Following an emotional three hours of testimony on a right-to-die bill Wednesday, state Sen. Alice Nitka (D-Windsor) shared a personal story about her mother to explain why she opposes the legislation.
At age 92, Nitka says her mother was "able bodied and still working" until one night when she fell and broke her hip. Nitka was at home covering her pepper plants to protect against an October frost. Nitka called her mother, who lived in Albany, and told her to look at the beautiful stars outside. Her mother switched the lights off to get a look and fell down in the dark.
Nitka says her mother went downhill over the next five weeks and was ultimately "eased out of life with morphine." To Nitka, that personal experience convinced her that it is not necessary to pass a law giving terminally ill Vermonters with fewer than six months to live the option of taking a fatal dose of medication.
"We already have a type of care that is easing people out of life," she says.
After collecting dust for more than a year, a right-to-die bill finally got a hearing on Wednesday before the Senate Judiciary Committee. More than 100 people packed a Statehouse hearing room for a bill that backers call "death with dignity" and opponents call "physician-assisted suicide." Committee chairman Dick Sears (D-Bennington) agreed to take testimony on the bill but predicted it likely wouldn't pass — even if it does get a vote, which is far from certain.
Sears opposes it. So do Nitka and Sen. Ann Cummings (D-Washington). That leaves only two members of the Judiciary Committee — bill cosponsors Jeanette White (D-Windham) and Diane Snelling (R-Chittenden) — who support the legislation. Nitka says she wasn't moved off her position by Wednesday's hearing, despite testimony from supporters including the architect of Oregon's right-to-die law, illustrating the long odds proponents face in getting the bill passed this year.
Despite vigorous opposition at Wednesday's hearing, support for a right-to-die bill in Vermont appears high. A Zogby poll commissioned by the main group backing the bill, Patient Choices at End of Life Vermont, in January found that Vermonters backed the legislation by a margin of 73 to 19. Among Vermonters 65 and older, the margin of support was 67 to 25. At Wednesday's hearing, though, opponents appeared to outnumber supporters 2 to 1, at least judging from their lapel stickers.
The House defeated a previous attempt to pass a right-to-die bill in 2007. But Gov. Peter Shumlin, elected in 2010, supports the bill, so backers reintroduced it in 2011 in the hope it would pass this time. At Wednesday's hearing, Shumlin's health commissioner, Dr. Harry Chen, testified by speakerphone from Washington, D.C., that the right-to-die bill was "a top priority" for the governor, who views it as "a civil rights issue that is about choice and dignity for Vermonters at the end of their lives."
Chen said he also personally supports the bill. "I have gained an understanding of the dynamics at the end of life," Chen said. "I've seen experiences that have gone well and those that have not gone well. Physicians do not have all the tools they need to allow terminally ill patients to die without needless suffering."
Ed Paquin (pictured), a former state legislator who now directs the Vermont Coalition for Disability Rights, said calling the bill "assisted suicide" is more accurate — and said the supporters' shifting terminology for the practice "shows that as people look into it, they see some of the problems." Paquin said he believes the legislation is motivated by compassion but warned it could have unintended consequences. One of them, he said, is terminally ill elderly or disabled people feeling pressure to end their lives so as not to burden their families.
"Our efforts at the end of life should be concentrated on a person's right to take or refuse treatment, to palliate their suffering and help them through a transition we are all going to go through," he said.
The star witness for Patient Choices Vermont was George Eighmey (pictured), a former Oregon state legislator and architect of that state's 14-year-old right-to-die law. Eighmey brought a raft of stats meant to show that the safeguards in Oregon's law — almost identical to provisions in the Vermont bill — have prevented the kinds of abuse that opponents fear. He said that every year, roughly 12,000 people die in Oregon of an illness that would make them eligible to use a fatal dose of medication. Of those, Eighmey said, 50 to 60 people per year actually take the medication.
In 14 years, Eighmey said the Oregon law has been amended only twice — both times to address concerns of opponents. One clarified that no individual can use the law based solely on disability. The other permitted the Catholic Church and Catholic hospitals to fire employees and evict tenants who used right-to-medicine on their property.
Eighmey sought to dispell the notion that legalizing "doctor-assisted suicide" would increase rates of teen suicide, because they view it as acceptable. In Oregon, he said, suicide rates for youth have decreased since the law went on the books in 1997.
"I lost my son six years ago to suicide," Eighmey told the committee. "I know how tragic it is. It affects me to this day. But he was mentally incompetent and chose to end his life. I will tell you it was kind of cruel because of who I am. I was told on many occasions I deserved what I got because 'you promoted this. Your children got the idea it was OK.' My son was 34 years old. We worked for 20 years to improve his mental capacity. We were unsuccessful."
Another parent whose child committed suicide testified against the right-to-die bill. Former Vermont legislator Cathy Voyer (pictured) told the committee that her son died by suicide at age 19 almost two years ago. As she choked up with emotion, Voyer urged the Senate panel she fears the bill will increase the rate of youth suicide in Vermont, already a leading cause of death for teenagers.
"I ask you today to not proceed on this bill, and if you proceed, please proceed cautiously," Voyer said. "Because the message it sends is not the message received by those in such severe emotional pain."
Dr. Diana Barnard, a Fletcher Allen Health Care doctor who was representing her own views, testified in favor of the bill. She said as medicine prolongs human life, more people are dying with "increased disease burden" and more suffering. "Some people find meaning in suffering. Some people are able to manage it. But there are people who find it unacceptable, and that's what would be addressed by this bill," she said.
Sears challenged Barnard (pictured)), saying her testimony was "completely at odds" with the Vermont Medical Society, which opposes the right-to-die bill. The Vermont Medical Society only represents some doctors in Vermont, Barnard replied, and tends to be "more conservative in their views." Echoing Nitka's experience with her mother, Barnard added, "We as physicians give meds specifically with the intent to alleviate pain and suffering. If it has another effect, like sedation or death, it is permissible because we are giving meds for the first purpose. We, as physicians, are ethically OK."
Dr. Phil Brown, the chief medical officer at Central Vermont Medical Center, testified against the bill. He said large numbers of terminally ill patients become depressed and would see assisted suicide as "the only choice." Sen. White challenge Brown's concern by noting that people suffering from depression — or anyone determined to be mentally incompetent — would not be eligible under the Vermont bill. Brown replied that "suicidality" is a "smoldering illness" that can be difficult to diagnose, leaving depressed patients vulnerable to pressures to end their own lives.
Sears adjourned the hearing with his own thoughts on the matter but without commenting on the bill's prospects.
"For me, this is a bill of conscience," he told the crowd. "Please recognize, for your legislators, this is one of those difficult bills where we try to weigh what our constituents say with what our conscience says about it. That doesn't mean that I'm right and they're wrong. Thank you all for being here. We'll make some decision about how to proceed from here."
Photo credits: Andy Bromage