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Is New Federal Rule a Threat to Act 39--Vermont's medical-aid-in-dying law?

5/17/2019

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​Perhaps you came across the May 13, 2019 opinion piece in the New York Times entitled, "Can Doctors Refuse to Treat a Patient?" which goes on to answer its rhetorical question with, "The Trump administration says they may, if treatment would violate their religious views."

The Times article discusses a proposed new federal rule from the US Dept of Health and Human Services. We want to take this opportunity to confirm that…
 
The proposed new rule will change nothing here in Vermont regarding Act 39.
 
PCV watches for rules like this in case there is action that needs to be taken.

Background: Since the 1970's numerous laws have been adopted that enable medical professionals to decline to provide specific medical services including abortion and medical aid in dying. These laws were adopted under both Republican and Democratic administrations. The new proposed rule would give stronger enforcement capability to the Office of Civil Rights of the US Dept of Health and Human Services. In other words, medical professionals who have religious or moral objections to providing certain kinds of services will have a strong ally in the US government to help them avoid any consequences from refusing to provide services that conflict with their beliefs.

Act 39: Vermont’s Act 39 already makes it voluntary for physicians to prescribe medical aid in dying for patients. Therefore, the proposed new rule would have no impact.

Federal Laws Relevant to Act 39:
 
  1. Assisted Suicide Funding Restriction Act of 1997 This law says that federally funded health centers, of which we have several in Vermont, are not permitted to pay for services related to medical aid in dying. As a result, for example, patients of the Veterans Administration who want medical aid in dying would have to find and pay for a private doctor for this service. This has been the case since Act 39 was enacted. The new proposed rule changes nothing.
  2. The Affordable Care Act (ACA) includes a provision preventing institutions that receive federal funds from discriminating against employees who refuse to participate in medical aid in dying. Since Act 39 states that participation by medical personnel is voluntary, the ACA provision has no impact. The new proposed rule changes nothing.
 
Alarming Nevertheless: The proposed rule is focused on abortion, but it also relates to medical aid in dying and contraception. Certain definitions may be expanded to allow less coverage for women’s health by insurers and employers. The rule is alarming because it puts doctors’ beliefs ahead of patient needs with the result that patients have to be even more vigilant to make sure that they learn of all their options and are prepared to advocate for their health care needs.

A good in-depth analysis is provided by Health Affairs journalist Katie Keith in "Trump Administration Prioritizes Religious and Moral Exemptions for Health Care Workers."

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  • Home
  • News
  • About Act 39
    • Text of Act 39
    • Act 39 Overview
    • PCV Guides and Resources
    • S.74 Amendments - Summary >
      • Text of S.74
    • Residency Issue
  • Resources
    • Guide to Medical Aid in Dying and End-of-Life Decision-Making
    • How to Talk to Your Doctor About Act 39
    • Frequently Asked Questions
    • Guide to Medical Decision-Making
    • Guide to Advance Care Planning for Dementia
    • Book Reviews
  • VIDEOS
  • Events
  • About PCV
    • Overview
    • Leadership
    • Advisors
    • Founders
    • History
    • Tributes
  • Donate
  • Contact
  • Clinician's Guide