Patient Choices Vermont surveys candidates for statewide and legislative positions.
We have also posted the guide in Scribd below. If it appears too small to read, scroll to the bottom and click on the Fullscreen icon (right side), then scroll to find the candidates from your district.
We have data for many, but not all candidates. If they didn't respond to our online survey and have no voting record on this issue, the line is left blank. If you know a candidate who hasn't responded, please ask them about their position and suggest that they contact PCV so that we can add their data to the table below.
Please note that in our survey "OPPOSE" answers are from candidates who would vote to keep Act 39 in place, whereas "Support" answers are from candidates who would vote for restrictions or repeal.
On Tuesday, October 9, 2018 delegates of the American Academy of Family Physicians (AAFP) approved a substitute resolution to adopt a position of "engaged neutrality" toward medical aid in dying as a personal end-of-life decision in the context of the physician-patient relationship.
AAFP President Michael Munger, M.D., of Overland Park, Kansas says, "The action taken today allows the AAFP to advocate for engaged neutrality on this subject at future AMA House of Delegates meetings. Through our ongoing and continuous relationship with our patients, family physicians are well-positioned to counsel patients on end-of-life care, and we are engaged in creating change in the best interest of our patients."
This stance puts them at odds with the American Medical Association (AMA) Code of Ethics which states: “Instead of engaging in assisted suicide, physicians must aggressively respond to the needs of patients at the end of life.”
The substitute resolution also calls on the AAFP to reject use of the phrase "assisted suicide" or "physician-assisted suicide" in its own formal communications and to direct the Academy's delegation to the AMA to promote the same action in the House of Delegates.
"We have to understand the power of family physicians," he said. "We have an ethical, personal role in our patients' lives. We can't be opposed to something that some people think is valuable. I think we have to have a more neutral stake in this difficult area. We have to understand the power of family physicians," says Arnold Pallay, M.D., AAFP delegate from Montville, New Jersey.
The Vermont Medical Society (VMS) has already adopted a neutral position on medical aid in dying, in recognition that it is legal in Vermont and that many Vermont doctors and their patients have already participated in the Act 39 process. The VMS policy may be found at http://www.vtmd.org/sites/default/files/2017End-of-Life-Care.pdf.
We understand that Vermont doctors participated in the AAFP meeting and urged adoption of the new policy.
“As prominent national organizations like AAFP recognize the legitimate and very personal nature of a decision to use medical aid in dying, we will increasingly solidify end-of-life choice and the comfort it provides, “ says Betsy Walkerman, President of Patient Choices Vermont. “We are pleased that Vermont’s careful and measured approach to medical aid in dying is contributing positively to changes like this on the national level.”
Vermonters reflect on five-year anniversary of the state's Medical Aid in Dying law.
Tom Ozahowski, is shown walking on a wooded trail near his Thetford home. He made his career at Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire where he worked with patients who often stared death in the face.
"People have cardiac arrests and have near death experiences that, it's not everybody, but some of them have had profound situations that have helped me," he said those situations have helped him find peace with his fate.
"I was diagnosed in 2008," Ozahowski said regarding his prostate cancer, which has spread to his bones. "I have no idea exactly whats in store."h
The one thing he does know is how he plans on dying.
"My sons are totally in agreement that I can use Medical Aid in Dying and get a prescription to be self-administered," he said.
Dr. Diana Barnard, with the University of Vermont Medical Center, would like to see more Dartmouth-Hitchcock doctors on board.
The palliative care specialist said most of her patients worry about losing their sense of control, something many wish to gain using Act 39.
"Most people that I talk to don't want to die. They want to live, but they are dying from their underlying illness and we cant stop that," Board Member Dr. Diana Barnard said.
In the past five years, the state's Department of Health said 52 people have qualified to utilize the law, but only 29 people have chosen to end their lives.
"The law itself was really carefully crafted and is working very well," said PCV President Betsy Walkerman, also featured in the story.
Click to Watch the Story...
