Vermont Assisted Suicide Bill Changed, Still Problematic

State   |   Alex Schadenberg   |   Feb 14, 2013   |   6:26PM   |   Montpelier, VT

Yesterday, while doing my work, I listened to a very interesting debate on Bill S 77, the assisted suicide bill in Vermont. To give you the long and the short news, the bill was amended and is now completely different. True Dignity Vermont reported on this development with the following article on their site titled: A Huge Surprise.

True Dignity is stunned and doesn’t know quite what to say.

The Vermont Senate has just approved for third reading an amended version of S. 77 that makes it into a completely new end of life bill. Senator Peter Galbraith of Windham County and Senator Bob Hartwell of Bennington County introduced the amendment, which struck out every provision in the original S. 77 and replaced it with a bill that does nothing more than grant immunity from civil and criminal penalties to doctors who prescribe medication to help patients sleep or relieve pain while also warning them that taking an overdose will kill them, and stipulating the amount that constitutes an overdose.

The senators assert that this bill puts the question of whether and how to commit suicide back on the patient. The amendment also stipulates that the patient’s family members will not be subject to civil or criminal penalties if they are with the patient when he takes the lethal dose and dies.

The two senators relied on the principle of double effect to create this amendment. The doctor will not be prescribing drugs for the specific purpose of a patient’s suicide, as he would have under the original bill. Rather, he will be prescribing drugs to bring sleep or alleviate pain. He will not be required to give the patient a warning any more than doctors are required to give warnings when they prescribe such drugs now. Giving the warning, however, will be necessary if the doctor wants to be exempt from civil and criminal penalties in a wrongful death case. It is entirely up to the patient whether he construes the warning as an instruction on how to commit suicide.

True Dignity is not happy with the amended bill. It would prefer a strict prohibition on assisting a person in suicide, believing that family members could still be near patients at the time of death without fear of prosecution, as long as patients did not inform them they were going to commit suicide. True Dignity believes there is no need for a bill protecting either doctors or families, and that doctors should be subject to prosecution if they purposely prescribe drugs with the intent of helping a patient commit suicide. If the people who want to do this are as “organized and purposeful” in their determination to bring about their deaths as we were told during the debate, True Dignity believes they should take full responsibility for their actions, without involving anyone else.

There was never any hope in Vermont, however, of such a bill’s being adopted. Just as it opposed the bill legalizing assisted suicide, the Vermont Medical Society is on record as opposing a bill banning it. The reason for the society’s opposition has been that it would expose doctors who were prescribing drugs with the intention of relieving pain but with the knowledge that these could have the unintended effect of hastening death, to the incorrect charge of assisting in suicide. Doctors already prescribe pain medications, and patients already know they can use them to end their lives.

The second option was killing the bill altogether. Of the possible options, that would have been the one we would have supported wholeheartedly. We have been told that the votes to do that simply were not there. There were only thirteen votes of the fifteen needed to kill the bill, so it was necessary to compromise with Senators Hartwell and Galbraith.

That said, this amended bill is far better than the S. 77 it replaces. It takes the state out of end of life discussions and puts the onus on the patient, who may or may not have end of life discussions with his family and doctor.

The bill now goes back to the Judiciary Committee, where proponents of assisted suicide will try to amend it back to its original state. It could be brought back to the Senate Floor for a vote as early as tomorrow afternoon.
Stay tuned.
True Dignity Vermont then followed up with the wording of the new Bill S 77, which follows:
V.S.A. means Vermont Statutes Annotated
Sec. 1. 18 V.S.A. chapter 113 is added to read:

(a) As used in this section:
(1) “Double effect medication” means medication prescribed to relieve pain which also may have the effect of hastening death or substantially increasing the risk of death.
(2) “Terminal condition” means an incurable and irreversible disease which would, within reasonable medical judgement, result in a death within six months.
(b) A physician who prescribes a double effect medication to a terminally ill person, which, if not taken as prescribed would be lethal, shall not be subject to criminal or civil liability or professional disciplinary action if the physician warns the person about the effects of taking the medication and the person self administers the medication and dies as a result.
(c) A person shall not be subject to criminal or civil liability solely for being present when a person with a terminal condition takes a lethal dose of medication that has been prescribed by a physician.



Euthanasia Prevention Coalition commentary:

Bill S 77, as it stands now, is clearly different than its earlier versionl, which was an “Oregon style” assisted suicide bill minus a few of the “safeguards” that Compassion & Choices now believes are unnecessary.
The new Bill S77 leaves assisted suicide as an illegal act while creating clear guidelines to ensure that physicians and families are not prosecuted in cases of a death related to a double effect.
The Euthanasia Prevention Coalition (EPC) agrees that there is a clear difference between intentional killing and death by double effect. Double effect refers to an act which intends a good outcome but due to an unintended side-effect results in a bad outcome.

The new Bill S77 may encourage the abuse of the principle of double effect since it would protect people from prosecution when they knowingly overdose. This is not the same as the double effect, because it is the intentional overdose rather than unintentional overdose.

This is the same as passing a law that only allows people with disabilities to park in a disability parking spot, but allows a parking attendant to direct a person without a disability to park in a disability parking spot, so long as the parking attendant first warns the driver that the spot is restricted to people with disabilities.

Since no physician will ever be prosecuted for prescribing large doses of analgesics for the purpose of alleviating suffering, therefore this bill, in fact, does not accomplish anything but possibly opening the door to abuse.

EPC is not comfortable with the wording of the new Bill S77. Note: Alex Schadenberg is the executive director of the Euthanasia Prevention Coalition and you can read his blog here.