Controversial VT assisted suicide bill up for review Zogby poll shows 78% of Vermonters support it.

Author: Polly Johnson

In the aftermath of the Terri Schiavo case, the controversial issues surrounding physician-assisted suicide and euthanasia have entered into the forefront of political and social debates.

For clarification, euthanasia refers to the act of either lethal injection or the suspension of medical treatment in order to end a life, while physician-assisted suicide occurs when a physician provides the means of death for a terminally ill patient, but the patient takes the final step in inducing suicide. The debate dates back to the era of Hippocrates, who was the first physician to separate medical ethics from religious and spiritual views. Today, all physicians must pledge the Hippocratic Oath as a symbol of the medical code of ethics with the most relevant segment stating that the physician will neither give a deadly drug to anybody if asked for it, nor suggest one.

The issue, which has always provoked strong opinions on both sides of the debate, is now coming to the forefront in Vermont as one group seeks to change state law.

The group Death with Dignity has emerged and is in the process of trying to pass House Bill 168, that would allow physicians to prescribe suicide drugs for terminally ill patients who make known their wish to die peacefully. Dr. Diana Barnard, a doctor at Porter Medical as well as a member of the Shelburne based Death with Dignity Vermont, explained, "This whole thing started when a retired businessman from Shelburne and a friend of his were talking about some end of life issues and they decided they would want the option of death with dignity." The bill, which was rejected last year in the State Legislature, was reintroduced this February and is now gaining more headway, stemming from the support of both new and established groups and citizens.

House Bill 168 "proposes to allow a mentally competent patient who is expected to die within six months to end his or her life in a humane and dignified manner by prescription medication." It is based on the law in place in Oregon, where assisted suicide is legal, and as Barnard noted, "It seems to be working well there." According to the bill, the patient must be "capable," which means he or she must be completely cognizant of his or her decision, and have the ability to clearly communicate his or her wishes. Another important component of the bill is the patient's right to rescind his decision, no matter what his mental state.According to Barnard, "There is definitely information to indicate that this is something that Vermonters want. There have been a couple of polls, a Zogby poll this year that showed 78 percent of Vermonters in favor, and a different poll last year that showed similar results."

While the bill is being considered in the legislature, an expected slew of opposing groups have voiced their opinions, and not quietly. Barnard stated that "a lot of the opposition appears to come from organized conservative religious groups, who are the most vocal opposition - quite frankly, it still puzzles me why that is the case since from my perspective, this whole movement is about expanding choice for people at the end of life."

In general, those opposed to physician-assisted suicide feel that instead of devoting time and resources to ending a patient's life, those resources should be invested instead in improving hospitals and end of life care.

Dr. Robert D. Orr, president of the Vermont Alliance for Health Care and a professor of family medicine at the University of Vermont, noted, "Our primary concern is that the abuses, expansions and complications from these practices are not immediately evident." Orr refers to Oregon and the Netherlands, where euthanasia is legal and where he and other experts have proposed that both negative and positive results are being shown. Physician-assisted suicide was introduced in the Netherlands in 1984 and legalized soon after. Orr and others in opposition to the practice argue that the abuses and complications wrapped up in the issue will ultimately lead to the immoral and untimely death of millions of patients. Already Orr noted that in the Netherlands "most disturbing of all, over 25 percent of the time physicians induced death without a request from the patient, based instead on the request of family members or on the physicians' own clinical judgment."

At the core of the debate is a difficult, moral question that baffles citizens and physicians alike. It seems there is no right answer - some argue that preventing human beings from choosing their own means of death is stripping them of their basic honor, dignity and personal freedom, saying that assisted suicide is a constitutional right based on the due process clause of the 14th Amendment. Opposition is just as prevalent as is support - some of the most serious opposing arguments are religious and moral considerations, with most opponents arguing for the value of the "sanctity of life" and believing that assisting another person in death is murder. As Orr noted, "If Vt. does not heed the negative experience in other jurisdictions, we are doomed to learn the consequences ourselves - to our detriment."