Wednesday February 20, 2013

MIKE FAHER

Brattleboro Reformer

BRATTLEBORO -- In the weighty debate about end-of-life choices for the terminally ill, a local legislator played a critical -- and controversial -- role in state Senate deliberations this past week.

The Senate bill was designed to allow terminally ill patients in Vermont to legally receive a lethal dose of medication if they so choose.

The initial bill, modeled on Oregon's "Death With Dignity Act," included provisions designed as safeguards: For instance, patients had to be mentally competent and had to request the medication three times, including once in writing.

Also, two doctors had to agree that a patient had fewer than six months to live.

But on Wednesday, Sen. Peter Galbraith, D-Townshend, joined Sen. Robert Hartwell, a Bennington Democrat, in offering a sweeping amendment that replaced much of the original bill with a more hands-off provision: Doctors who write lethal prescriptions to the terminally ill, the legislation said, could not be held criminally or civilly liable and would not be subject to professional disciplinary action.

Two 15-15 ties

Subsequent debate produced two 15-15 ties in the Senate, with Lt. Gov. Phil Scott twice breaking that tie in favor of preserving the Galbraith-Hartwell version of the bill.

Ultimately, that version was approved Thursday by the Senate in a 22-8 vote.

"We actually developed a 2-to-1 consensus around the idea of patient choice," Galbraith said Friday.


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The second-term senator said he had been listening to both opponents and proponents of the initial bill when he was struck that there was "a lot of common ground."

Proponents wanted terminally ill patients to be able to choose to end their own lives.

"The opponents were saying, ‘We don't want to see a state-sponsored process for suicide,'" Galbraith said.

Galbraith said he talked to many constituents about the issue. He believes the changes he proposed -- and which eventually were approved -- were a good compromise.

"I drafted an amendment that leaves the end-of-life decision between a doctor and her patient," he said.

In response to critics who say the amended bill lacks safeguards for patients, Galbraith said he did not believe those processes were realistic in end-of-life situations.

"This is not the way it really works," Galbraith said.

He added that a constituent praised his work with the following message: "Thank you for getting rid of these hurdles."

However, others remain convinced that changing the initial bill was a bad idea. Among those voting against the amended bill was Sen. Jeanette White, a Putney Democrat.

White's objections were recorded by Wednesday's official Senate journal: "While I want to see this bill go forward, this bill as it now exists is 180 degrees from the original intent and is such a travesty that I would rather have the other body start anew (than) try to improve this bill."

On Friday, White detailed her objections.

"This has no safeguards. There is no requirement for competency, no age requirement, no requirement that the doctor advise you of the availability of palliative care, no requirement that the doctor even advise you of what might be a lethal dose ... no requirement that the patient ask for the drug or suggest his intentions," White wrote in an e-mail to the Reformer.

"This bill gives physicians immunity with no protection for patients," White added. "According to the attorney general's office, it seems to be so broad as to cover any form of professional discipline or tort liability even for misconduct or gross negligence. And because it is all ‘wink wink,' there is no ability for an after-the-fact review."

White said there were a variety of reasons behind the revised bill's passage in Thursday's final vote.

"Some voted for it because they saw it as a way to kill the original (bill), some because they just did not want to have to vote on this highly charged issue, some because they believed it provided a good answer to a thorny issue (and) some to at least keep something alive that might have the chance to be improved on by the House," she said. 

The matter now will be taken up by the House, where Speaker Shap Smith reportedly expressed doubts about an end-of-life bill that was "changed on the fly" in the Senate.

Galbraith does not agree with that characterization.

"It was not changed on the fly. This is how the legislative process works," he said. "This was the result of a deliberative process."