Burlington Free Press
July 22, 2004

Reader's Forum: Let's continue to study physician-assisted suicide
By Dick Walters

Dr. Bob Macauley, in his My Turn piece (Free Press, July 13) urges that advocates and opponents abandon their discussion of physician-assisted dying (PAD), and, instead, that all should work together toward the goals of improving existing options at the end of life.

He overlooks the fact that both proponents and opponents of PAD have been working on the attorney general's initiative to improve end-of-life care in Vermont.

This group was largely responsible for the bill on advance directives that passed in the last legislative session. The group continues to work to improve the protocols for advance directives, palliative care, pain management, etc.

On these issues, the attorney general held three recent public hearings around the state at which many supporters of Death with Dignity Vermont (DWDV) spoke strongly of the need for palliative and hospice care. Supporters recognize that, although few Vermonters each year would take full advantage of a law that legalizes PAD, many more will take comfort in knowing that they will have the option, should they need it.

Although the tone of Dr. Macauley's article appears to be neutral on the issue, he has been a principal speaker opposing DWDV at public forums. These forums were collegial, thoughtful, respectful meetings at which people were given an opportunity to discuss, learn and form their own opinions. In Oregon, the only state that has legalized Death with Dignity, the dialogue has advanced all aspects of end-of-life care. In Vermont, the recent dialogue has been most productive, whereas two years ago, before DWDV legislation was introduced, end-of-life issues were rarely discussed.

A small group of Vermonters formed DWDV to introduce the legislation. It is they, not the national groups, who continue to lead and direct the Vermont movement. They believe that we should have available the full range of end-of-life choices, including emotional and spiritual support, relief from pain, hospice care, and hastening death by self-administering a legal prescription.

The proposed DWDV legislation does not tell anyone patient or doctor what to do or not do. It simply gives terminally-ill, mentally competent adults the right to choose the timing and manner of their death. It specifically respects the right of those patients and physicians who choose not to utilize a DWD law, but we respectfully say that they don't have the right to determine the choice for others.

Before the Legislature adjourned this year, 78 representatives (a majority) requested the Legislative Council to research Oregon's six-year experience with its Death with Dignity Act in order to identify and resolve facts upon which Vermont advocates and opponents disagree.

The council will report its findings to the Legislature before the start of the next session, thereby clarifying the issues for the legislators. Interested parties have supplied information and references to aid the council in its study.

An old adage says, "Not to decide, is to decide." If we decide not to further discuss and take action on all of the end-of-life options that are available, then we are left with the status quo. Yet the majority of Vermonters have expressed an interest in PAD. We must respect that position and continue the dialogue; terminally-ill persons deserve to have end-of-life options available, should their quality of life become intolerable.

Continuing the dialogue will help to ensure that no physician will be put at risk for criminal prosecution by complying with a patient's request for lethal medication and that Vermonters would no longer feel the need to terminate their own lives months prematurely because they feared losing personal control over their own destiny as their terminal disease worsens.

Let's continue to talk about issues that all of us will face. A healthy, thoughtful discussion is not a waste of time and money, as Dr. Macauley implies, but an opportunity to bring health care issues to the fore and ultimately to improve the entire spectrum of health care options at the end of life.

Dick Walters is a resident of Shelburne and chairman of Death With Dignity Vermont Inc.