Another Slippery Slope
Although I did not see the Vermont Right to Life flier that was referenced in the January 28 letters to the editor [Feedback: "Offensive Insert" and editor's note], I support a woman's right to choose. But I agree with the editorial decision to run the ad. I also agree with the editor's note that it can be a slippery slope to censor ad content. Another slippery slope? Inferring [with the line, "Remember Paris?"] that there is any comparison whatsoever between the Charlie Hebdo tragedy and some critical letters to the editor received by Seven Days.
E. Greenbush, NY
The Problem With Pot Laws
[Re "Legal Pot in Vermont? Not Yet, Say Some Top Policy Makers," January 21]: The argument for legalizing marijuana has been staring us in the face for some time now: the disparate, arbitrary, capricious and discriminatory enforcement of the laws concerning it. So a sitting Vermont judge has 40 plants in her backyard and two pounds of it in her house; the consequences to her were negligible. Had that been one of my twentysomething sons — who just happen to be black — they'd be buried deeply in prison and their lives would be ruined. Our law-enforcement authorities insist that they "have to preserve the criminal option." Preserve it for whom? Very simply, either the criminal laws apply to all or they don't apply to anybody.
Vaughn A. Carney
Du Pont Disappointment
[Re Movie Review: Foxcatcher, January 21]: I saw the movie Foxcatcher — about multimillionaire John du Pont and his tragic obsession with the U.S. Olympic wrestling team — with my husband, Gerard Colby, who is the author of the twice-suppressed exposé on the du Pont family and company. We wondered how much the movie would reveal about one of America's richest families.
While the movie had its riveting moments, we were disappointed. Rick Kisonak's review was right on: "The movie ... say[s] absolutely nothing of consequence about America, entitlement, the power of privilege, the haves and have-nots ... It offers little more than the portrait of any unstable hobbyist behaving in unstable ways ... [The movie] makes no effort to explain [the tragedy.] It comes out of nowhere, the random act of a deranged man."
Apart from the opening scene of a du Pont family foxhunt and some shots of du Pont's huge mansion, viewers have no idea what his family's enormous wealth (including a decades-old family feud over controlling the wealth) had to do with his sense of isolation, his paranoia, his collaboration with Delaware's police and his descent into madness.
For the real story, I suggest you read the recently republished and updated ebook edition of Colby's Du Pont Dynasty: Behind the Nylon Curtain. The new introduction deals extensively with John du Pont and how the family let him drift into madness with no accountability. The book is part of the Forbidden Bookshelf series published by Open Road Media.
How Many Beds?
If I read your story correctly ["Single Provider?" January 21], we get to spend $187 million for a hospital renovation that will not increase the number of beds — only the percentage of single, more expensive rooms. This project, instead of meriting a certificate of need, merits certification of fiscal insanity. The egos at that hospital are insatiable!
[Re "Good for the 'Hood," January 21]: For many years I have searched for an answer to the questions, "Who am I?" "What am I?" I have sought out therapists, shamans and gurus, all to no avail. Then, just when I thought my searching was all in vain, as I aimlessly perused a restaurant review of ArtsRiot's kitchen, there it was: "button-size bombs of fungal essence." I am now at peace. Thank you, thank you, thank you. Uh ... what kind of mushroom did you say those were? P.S. If dere's uh Pulitzer for Best Journalistic Phrase, youse guys iz a shoo-in.
Bigger = Better?
"Single Provider?" [January 21] provides readers with an overview of the University of Vermont Medical Center's voracious appetite for new facilities that comes with a price tag of $245.3 million (when adding the extraordinary $5.7 million for recent rebranding to the proposed cost of a patient tower and South Burlington facility purchase).
Not mentioned was the financial debacle associated with the last huge project on the hill, the Renaissance Project, when, some readers may recall, then-Fletcher Allen president and CEO William Boettcher failed to inform state regulators that the price tag of the 2005 version of the monolith was nearly $200 million more than the $173 million he told us it would cost. For this deception, Boettcher plea-bargained for a two-year federal prison term. To read that hospital officials are opposing at least two applicants for "interested-party status," one of which is the nurse's union, doesn't give one confidence that transparency is a guiding principle as this process begins to unfold.
Another omission in the January 21 lead story was mention of how, through a terribly imbalanced system of reimbursements, independent medical practices are being squeezed to the point that their survival is at stake. This situation was covered well in "Independent Docs Struggle to Compete With Hospitals" [October 1, 2014]. UVM Medical Center president and CEO Dr. John Brumsted, when asked about networking and partnerships, is reported to have said, "Organizations need to lose a little autonomy to gain value." There's evidence that in the field of primary care, some health outcomes, such as the rate of hospitalizations, are significantly better in very small practices. Do Vermonters want all their medical care provided by a single provider? A debate on the meaning of "value" in the context of providing quality health care will, I hope, be something that the Green Mountain Care Board can facilitate, because bigger is not always better.
Nobes is a retired physician assistant.