A Finished Heart by Eliot Cherry
PCV sponsored the presentation of an intimate one-act theater production as part of the recognition of the five-year anniversary of Vermont’s End of Life Choice Law (Act 39). We brought author, composer, and actor, Eliott Cherry here from Oregon to present his deeply personal story of love, life, and dying.
The three, hour-long performance, staged from May 17-19, 2018 brought audience members in touch with the universal experience of dying, amid humor and loving conversations at the Unitarian Universalist Congregation in Norwich, at the Shelburne Town Hall, and at Chandler Center for the Arts in Randolph.
Eliott's performances prompted conversations about care giving, personal choices, and fundamental human connections. Each performance was followed by a discussion session, and PCV provided information about Vermont’s End of Life Choice Law (Act 39).
Dr. Diana Barnard appearing before the New York State Legislature's hearings on medical aid in dying.
In recognition of Legislators and Act 39 Supporters PCV hosted a reception at the Statehouse in Montpelier on May 16, the 5th Anniversary of the enactment of Vermont's End of Life Choice Law.
Five years ago, Vermont made history as the first state to adopt an end- of-life choice law through legislative action after more than a decade of research and debate. On May 16, 2018 the public was invited to the Statehouse in Montpelier to hear Lt. Governor David Zuckerman and other legislators and families with Act 39 experience speak in recognition of this important anniversary. Vermonters regularly express their gratitude for Vermont's Act 39, which provides mentally competent adults who face an impending death from terminal illness with the freedom to choose medical aid in dying.
This reception provided an opportunity for families and friends who have had experiences with Act 39 to express their gratitude and tell their stories to the legislative and community leaders who made medical aid in dying possible in Vermont.
A few weeks ago, just by chance, one of the doctors on the Patient Choices Vermont (PCV) Board of Directors discovered that the sole pharmacy in Vermont that had previously been filling prescriptions for medical aid in dying under Act 39, was directed by their new corporate owner to stop providing this service.
So, you may ask, why did they receive this directive?
The new corporate owner of the Marbleworks Pharmacy in Middlebury was just being cautious. Since laws like Act 39 are available only in a handful of states, they needed to understand the law. PCV contacted the corporate executives at the top level, and we were able to provide the information they needed. As a result, Marbleworks is now once again supplying the drug that has been the most used under Act 39.
I realized during these communications that no other organization or state agency had the responsibility or would have taken the initiative to reverse this situation. Patient Choices Vermont is the one organization that is making sure that Vermonters have practical access to medical aid in dying. We are proud and relieved to have averted what could have been a crisis for patients.
You may have heard that the drug that has been primarily used for medical aid in dying is very expensive. That's true. The Seconal prescription costs $3,700. This is because there is only one supplier worldwide and the demand is low, so there is no incentive for competitors to enter the market to help bring the price down. The good news is that a new drug formula, called DDMP2, has now been used extensively for medical aid in dying in California, which has a law similar to Act 39 and far more patients than we have in Vermont. DDMP2 costs $700. This drug requires a compounding pharmacy to dispense it, so we located a pharmacy in Vermont that will do so - the Rutland Pharmacy.
PCV has launched an intensive effort to increase the number of pharmacies who are able to fill prescriptions for both of these medications. We are calling both regular and compounding pharmacies, educating pharmacists about Act 39, and working to establish more locations that will be prepared to supply both drugs.
If you or a friend are discussing medical aid in dying with a doctor, we would highly recommend that you ask the doctor to call us. We can put doctors in touch with experienced medical colleagues who can discuss clinical matters, dosages, instructions and what pharmacies to use. This is a relatively new part of medical practice, so it is important for doctors to check up on the most current information, even if they have prescribed before.
We really appreciate your interest in being part of the communication network on these issues. To be sure, medical aid in dying is just one option in a spectrum of choices that any given person might make toward the end of life. It's important, from PCV's perspective, that all Vermonters have the opportunity to learn about their medical options and their care options, and to choose what will be most self-affirming for them.
Vermont Edition's reporter Jane Lindholm and producer Matthew F. Smith say, "It's been four years since Vermont started allowing terminally ill patients to seek the help of a doctor to end their own lives. We're looking at how patient choice at the end of life is working in our state, and how Vermonters have used the program since it began in 2013.
