• Bad compromise
    February 17,2013
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    Perplexity is in order following action by the Vermont Senate last week on the “death with dignity” bill.

    The Senate was sharply divided on the bill, and emotions on both sides were keen. The Senate Health and Welfare Committee, led by Sen. Claire Ayer, was in favor of the bill. The Senate Judiciary Committee, led by Sen. Richard Sears, was against it. As the bill came to the floor, it seemed that a majority of senators were poised to approve it.

    It is an issue that will not go away, and that’s because it addresses a circumstance that does not go away. Many dying people and their families believe a process should be available to them to allow terminally ill people who are experiencing unendurable pain to end their lives legally and with the help of a physician. Whether the state passes a law or not, this dilemma will continue to face people, and some will wish they had an approved option.

    And yet opposition remains equally persistent among those who believe the state has no business sanctioning what they view as physician-assisted suicide. It is a question of respect for life and of the well-being of vulnerable people. There are laws in Oregon and Washington, after which Vermont’s bill is modeled, that lay out a process designed to ensure that the well-being of dying people is honored. But for opponents, that does not address the core problem, which is state involvement in and approval of a process to bring about death.

    The Senate’s attempt to bridge the divide between these two sides took the form of an amendment from Sen. Peter Galbraith that is worse than either a yes vote or a no vote on the original bill. In order to remove the state’s role as the sanctioning agent for the end-of-life process, the amendment did away with the safeguards designed to protect patients. Instead, it merely lifted the threat of criminal or civil action against physicians or family members involved in the administration of a lethal dose.

    It’s as if the Senate were to respond to foes of abortion by saying, “We’re going to keep abortions legal, but we’re going to throw out any regulation or oversight meant to keep it safe. That way the state will not be involved in the abortion process. Is everybody happy?”

    It’s hard to see how anybody could be happy with the Senate’s action on the death-with-dignity bill. The law allows physicians to prescribe a lethal medication, but it omits the humane procedure that is meant to avoid the outcomes feared by opponents.

    Those procedures include the requirement that patients be mentally competent, that they must request three times that they wish to be prescribed a lethal medication, once in writing, and that they receive independent diagnoses from two physicians that they have less than six months to live. And they have to administer the dose themselves. Under the Senate bill insensitive quacks would have free rein.

    The Galbraith amendment was highly controversial within the Senate. Ayer said she detested it. The Senate vote on the amendment was tied, 15-15, requiring Lt. Gov. Phil Scott to cast the tie-breaker. He voted in favor of the amendment. Ultimately, the Senate passed the amended bill, 22-8.

    It is likely the Senate bill will undergo significant revision in the House, many of whose members favor the straightforward death-with-dignity bill that was originally proposed in the Senate. Ayer said she hoped to serve on the conference committee to resolve differences between the Senate and House bills to make sure the expected House version prevails.

    Some issues do not lend themselves to compromise, and this appears to be one of them. If lawmakers oppose the end-of-life measures laid out in the original bill, they ought to have the backbone to vote no. Granting immunity to doctors is no great stride forward since doctors are not likely to face prosecution anyway. If lawmakers believe steps are warranted to create safeguards in the troubling circumstances of a painful death, they ought to have the backbone to vote yes.

    Dick Walters is president of an organization called Patient Choices Vermont, and he praised the Senate action. He also said he looked forward to working with the House as it takes up the bill.

    Indeed, the Senate took a step forward in removing the spectre of criminality from the end-of-life process, and that is the occasion for Walters’ positive statement. But it’s hard to believe advocates for the death-with-dignity cause are happy with the watered-down version passed by the Senate. Working with the House will be high on their agenda.
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