After a decade of debate, on Monday Vermont became the fourth U.S. state to legalize physician-assisted suicide.
The state's new "End of Life Choices" law allows doctors to prescribe lethal doses of medication to terminally ill patients who wish to end their lives. The law is effective immediately, but it’s now up to the Vermont Health Department to adopt regulations, which could take weeks.
Vermont Governor Peter Shumlin has voiced strong support for the law. In addressing opponents, he assured them, “This bill does not compel anyone to do anything that they don't choose in sound mind to do. All it does is give those who are facing terminal illness, are facing excruciating pain, a choice in a very carefully regulated way."
For the next three years, the law includes heightened safeguards: 1) The patient must express their desire to die three times, including once in writing; and 2) A second doctor must confirm that the patient is terminally ill and of sound mind. After July 2016, rules on doctor reporting and monitoring will become more lax. No doctor will be required to assist a patient in ending her life.
Opponents to the bill vow to appeal the decision. Some worry that the bill will lead to elder abuse and that decisions could be based on misdiagnoses. Edward Alonzo of Burlington says, "We need to be more of a caring, compassionate society, not one that says 'Take a pill, go away.'” He adds, “People don't have the best of intentions, always, with their family members.”
Barbara Combs Lee, president of Compassion & Choices, asserts the law is a measure of harm-reduction. She affirms that to keep the practice safe, it must be transparent and easy to understand: "If you keep it undercover in the shadows ... that's when we worry an unregulated and underground practice that you can't regulate at all."
Physician-assisted suicide first gained media attention in the 1990s when Dr. Jack Kevorkian was charged with second-degree murder for the deaths of over 130 patients. Dr. Kevorkian, a.k.a. “Dr. Death," provided his terminally ill patients who wished to end their suffering with a myriad of assisted-suicide measures. He stood trial numerous times and spent eight years in prison.
In 1997 Oregon was the first U.S. state to legalize physician-assisted suicide, and that law serves as the model for Vermont’s. Washington and Montana followed suit in 2008. Most recently, Massachusetts voters defeated the measure 51-49% on the November 2012 ballot. Connecticut and New Jersey have also debated the issue. Proponents of physician-assisted suicide hope the passage in Vermont will inspire its implementation in other states.
Physicians do not expect many patients to exercise their new right. Based on the numbers in already-legalized states, Vermont Health Commissioner Dr. Harry Chen predicts doctors may only write between 10 and 20 lethal prescriptions each year. He says, “It’s used by a very small number, but it brings comfort to a much greater number knowing it’s there.”