Shelburne News
February 21, 2003

Death with dignity: an ethical and humane alternative
By Susan Davis

They sat with winter’s sunlight streaming in behind them, two friends who have been brought together through a common cause - death - not their own, although that certainly is not far removed from their consciousness - but rather the cause of Death with Dignity.

Dick Walters and Dr. Carmer Van Buren, both of Shelburne, have organized Death with Dignity Vermont, an offshoot of a national movement that is supported through legislation.

“We have created a political action arm to bring a five-year-old Oregon law to Vermont,” said Walters. “We are not trying to reinvent the wheel. We are highly focused, very active and full of energy. We are not soliciting ‘membership’ in a cause or organization, rather we are taking a different approach - taking our concept directly to the Legislature and building from there out,” he added.

The registered 501-C4 political action group began by contacting a number of Vermont legislators and found support. House representatives Marcolm Severance, a 78 year-old former University of Vermont professor from Colchester and William Aswad (D-Burlington) who at 81 is the oldest member of the House, are expected to co-sponsor the bill in the Vermont House. Together they have been circulating their proposal among House members to garner support, which, if taken up, should ignite an emotional and fiery debate.

A companion bill in the Senate is expected to be introduced by Sen. Virginia Lyons (D-Chittenden), a resident of Williston.

In an earlier interview Lyons noted that her concerns are about the quality that comes at  the end of someone’s life. “Relieving pain and suffering for people who have terminal illness,” she said. Making her concerns personal, Lyons told about watching her mother-in-law die of lung cancer. “A lot of us have relatives who have been through this,” said Lyons. “It’s important for the dying to have control over their destiny and plan for the last part of their life.”

“At the heart of it, this is not a political issue,” said Van Buren, a retired primary care physician in Burlington. “We are looking for bipartisan support; support from independents and progressives as well.”

The draft bill written by Death with Dignity Vermont will allow a terminally ill, mentally competent person, with a life expectancy of less than six months, to request and receive a prescription from his/her physician to hasten his/her life in a humane and dignified manner. The prescription must be self-administered, either in private or in the presence of a family member, friends or a doctor.

“This is not a physician-assisted suicide,” said Dr. Van Buren. “It’s different. Physicians have for years had options in helping patients hasten their death. Physicians are now legally and ethically allowed to terminally sedate patients. The process allows them to sedate a dying patient in severe pain to the point where they are unconscious. That patient cannot take in water or food and ultimately dies,” said Van Buren. “That patient is unaware of their suffering until they die. As a physician, you know full well that you’re hastening the death of an individual. Which is more humane? What is the ethical difference?”

Major provisions of the proposed legislation were written to protect both the dying patient, their physician and family members. Those provisions are:

·      A written, witnessed request by the individual to their physician.

·      That request must be voluntary with no evidence of coercion.

·      A terminal diagnosis must be confirmed by two independent physicians, and if recommended by either of them, an evaluation of mental competency of the patient by a mental health professional.

·      A 15-day waiting period prior to receiving the requested prescription.

·      The request is revocable by the patient at any time.

·      The medication would be prescribed by the doctor and must be self-administered by the patient.

·      Participation by a doctor is purely voluntary.

·      There will be no criminal liability for a physician, family member or caring friend who is present at the administering of the prescription.

·      It will have no effect on the dying person’s life insurance/

·      The law would be monitored by the State Health Department.

What kind of support can Walters and Van Buren expect from Vermont physicians?

“As we began our research, we polled 1,606 practicing Vermont doctors,” said Walters. “We received an outstanding response - 16 percent - from 269 doctors and of that number 73 percent expressed support for the legislation. Over 100 physicians have said to use their name as we go about getting support,” said Walters.

In 1997, the state of Oregon passed a Death with Dignity law. Since that time only 91 terminally ill patients, less than 0.1 percent of total Oregon deaths during that period, have opted for a hastened death. The vast majority of those who did were in the last stages of cancer, and were receiving hospice care and died at home. And most of those patients who requested a prescription to die with dignity did not avail themselves of the law - rather they found comfort in knowing they had the option.

“Since the law was passed, Oregon has risen to be the number one state for hospice care, and the number one state for palliative care (alleviate pain without curing the cause) in the nation. We think that’s a direct result from Death with Dignity,” said Dr. Van Buren.

“The success, if you want to call it that, in Oregon and the fact that so few have utilized the law, lessens in our opinion, the ‘slippery slope’ that our opposition will decry,” noted Van Buren.

“What our legislation proposes is basically a Patient’s Bill of Rights,” said Walters. “It is not meant to replace palliative care but rather creates a whole continuum of care,” added Van Buren.

Thus far, there is no scheduled date when the legislation will be brought before either the House or the Senate but in the meantime, supporters of the bill continue to work hard to spread the word.

Will they be able to succeed in Vermont? “Well,” said Walters with a smile and a look of resolve, “I’ve never gone out to a sailboat race without the intention of crossing the finish line first.”

For more information about the Death with Dignity Vermont effort, log on to their website: www.deathwithdignityvermont.org or call 985-9473.