Betsy Walkerman, president of Patients Choice Vermont, joins the program to discuss how Act 39 has been utilized in Vermont, and what she hears from people choosing this method of end-of-life care. And Ed Paquin with the Vermont Coalition on Disability Rights shares his concerns about the law, especially as it pertains to perceptions of people with disabilities.
Also joining the program is Dr. Robert Tortolani, a retired physician and a former president of the Vermont Medical Society, to discuss how physicians talk to their patients about this issue, and why the society dropped its formal opposition to the law in November.
We'll also hear from Vermont performer Rob Mermin, who shares his story of helping his friend Bill Morancy hasten the end of his life in 2015.
Click to listen to the full one-hour broadcast...
Patient Advocacy Groups Welcome Federal Court Ruling Clarifying that Consent Agreement About Doctor-Patient Conversations “Does Not Represent” Court’s Views
Groups Emphasize Vermont Law Still Requires Doctors to Inform Patients of All End-of-Life Options, Including Medical Aid in Dying
Two patient advocacy groups today welcomed a federal judge’s ruling that the Vermont Attorney General’s consent agreement with physician plaintiffs “does not represent” the court’s views in a dismissed lawsuit that sought to weaken the doctors’ duty to inform patients about all of their end-of-life care options.
The two organizations, Compassion & Choices and Patient Choices Vermont, emphasized that this ruling leaves intact a doctor’s duty to obtain informed consent from patients by providing all their end-of-life medical options.
The groups intervened in the suit and filed the motion to strike the consent agreement from the court record because it caused confusion about physician obligations to patients under Vermont law, including the 2013 Patient Choice at End of Life Act (Act 39). The law gives mentally capable, terminally ill adults in Vermont the option to receive a doctor’s prescription for medication they can decide to take to end unbearable suffering and die peacefully in their sleep. The plaintiffs’ misrepresentation of the court’s dismissal of the case only worsened this confusion.
In his Dec. 18 ruling, U.S. District Court Judge Geoffrey W. Crawford concluded:
“The agreement does not represent the views of the court on the merits of the parties' dispute … The consent agreement is a purely private agreement-not a judicial ruling-and not subject to review on appeal. But it is far from inconsequential and maintaining it on the court's docket has value in informing the public of the terms of the settlement struck by the parties.”
“Judge Crawford’s original ruling dismissed the plaintiffs’ case for lack of standing, but then the plaintiffs and the Vermont Attorney General’s office entered into a private consent agreement that contradicted the plain language of Vermont law,” said David Bassett, of WilmerHale, co-counsel on behalf of Compassion & Choices, Patient Choices Vermont and two Vermont patients, Benedict Underhill and Monica van de Ven (who died peacefully in January by utilizing Vermont’s Patient Choice at End of Life Act). “Absent the clarification we obtained this week, physicians could have mistakenly believed it was acceptable for patients to make critical medical decisions without being informed of what their real care options are at the end of life.”
“The plaintiffs have wrongly claimed victory in a case they lost, so we are happy that the court has set the record straight,” said Kevin Díaz, national director of legal advocacy for Compassion & Choices. “We still believe the agreement the state reached with the plaintiffs was unnecessary. We will be watching carefully to ensure that physicians fulfill their duty to fully inform terminally ill patients about all their end-of-life care options and the Attorney General’s office enforces the law.”
“The Vermont legislature was very clear in Act 39 and in our Patient’s Bill of Rights for Palliative Care and Pain Management that patients are required to be informed of all available options near the end of life,” said Betsy Walkerman, President of Patient Choices Vermont. “The plaintiffs in this lawsuit sought to muddy the waters and confuse medical professionals about their obligations.”
Last April, Judge Crawford dismissed the suit filed in July 2016 against the state of Vermont by Alliance Defending Freedom on behalf of the plaintiffs, Vermont Alliance for Ethical Healthcare and Tennessee-based Christian Medical and Dental Association. The groups claimed Vermont’s 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. Judge Crawford’s ruling concluded the Patient's Bill of Rights for Palliative Care and Pain Management and another Vermont law, 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.”
