Monday May 6, 2013

MIKE FAHER

Brattleboro Reformer

BRATTLEBORO -- It’s called "an act relating to patient choice and control at end of life."

But the controversial bill that follows -- allowing doctors to prescribe lethal doses of medication to terminally ill patients -- has split local representatives who argued passionately for and against it even after an affirmative vote Wednesday in the state House.

A key question is whether the state is promoting suicide, and, if so, what younger people who are not terminally ill may make of that.

"I’m dreadfully fearful of the message that we’re giving to adolescents," said state Rep. Mike Hebert, R-Vernon. "We as a state are saying, ‘Suicide is a solution.’"

But Rep. Mike Mrowicki, D-Putney, supported the bill and contends it "isn’t that simple or black and white."

"As someone who has worked with youth for decades and raised my own kids, I know that when kids have good connections with adults, they can understand life is complex with complex issues," Mrowicki said. "This is how we help them become productive adults who can tell the difference between a teen impetuously entertaining suicidal ideation as much different than an elder with a terminal disease who seeks a dignified end to their suffering."

When initially proposed in the state Senate, the bill had been modeled on Oregon’s "Death With Dignity Act" and had included provisions designed as safeguards.


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For example, patients had to be deemed mentally competent and had to request lethal doses of medication three times, including once in writing.

But by the time the Senate approved the legislation in February, the bill was stripped of most of that language and took a "hands-off" approach that simply said doctors who write such prescriptions could not be held liable.

Rep. Dick Marek, D-Newfane, believes that approach "would have been largely ineffective." The version of the bill approved Wednesday by the House is "essentially similar to the original Senate version" and restores many safeguards, Marek said Friday.

"This creates a process that, I think, protects against possible abuses" while also preserving patient choice, Marek said. The House vote was 81-64 to approve the bill. Windham County’s representatives voted 10-2 in favor of the legislation, with Hebert and Rep. John Moran, D-Wardsboro, casting votes against it.

"The House was divided. It had nothing to do with partisanship," Hebert said. "It’s a very personal thing based on what you have seen in your own life."

Hebert cites his faith as one reason he opposed the bill. He also recalls his own mother, whom he said lived 13 years "of very high-quality life" after she had been diagnosed as terminally ill.

There are similarly personal stories on the other side of the issue, however.

"Passage of this bill in the House this week was helped greatly by the compelling testimony of Brattleboro’s Ben Underhill. His long fight with multiple myeloma continues as he fights to both survive and thrive," Mrowicki said.

"His courage in the face of his battle with multiple myeloma is admirable and puts a face on those who continue their fight with life-threatening disease and, at the same time, want the option of patient choice should the time come that it would be appropriate," Mrowicki added.

Rep. Mollie Burke, a Brattleboro Progressive Democrat, compared the end-of-life debate to the equally emotional debate over abortion rights.

"I really felt that it’s a choice, just like a woman’s right to choose whether to terminate a pregnancy," Burke said. "And I felt that I shouldn’t get in the way of that choice."

Rep. Matt Trieber, D-Rockingham, said he was most concerned that the bill ensured that terminally ill patients "are aware of what all of their treatment options are."

He added that similar laws in Oregon and Washington have not encouraged large numbers of patients to seek life-ending medication.

"A lot of the fears that people have just haven’t taken place," Trieber said. 

It remains unclear, though, what shape Vermont’s law may take. The House-approved version now goes back to the Senate, and lawmakers will try to reconcile two very different bills.

Sen. Peter Galbraith, a Windham County Democrat who had advocated successfully for the Senate’s stripped-down version, said he hopes that language ultimately will prevail.

"I’d prefer that this stay within the doctor-patient relationship," Galbraith said. "I think we over-legislate. These are essentially private issues."