Wednesday March 14, 2012

MONTPELIER (AP) -- Alice Cook Bassett died in December, several weeks after deciding to stop eating and drinking. The 86-year-old decided she didn't want to live anymore with intractable nausea, her daughter said.

In her final days, she asked her daughter, Cindy Cook, to back legislation in Vermont to make the path to death easier for others. This week, lawmakers are beginning to debate a bill that would allow terminally ill people to end their own lives with a doctor's help.

Those last weeks that Basset, a former state representative from Burlington, spent at her daughter's home in Adamant "gave me a lot of clarity about how weak we are as a society about acknowledging that death is a part of life," Cook said this week. Too often missing is "just making space for people to die in a way that feels most appropriate to that person."

The Senate Judiciary Committee began taking testimony on Tuesday on a bill to make Vermont the fourth state -- following Oregon, Washington and Montana -- to allow a terminally ill patient to obtain a prescription from a doctor for a lethal dose of medication.

Several safeguards would be built in: The patient would have to make three requests -- one in writing -- over 15 days. The request would have to be witnessed by two people who are not the patient's doctor or counselor, not related to the patient or able to benefit from the death in any way, and not an employee of the health care facility where the patient is staying.

Despite strong support from some quarters, including from Democratic Gov. Peter Shumlin and House Speaker Shap Smith, and a big lobbying push, prospects for the bill are uncertain at best. The Judiciary Committee is chaired by a strong opponent, Sen. Richard Sears, D-Bennington; and the Senate is led by another strong opponent, President Pro Tem John Campbell, D-Windsor.

Sears said Tuesday he decided to take testimony on the bill at the request of some of his Bennington County constituents and Shumlin.

"I just think it's the wrong thing to do," Sears said. "We need to concentrate in this state on hospice and palliative care." Hospice is a specialty in dealing with the dying, while palliative care involves alleviating patient suffering.

Sears said one motivation for hearing testimony was that committee members wanted to learn about the issue in case the legislation was attached to another bill late in the legislative session.

The first person to testify on the bill was Paul Harrington, executive vice president of the Vermont Medical Society, who said the doctors' group has opposed the legislation since first taking a position on it in 2003.

Harrington said the doctors' main objection was based on a belief that the government shouldn't intervene in an often difficult and intimate series of conversations between doctor and patient about the patient's approaching death.

"It's so much at the heart of the physician-patient relationship," Harrington said. By injecting a series of requests and witnesses into a system of seeking lethal medication, Harrington said, "You'd be turning decisions made at the bedside into a highly bureaucratic process."

He also said doctors often prescribe drugs including morphine for dying patients that have the "dual effect" of lessening pain and sometimes hastening death. But he said medical ethics demands that the intent be alleviating suffering.

Sen. Diane Snelling, R-Chittenden, a sponsor of the bill, questioned whether a survey of its members that helped lead the Medical Society to its opposition was biased. "Might you have gotten a different response if you had used different language in your questions?" she asked.

Sears said in a later interview that what language to use has been a significant part of the debate. Opponents call it "physician-assisted suicide,' he said, while supporters speak of "death with dignity" or "end-of-life choices."