Rutland Herald
December 4, 2004

Assisted-suicide study encourages supporters

By John Zicconi, Vermont Press Bureau

MONTPELIER - The state Friday released a long-awaited study on physician-assisted suicide, spurring supporters to begin a new drive to get lawmakers to approve the practice in Vermont.

Legislative leaders last winter considered but rejected a measure to make Vermont the second state to legalize physician-assisted suicide. The full Legislature never actually debated the issue.

But right before lawmakers adjourned in May, about 100 of them asked Vermont's Legislative Council to compile a report that outlined the "factual disputes" related to both Oregon's so-called Death With Dignity law and Holland's euthanasia law.

The 43-page document catalogs areas of dispute in Oregon and the Netherlands, and tries to either support or knock down claims using study data and interviews with health-care experts.

The report, however, draws no conclusion about the merit of physician-assisted suicide.

"There will be bills pursuing this again," said William Russell, head of Vermont's legislative council. "The rational behind this report was as much as possible to clear away what (assisted suicide laws) do and don't do."

The new legislative session begins in January.

Supporters of bringing doctor-assisted suicide to Vermont quickly hailed the report as supporting their position. They dispute fears the Oregon's law pressures the elderly, depressed, disabled and uninsured to end their lives.

"There were a lot of fears and misconceptions about the law, and this report lays to rest many of them," said Dr. Diana Barnard, a Middlebury family-care physician and supporter of physician-assisted suicide. "Now we can have a legitimate debate."

Assisted-suicide opponents said they were confident the report would do nothing to curtail the substantial coalition that formed last year to oppose such a law.Opposition to the proposal crossed party lines and included respected health care organizations like the Vermont Medical Society, the Vermont State Nurses Association and the Coalition for Disability Rights.

"We are not afraid of the discussion," said Mary Hahn Beerworth, executive director of the Vermont Right to Life Committee, which also opposes physician-assisted suicide.

"The last two years have produced more opponents after discussion than before," she said. "Every time we have an opportunity to engage the subject there is less and less support."

Oregon voters in 1994 approved a referendum giving physicians the right to prescribe medication to end life for people suffering from a terminal disease.

The law went into affect in 1997 after withstanding several legal challenges.

According to the Vermont report, 255 Oregon residents have been given lethal prescriptions, but only 171 people - 67 percent - took the medication.

Holland legalized assisted suicide in 1984. Total deaths were not cited in the Vermont report, which indicated about 200 people per year die with assistance.

One Oregon survey said more than 20 percent of people who ask for lethal medication do not qualify under the law, and about 30 percent of the state's physicians will not prescribe lethal drugs.

The Vermont report concluded there were no known instances of Oregon physicians helping patients to end their life but not reporting it as required by law. Underreporting had been documented by studies in the Netherlands, the report said.

Opponents have expressed concern that patients might request a lethal prescription because of financial or family pressures. One study found that 11 percent of patients requesting a prescription cited a financial burden, while 6 percent said they lacked social support.

A study of hospice nurses and social works found that financial concerns or a lack of social support were "relatively unimportant" to patients who received a lethal prescription, the Vermont report said.Opponents are also concerned that people suffering from depression are more likely to request assisted suicide.

The Vermont study said 20 percent of all patients requesting suicide had symptoms of depression, but 11 percent changed their minds before receiving medication.

Oregon law requires a psychological evaluation when a doctor believes a patient suffers from a mental disorder to ensure the patient is competent to make an informed choice.

Researchers could not find studies that indicate why people with disabilities request physician-assisted suicide. But Ann Jackson, executive director of the Oregon Hospice Association, told Vermont researchers that assisted suicide is not disproportionately used by the poor, uneducated, uninsured or minorities.

About 97 percent of those requesting suicide are white, and there is no evidence to suggest that anyone is coerced into using it, the Vermont report said.

The most common reasons patients site for choosing assisted suicide are loss of independence, poor quality of life, a readiness to die and controlling the circumstances of their death.

Contact John Zicconi at john.zicconi@rutlandherald.com.