The plaintiffs then negotiated a consent agreement with the Vermont Attorney General without consulting Compassion & Choices and Patient Choices Vermont. The plaintiffs filed the consent agreement with the court on May 5, the day of the appeal deadline, without notifying the Attorney General, Compassion & Choices and Patient Choices Vermont.
David Bassett, Samantak Ghosh, Nina Garcia, and Stephanie Neely of WilmerHale, Ron Shems of Diamond & Robinson, and Kevin Díaz are co-counsel on behalf of Compassion & Choices, Patient Choices Vermont and two Vermont patients, Benedict Underhill and Monica van de Ven (who died peacefully in January by utilizing Vermont’s Patient Choice at End of Life Act)
Groups File Motion to Strike Agreement that May Limit Doctor-Patient Conversations about End-of-Life Care
Lawsuit Consent Agreement Causes Confusion about Physician Obligations to Patients
Compassion & Choices and Patient Choices Vermont today filed a motion to strike from the court record the state’s Consent Agreement with physician plaintiffs in a dismissed federal lawsuit seeking to limit information provided to patients under Vermont law. The case sought to weaken the physicians’ duty to inform patients about all of their end-of-life care options. The groups oppose the Consent Agreement because it causes confusion about physician obligations to patients under Vermont law.
“Act 39 enables people near the end of life to intentionally live their remaining weeks or months knowing that they have the means for a simple and peaceful ending. Our goal is to make sure that all Vermonters know about this option and can make fully informed decisions about their end-of-life choices,” said Betsy Walkerman, president of Patient Choices Vermont. “That’s why it is critical that the court clarify the record and remove the Consent Agreement.”
“The Consent Agreement appeared to suggest legal and professional obligations that apply to medical providers to counsel or refer patients when they ask about medical options at the end of life somehow didn’t apply to plaintiffs,” said Kevin Díaz, national director of legal advocacy for Compassion & Choices. “The court should strike this agreement because it impacts the rights of patients by attempting to establish an unreasonably restrictive interpretation of Vermont law that directly contradicts the plain language of the statute and the court’s order.”
Last April, U.S. District Court Judge Geoffrey W. Crawford dismissed the suit filed in July 2016 against the state of Vermont by Alliance Defending Freedom on behalf of the plaintiffs, Vermont Alliance for Ethical Healthcare and Tennessee-based Christian Medical and Dental Association. The groups claimed Vermont’s 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. Judge Crawford’s ruling concluded the Patient's Bill of Rights for Palliative Care and Pain Management and another Vermont law, 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 here].
The plaintiffs then negotiated a Consent Agreement with the Vermont attorney general without consulting parties to the lawsuit, including Compassion & Choices and Patient Choices Vermont. The plaintiffs filed the Consent Agreement with the court on May 5, the day of the appeal deadline, without notifying the attorney general, Compassion & Choices or Patient Choices Vermont.
The Consent Agreement and Stipulation states:
“In accordance with the Consent Agreement, the State has included a revised question and answer for “Are doctors required to tell patients about this medical aid in dying?” on the “frequently asked questions” section of the Vermont Department of Health’s website about Act 39 … Nothing in the Consent Agreement gives up any legal rights of patients [but] The State will not oppose a motion to strike the Consent Agreement from the district court’s docket … ”
“By stipulating that ‘medical providers do not have a legal or professional obligation to counsel and refer patients for the Patient Choice at End of Life process,’ the stipulating parties are causing confusion about the rights of patients to such counseling and referral,” said David Bassett of WilmerHale, co-counsel on behalf of Compassion & Choices, Patient Choices Vermont and two Vermont patients, Benedict Underhill and Monica van de Ven (who died peacefully in January by utilizing Vermont’s Patient Choice at End of Life Act). “By limiting Act 39’s informed consent obligation — a critical aspect of the law — the Consent Agreement not only interferes with the prerogatives of Vermont courts and the legislature, but also impedes the successful implementation of the law,” concluded Bassett.