by Robert Maynard
On Wednesday March 14th from 9:00 AM until noon, the Senate Judiciary Committee held a hearing on S.103, a bill dealing with end of life issues and patient directed dying. The committee usually meets in room one of the Statehouse, but moved the hearing to room 11 to accommodate the interest in the issue. Despite the move to a bigger room, there was standing room only with some attendees spilling out in the hall. Most wore stickers either expressing support or opposition to the law. The majority of the stickers expressed an opposition.
The hearing was broken into three sessions.
The first session featured Ed Paquin, Director for the Vermont Coalition for Disability Rights. Since he was representing a coalition of 20 different groups, his testimony was allotted its own separate session. Mr. Paquin’s main point was that the issue here was not whether the individual patient has a right to take his/her own life, but whether members of the medical community had a right to assist in the bringing about the death of the patient. Paquin saw this as a step down a path fraught with unforeseen consequences as it represented a shift in focus on the part of medical professionals away from promoting health and enhancing life.
In expressing this concern, Paquin noted that what the profession once considered normal is now considered bizarre. A case in point was the general acceptance of euthanasia in the U.S. and Europe prior to WWII. We now consider this an unacceptable practice, but a large percentage of the medial profession once considered it acceptable. The argument being made here was that even medical professionals are human and not immune to getting caught up in such notions. He also brought into question the idea that the ending of life may be required to afford one dignity, and pointed out that those suffering with end of life issues have ways of realizing their dignity without taking their life. Equating the term “death” with the term “dignity” is sending the wrong message to those who are suffering with thoughts of suicide.
The second session was dedicated to testimony from supporters of the law. They included the lobbyist for Patient Choices Vermont, several doctors, an Episcopal Church minister and the nephew of former House Speaker Richard Mallary. The doctors included the Commissioner of the Department of Health and a representative of Oregon Compassion and Choice. A central theme, as expressed by Michael Sirotkin from Patient Choices Vermont, was that many of the objections to the bill were based on misinformation and fear. Some of the doctors testified to the struggles that their patients have with end of life issues and argued that such legislation was needed to relieve the suffering of such patients. They assured the Committee that the slippery slope argument about heading toward a “culture of death” was not a valid concern as they valued life.
The Department of Health Commissioner expressed the Shumlin Administration’s position that this was a civil rights issue related to individual choice. The representative from Oregon Compassion and Choice disputed the notion that Oregon represented the kind of slippery slope that opponents argued it did. For a summary of some of the conflicts between theory and practice surrounding the Oregon approach, this was prepared with input from the Vermont Alliance for Ethical Health Care. He also disputed the notion that allowing people to die with dignity was the same thing as suicide. The first was supposedly a rational and deliberative choice made by someone to end their suffering, while the second was a choice made as a result of depression.
This would appear to be an artificial distinction. The dictionary definition of suicide is “the action of killing oneself intentionally.” The definition does not make distinctions as to why the act was taken. It should be noted that Oregon Compassion and Choice is an advocacy group whose purpose is to promote the cause of allowing physicians to assist patients with dying.
The final group consisted of medical professionals from the Vermont Alliance for Health Care Ethics, who expressed concerns about the detrimental effect that this approach would have to the ethics of the health care profession. There also was one parent, Cathy Voyer, of a suicide victim who was concerned about the effect that this approach would have on the suicide rate. She noted that Vermont’s suicide rate was already well above the national average .
In addition, Voyer pointed out that Oregon’s suicide rate has experienced a significant increase corresponding to the passing of that state’s physician assisted suicide bill to the point where it was 35% above the national average as of 2010. ‘After decreasing in the 1990s, suicide rates have been increasing significantly since 2000, according to a new report, “Suicides in Oregon: Trends and Risk Factors,” from Oregon Public Health.’
The Oregon bill went into affect in 1998 and the suicide rate increase started in 2000. Both Hospice Nurse Lynne Caulfield and E.R. Director for Central Vermont Hospital Phillip Brown addressed advances in the field of end of life care. They thought that allowing physicians to assist in bringing about the patient’s death undermined the continuation of such advances. Dr. Brown also argued that for those who are depressed and had suicidal thoughts, the possibility of having a physician assist in their suicide would become an obsession and become the only choice available in their mind.
Edward Mahoney, Ph.D. specializes in medical ethics and argued that by legislating public acceptance of suicide it makes us all complicit in the act. Far from being a private and personal decision, such legislation would make it a public matter. Furthermore, since most such laws mandate that the person opting for suicide be of sound mind, it really is putting the decision in the hands of the medical professional who makes the determination of whether the patient fits that criteria. What was once a private choice now becomes something that requires the stamp of approval from a medial professional. Giving that profession the decision making power over life and death issues is a recipe for the corruption of that profession.