An End to the Suffering

By Malcolm F. Severance, PhD, Livin' the Vermont Way Magazine, Jan. 1, 2006

Vermonters respect the values of compassion, self-determination and personal freedom. We all want to be in control of our lives. So it is no surprise that a recent poll by Zogby International showed that 78% of Vermonters want greater control over how we die, and support proposed legislation (HB 168) called the Vermont Death With Dignity Act. This strong majority supports giving mentally competent, terminally ill Vermonters, with less than six months to live, the option to seek medication to end their suffering, should it become intolerable. This support comes from all corners of the state, regardless of age, education, religion or party affiliation. It comes from a strong majority of Vermonters who self-identify as Republicans, Independents, liberals, conservatives, Catholics, Jews, and Protestants.

The Vermont Death With Dignity Act begins with the presumption that as individuals we decide how we live and how we die. It is not a decision for hospital administrators to make for us — and certainly not for any government to decide. How many of us have had a family member or friend whose final days were spent without the comfort, compassion, control and respect we all want and deserve at the end of life?

The Vermont legislation is modeled on a law that's been in effect in Oregon for eight years. At the request of seventy legislators, including proponents and opponents alike, a thorough study was performed on the Oregon experience by the Vermont legislature's nonpartisan legal advisor. Their report demonstrates there is no evidence of problems with the Oregon law and lays to rest the fear-based claims and innuendo of those who oppose this legislation.

In Oregon only the patient can initiate a request for medication: neither doctors nor family members can do so. Also, the law is replete with safeguards: for example, the patient's doctor — and a second, consulting physician — must agree that the patient is competent, within six months of death, and under no external pressure to request the medication. If either physician believes the patient suffers from a psychological condition or depression, the patient must be referred for counseling before medication can be prescribed.

The Death With Dignity Act also mandates that every patient be informed of all feasible alternatives, including the best options for pain management and hospice care. The patient is in control at every step and remains under no obligation to take the medication even after it has been prescribed. Finally, the patient must be physically able to take the medication unassisted — it cannot be administered by anyone else.

Those who would deny Vermonters this dignity of choice and control refuse to look into the hollow eyes of a dying person and say they will deny them the right to decide when to end their suffering on their own terms. This small minority of opponents is entitled to their own beliefs, yet their apparent goal is to impose their own personal and religious views on the rest of us.

Vermonters deserve better. We deserve the Vermont Death With Dignity Act. Here is a brief summary of the legislation and its safeguards.

• The patient's doctor must determine that the patient is competent, within six months of death, and under no external pressure to request the medication.
• A second, consulting physician must verify the patient's diagnosis, prognosis and competency, and must attest that the patient is acting voluntarily and not being coerced.
• If either physician believes the patient suffers from a psychological condition or depression, the patient must be referred for counseling before medication can be prescribed.
• The patient must be informed of all feasible alternatives including pain control and hospice care.
• Only the patient can initiate a request for medication under the law — neither doctors, family members, trustees, or anyone else can initiate a request.
• In order to receive a prescription for medication, a patient must make a verbal request and a written request, and then reiterate the verbal request after a fifteen day waiting period.
• The witnesses must attest that the patient is of sound mind, acting voluntarily and is not being coerced.
• The patient must be physically able to take the medication unassisted – it cannot be administered by anyone else.
• The patient may rescind the request at any time and in any manner, and remains under no obligation to take the medication even after it had been prescribed.

The Oregon experience continues to disprove all the conjectural and speculative arguments against Death With Dignity. Pain management, hospice care, and palliative care are better in Oregon than in most other places in the United States, and actually have improved significantly since Death With Dignity was enacted there eight years ago. Although few individuals use the medication in Oregon, many thousands gain peace of mind from knowing that the option is available should their suffering become intolerable. Dying Oregonians retain the dignity of making their own choices. Knowing they are in control, they are able to focus on enjoying and living their lives, rather than being tortured by the specter of an unbearable death.

This Act will provide an important freedom and will not force anyone down a particular path. As proven by Oregon's experience under the Death With Dignity Act, the process is patient initiated, patient driven, and patient implemented. Doctors should listen to their patients and lawmakers should respect the will of the people. The Death With Dignity Act will bring peace of mind to thousands of Vermonters who will find great comfort in knowing that they have an option to retain control over their final days.

I hope that all our lawmakers will recognize that nearly four out of five Vermonters support Death With Dignity legislation and will keep an open mind on this important bill. I hope my colleagues in the legislature will give Vermonters the option, should we ever become terminally ill, to have the freedom to make our own choices about leaving life in peace and with dignity.

__________________________________________

Malcolm F. Severance, PhD is Professor Emeritus and Trustee at the University of Vermont and a Republican state representative. He can be reached at severance@bsad.uvm.edu.

For more information about HB 168, visit www.deathwithdignityvermont.org.

Email this page to a friend Share on Facebook Share on StumbleUpon Print this page