Burlington Free Press
June 2, 2004

Dialogue on death

cc22.8,84,48,(T);The importance of Vermont's debate over physician-assisted suicide was reinforced last week with a federal appeals court decision that such matters should rest with the states.

In a sharp rebuke to U.S. Attorney General John Ashcroft, the U.S. Court of Appeals for the Ninth Circuit said that federal officials overstepped their authority by trying to block Oregon's Death With Dignity Act.

The Oregon law permits terminally ill patients expected to die within six months to receive prescriptions from their doctors for lethal drugs. In dismissing Ashcroft's attempt to use federal anti-drug laws to gut the Oregon statute, the appeals court said that physician-assisted suicide involved "general medical practices historically entrusted to state lawmakers."

Some Vermonters have cited the Oregon law as a model for Vermont. Since its approval in 1994, more than 170 Oregonians have used their law, including 42 last year.

The appeals court ruling suggests that Vermont has the legal right to pass a physician-assisted suicide law. That means the issue could become even more controversial in the fall elections.

Physician-assisted suicide was subject to vigorous statewide debate last year. The issue was discussed in the 2004 Legislature, but no bill made it out of committee. In May, 78 House members asked the Legislature's research office to analyze the Oregon law, and advocates plan to reintroduce legislation on the subject.

Debate over physician-assisted suicide shouldn't obscure the fact that Vermont could do much more to ease the suffering of people nearing the end of life.

Testimony during the 2004 session showed that Vermont has done a poor job giving terminal patients more control over critical care decisions. Called advanced directives, these plans include a durable power of attorney for health care that permits patients to designate someone to act as their agent in medical matters should they become incapacitated. Advanced directives also can cover such health-care instructions as do-not-resuscitate orders and pain management.

In response, the Legislature agreed to support an effort by Attorney General William Sorrell to draft a comprehensive end-of-life policy for Vermont. In addition to advanced directives, the attorney general would seek better training for health-care professionals in pain management and develop state standards for treating pain. The Legislature asked Sorrell to finish his report by Nov. 15.

The 2004 Legislature also expanded the patients' bill of rights to require that nursing homes inform residents about hospice care.

Vermont needs to continue the dialogue over physician-assisted suicide, especially during the fall election campaign. There should be no argument that the state should do more to ensure that people have greater control over other facets of their final days.