Last week's news story, "Last Rights: Putney Woman Becomes the Third Vermonter to End Her Life Using New Law," generated dozens of online comments — for and against Act 39, aka Vermont's death with dignity law. Here's a sampling of the discussion:
I believe our dear friend Annette Vachon was the first person in Vermont to use the death with dignity law this past October. I am overwhelmingly thankful for her ability to do so. Her decision may be one of the bravest things I've witnessed. The process has a lot of hoops and red tape. Missing from the requirements above is merely finding a pharmacist who would fill the prescription. That in and of itself was a challenge. Good luck finding a CVS or Rite Aid that will. Hospice, too, was at odds with how to handle a right-to-die candidate. It was my hope that Annette's death would help the next person through the process and maybe ease the taboos around the idea. I'm happy to finally see some dialogue on the issue. Thanks for the article.
This piece tells of a woman who had every resource in her life — she was well traveled and well educated, and had good health care, close family and friends. We will likely never hear the story of the person with no resources and no close family, as well as no access to good health care, who felt pressured by circumstances to decide to end his or her own life — or worse, pressured by an impatient, tired family member to die and get out of the way. This is scary business with a serious lack of safeguards.
I just hope this law is still in place if I ever need it.
Thanks to Terri Hallenbeck for lifting the veil over Act 39's implementation. It is good to be reminded that the law requires doctors to report only the writing of a prescription, not what happens afterward. We know what happened to only two prescriptions. We cannot verify Linda Waite-Simpson's claim that there have been two other assisted suicides in Vermont. We cannot know whether there were complications, abuse or errors. We cannot know if there are unused drugs sitting in somebody's house waiting to be stolen or taken by a child.
While I sympathize with Lake's family members and understand their need to find a kernel of good in her death, I find her sister's description of her suicide as "pretty awesome" to be disturbing. Suicide is a public-health problem. Suicide contagion is a phenomenon so well known that the World Health Organization has issued guidelines warning against the glorification or romanticizing of suicide and urging reporters to include contact information for suicide prevention agencies in articles about it.
I wish Hallenbeck had eschewed calling Lake's death "remarkable." The fact is that there are too many suicide deaths. Suicide is not remarkable, and Lake's publicized one will almost certainly contribute to making suicide more ordinary than it already is. In Oregon, non-assisted suicides began to increase three years after legalization of assisted suicide and have continued to rise at a rate consistent with contagion. I fear for readers of this article, some of whom will have depression or another disability, some of whom will be dealing with terminal diagnoses. Some will see suicide, assisted or not, as the solution to their problems. Some, less privileged than Lake, will see it as the only solution. Those people's suicides will, in the words of Lynne Vitzthum, have been "socially engineered" — not freely chosen.
Anyone who opposes this law has no idea what it means to have a terminal illness. It's one thing to believe you're going to die one day. It's quite another to know you're going to die a miserable death soon. Most people I have met deny death, one of the most basic facts of life! I think it was Plato who said that much of life is a preparation for dying. death with dignity is not suicide. It's a rational choice to a rational natural process: dying.
This is a well-written article. Kudos to Terri Hallenbeck, and condolences to Maggie Lake's family and loved ones. One thing we need to remember in the volatile debate over Act 39 is that, contrary to the spin from people like Linda Waite-Simpson of Compassion & Choices, formerly the Hemlock Society: Not everyone presented with this option will choose it voluntarily, and we must be conscious of the very real vulnerability of those people — the poor, the aged, the severely disabled, just to name a few — and the need to protect them from coercion and abuse. Dying is not an either-or proposition. There is the potential for excellent palliative care for anyone with a terminal diagnosis, and improving access to such care should be the primary focus of our legislature, not providing means to an alternate death at one's own hand. The reality is that a "dignified death," and one without severe pain, is attainable without recourse to a hastened, artificial end. The potential for harm to the vulnerable inherent in Act 39 far outweighs any arguable "good" it can possibly do.
Carrie Christofferson Handy
It will work better when there are doctors in every area of Vermont willing to be a part of this death with dignity, as well as pharmacies that are willing to fill the prescriptions written. I guess it will just take time.
Of the 71 reports of assisted suicide in Oregon in 2013, information on complications or the length of time between ingestion of the lethal drug and death was reported for only 11 people. Information on the other 60 cases is "not known," according to the Oregon Public Health Division. While Oregon has data on assisted suicide, it is incomplete and insufficient to provide a true picture of how assisted suicide really happens. Also, while it is technically accurate to say that the longest reported time between ingestion of the lethal drug and death is 104 hours, this ignores the fact that some who take the supposedly lethal drug do not die from it. Data from the Netherlands shows that 18 to 25 percent of Dutch people who take the same dose of the same drug as is used in Oregon do not die.
There is a belief that the end of life needs to be mysterious and an act of fate, rather than a carefully thought-out process. Some would prefer that individuals linger in pain, because their "time has not come," according to some deity or other similar superstition. How arrogant to claim that we know what lies within the heart, mind and decisions anyone else makes regarding their quality, future and end of their life. Most of those who oppose this law are also among those who clamor for less government, particularly when it is convenient to them. Well, it would be good if they extended that to the lives of others and allowed them the respect and autonomy to choose their own path toward an inevitable end of life.
Having lost my mother in a situation with many parallels, I wholly endorse legislation that allows the terminally ill the opportunity to pass on their own terms. She spent her final evening with two of her children and a pastor, singing hymns, with a couple of laughs and a couple of cries. But in the end, we were all blessed that she got to choose her terms, and for that, she and her family will be eternally grateful.