Compassion & Choices and Patient Choices Vermont praised a federal judge’s ruling to dismiss a lawsuit brought by religious groups seeking to undermine Vermont’s Patient Choice at End of Life Act (Act 39).
The law gives mentally capable, terminally ill adult residents of Vermont the option to get a doctor’s prescription for medication that they can decide to ingest to end their suffering and die peacefully in their sleep.
The Vermont Alliance for Ethical Healthcare and Tennessee-based Christian Medical and Dental Association filed the suit in July against the State of Vermont. The groups claimed Patient's Bill of Rights for Palliative Care and Pain Management violated their religious rights by requiring doctors to discuss all end-of-life care options with their patients.
In December, U.S. District Court Judge Geoffrey W. Crawford granted a motion by Compassion & Choices, Patient Choices Vermont and two terminally ill Vermonters, Monica van de Ven and Benedict Underhill, to intervene in the case, allowing them to become a party to the lawsuit. David Bassett, Samantak Ghosh, Nina Garcia, and Stephanie Neely of WilmerHale, and Ron Shems of Diamond & Robinson, were co-counsel on behalf of intervenors.
In January, van de Ven died peacefully after taking a doctor’s prescription for aid-in-dying medication. Late yesterday, Judge Crawford dismissed the case. His ruling concluded that two Vermont laws, the Patient's Bill of Rights for Palliative Care and Pain Management] and Limitation of Medical Malpractice Action Based on Lack of Informed Consent, “continue to govern physicians in all aspects of their care of the terminally ill. Under these provisions, physicians must inform patients about all choices and options relevant to their medical treatment.” [See page 8 of opinion posted here].
“I am only sorry Monica van de Ven is not with us to celebrate this victory that her courageous advocacy made possible,” said Linda Waite-Simpson, Vermont state director for Compassion & Choices. “Her peaceful death illustrates the importance of ensuring physicians respect the law and hold patient's wishes as a paramount goal.”
“This federal ruling is important because it underscores the importance of putting complete information in the hands of patients so they can make informed decisions consistent with their values,” said Kevin Díaz, national director of legal advocacy for Compassion & Choices.“
“Justice has prevailed in this case for terminally ill Vermonters like Benedict Underhill,” said Betsy Walkerman, President of Patient Choices Vermont. “This ruling reinforces the professional obligation of doctors to have full and open discussions, respond substantively to all questions, and enable patients to make fully informed decisions.”
Dear Members of the Maine Health and Human Services Committee:
I am pleased to submit this testimony on behalf of Patient Choices Vermont (PCV), the non-profit organization that successfully lobbied for the passage of Vermont's Patient Choice at End-of-Life law (Act 39) in 2013. Similar to the Oregon statute, Vermont's law established a private, voluntary way for terminally ill patients who are fully able to make their own decisions to secure medication they can use to control the timing of their imminent passing. I see that the two bills currently before your committee are very similar to Vermont's law.
The text of Vermont's law is at
The Vermont law is working well and is being implemented carefully, without any hints of coercion, abuse or haste. The safeguards in the legislation, requiring approval by two doctors regarding the mental capacity of the patient and certifying that the patient has a life expectancy of six months or fewer are functioning well. None of the fears expressed by the disability community at the Vermont legislative hearings that disabled people would be coerced into early death have come to pass.
Vermonters are overwhelmingly grateful for the passage of this Jaw. PCV consistently receives notes of gratitude from people who are facing terminal conditions and want to live their remaining days to the fullest extent possible.
To date, there have been 47 prescriptions written. The number of prescriptions is tracked by the Vermont Department of Health. Data is not available on the number of people who actually used the medication, as this is a private matter.
The Vermont Department of Health website provides guidance and forms to be used in connection with our End-of-Life Choice law. To my knowledge, this has not been a complicated or expensive process. In fact, when Maine adopts a similar law, the Vermont Health Department website would provide a good starting point for the information and forms you will need. Please see:
I trust that you have been discussing your proposed legislation with your constituents. In Vermont, surveys consistently found that 75-78% were in favor of the proposed legislation, and this was reflected by the great volumes of phone calls, letters and emails that our supporters sent to their state representatives. The most recent national survey, conducted by the faith-based non-profit Lifeway reported that 67% agree that "When a person is facing a painful terminal disease, it is morally acceptable to ask for a physician's aid in taking his or her own life." They went on to report:
"Among faith groups, more than half of all Christians (59 percent), Catholics (70 percent), Protestants (53 percent), Nones (84 percent) and those of other religions (70 percent) agree. Most of those who attend religious services less than once a month (76 percent) also agree." http://lifewayresearch.com/2016/12/06/most-americans-say-assisted-suicide-is-morally-acceptable/
So, although you may hear strong objections from representatives of various church groups, I urge you not to take their statements as representative of a majority of their members.
I would, without reservation, call end-of-life choice a life-giving option. In this, I speak from personal experience. My father, Dick Walters, who was the co-founder of PCV in 2002, declined very rapidly from lung cancer in 2015. His remaining life was a matter of months, in which be was increasingly unable to move without gasping for breath. Palliative treatments would have required hospital procedures three times a week to drain fluids and prescriptions for opioids that would have left him unable to think straight or communicate well. My dad was a vibrant, fun-loving person who considered life without meaningful communication no life at all. He had worked persistently for 13 years for the adoption of Vermont's End-of-Life Choice law and in October 2015, he went through the procedures to obtain his medication and set a date to end his life. In the week before he died, dozens of people called and visited for their last talks with Dick, many coming for his special brand of advice. Toward the end, he told me that he had had the most meaningful conversations of his life in that last week. He didn't want to leave, but he couldn't stay. It was a beautiful time for intentional connections, made possible because he had his medication and could minimize pain medication in the last week.
Act 39 has positively impacted patient choices and quality of care across the entire end-of-life spectrum. While few people may choose this option, just having the choice puts more emphasis on patient quality of life and decision-making. Although medical professionals in general seek to do their best to educate and listen to patients, there is a different kind of engagement now that patients have a choice besides medical procedures and extended suffering.
Most of the arguments against end-of-life choice are based on two arguments: The first is the idea that medical treatment can solve all pain and care issues. I am sure that you will hear from many family members and medical professionals who will tell you that this simply isn't the case. The second argument is that an end-of-life choice law is the first step on a slippery slope toward authorizing euthanasia. This is a thinly veiled attempt by a small number of people to dictate their moral or religious beliefs to everyone.
There is a reason that thousands of Vermonters signed onto PCV's work to adopt Act 39 and why so many continue to support our work to educate the public and implement the law. People in Maine have a similar strong independent streak, and l sincerely hope that you will positively consider this legislation.
I would be happy to provide further information or discuss any aspect of this topic. Our board includes medical doctors, lawyers and several people who have had personal experience with medical aid in dying. Please feel free to be in touch if we can be of assistance.
Betsy J. Walkerman, Esq.