, Burlington’s Catholic Diocese, and, most recently, the Vermont Chapter of the American Cancer Society and the Hospice and Palliative Care Council of Vermont.

The Vermont Chapter of the American Cancer Society issued a statement that it "opposes all measures that would permit assisted suicide" because "it violates one of the most basic tenets of physician practice: Do no harm."

The Hospice and Palliative Care Council of Vermont has also stated recently that it opposes "any legislation either for or against physician assisted suicide," similar to the position of the Vermont Medical Association.