Vermont votes to allow "Death with Dignity"
Posted on Tuesday, May 14th, 2013 at 5:10 pm by Life Matters Media
The Vermont House approved a measure allowing physicians the ability to prescribe life-ending medications to some terminally ill patients seeking to end their lives. Vermont is set to become the fourth state allowing the legislation known as ”Death with Dignity,” following Oregon, Washington and Montana.
The Patient Choice and Control at End of Life Act awaits approval from Gov. Peter Shumlin, a Democrat and supporter of the bill.
“By a 75-65 roll call vote, the House approved a bill largely that copies a law passed by Oregon voters in 1997 for three years and then shifts to a system with less government monitoring,” The Associated Press reports.
This marks the first time this type of legislation has been moved to passage by a legislature. With safeguards similar to the Oregon bill, patients seeking the prescription barbiturates must first state their intentions three times- once in writing. A second opinion from a physician indicating a patient has less than six months to live and proof of sanity, are mandatory. Patients must wait 48 hours before filling the prescriptions.
“It’s an important step for terminally ill Vermont patients,” Dick Walters, president of Patient Choices-Vermont, said after the vote. “It’s a big step forward for the region and for the country as a whole,” the AP reports.
Come 2016, changes advocated by some of the state senators seeking less government involvement during the process will go into effect, including less monitoring from physicians.
“It’s huge,” said lobbyist Michael Sirotkin, who for years has been involved with the issue in Vermont. “I think it’s going to have a major effect on other states’ willingness to vote on this,” he told USA Today.
But not all lawmakers approved of the bill’s passage. ”There can never be a dignified death using a handful of pills or a lethal cocktail,” said Rep. Carolyn Branagan, a Republican from Georgia, VT.
Other opponents were concerned about the radical changes the bill underwent while in the Senate. ”We are passing a bill that has not been vetted,” said Rep. Paul Poirier, an Independent from Barre. “Do we want to pass a bill … just accepting 100 percent what the Senate did overnight?”
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POLST form presented at Northwestern Memorial, a seminar from LMM co-founder Mary F. Mulcahy, M.D.
Posted on Thursday, May 2nd, 2013 at 3:12 pm by Life Matters Media
“The Illinois POLST form is a step in the right direction,” said Mary F. Mulcahy, a co-founder of Life Matters Media and practicing oncologist at Northwestern University, while lecturing physicians about the form Thursday at Northwestern Memorial Hospital.
In March, the Illinois POLST form was released to the public, an effort headed by the POLST Paradigm and the Chicago End-of-Life Care Coalition. This update to the Illinois DNR advance directive aims to improve the quality of life for patients at end of life.
POLSTs, Physicians Orders for Life Sustaining Treatment, are more detailed than conventional living wills and advance directives. These forms give patients the freedom to indicate preferences regarding resuscitation, intubation, intravenous antibiotics and feeding tubes. Such forms are intended for patients in their last year of life, and they can follow patients across state care settings and direct doctors to provide or withhold lifesaving treatments.
The form should be adjusted over time to fit each patient’s prognosis. “This is not a one-time thing, as patients progress the form can change,” Mulcahy said. “There should be shared decision-making between physicians and patients.” To be valid, the form must be signed by the attending physician.
In the U.S., the average patient visits the hospital more than 30 times and meets nine different physicians during the last six months of life. These patients could benefit from having their medical wishes written down and on hand; the convenience helps cut through the chaos and confusion prevalent in care settings.
POLST was developed in Oregon in the 1990s, and now 14 states have POLST programs. Twenty-eight states are considering the use of such forms.
“Hopefully this form will change the culture and get people talking and preparing for the end of life,” Mulcahy said.
Palliative care expert Andrew Thurston, M.D., agreed. “I think this is great. My hope for the POLST form is that it will clarify patients’ wishes for their end of life care, and that it helps doctors more effectively communicate with their patients,” said Thurston. “We need more open discussion, and with easier language, this form helps.”
More about POLST
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Death with Dignity: Vermont House to vote amended end of life bill
Posted on Monday, April 29th, 2013 at 4:39 pm by Life Matters Media
The Vermont House will soon vote on a more stringent version of the Senate legislation known as “Death with Dignity.” The House legislation would grant physicians the ability to prescribe life-ending drugs to some terminally ill patients; however, the bill has more caveats, such as mandatory hospice enrollment.
Several weeks ago, the Senate whittled down its 22-page bill to just two pages, simply granting doctors immunity from prosecution for supplying life-ending drugs to any terminally ill patient with less than six months to live.
But with a 7 to 4 vote, the House Human Services committee backed a new bill restoring much of the process the Senate version eliminated, such as the requirements for both oral and written requests, and a 48-hour waiting period before filling a prescription. Furthermore, it requires every prospective patient to have an advanced directive and be enrolled in hospice, VPR’s Bob Kinzel reports.
“We have all of the safeguards that they have in Oregon. We have a 15-year track record in Oregon with this law,” said Rochester Rep. Sandy Haas, a Democrat who helped overhaul the Senate’s bill.
Oregon mandates patients verbally request life-ending drugs to their physicians, followed by a 15-day waiting period and then another verbal request. Patients also must submit written requests. Then, they wait 48-hours before picking up the barbiturates.
“That bill was about doctors. The bill we passed this morning is about patients,” Haas said. “The Senate bill purports to be immunity for doctors for malpractice, basically for misprescribing, for confusing patients about what happens.”
Republican Rep. Anne Donahue from Northfield, said she worries the new version will make it easier for families to coerce loved ones into committing suicide. “A person can then wait a month or two or three or more before actually taking (the drugs),” Donahue said. “And at that point there’s absolutely no protection about coercion, family pressures, financial pressures and even whether a person still has the capacity to make that decision.”
Donahue said she favors how the Senate version limited the ability of the state to intervene once an individual committed to end his or her life. “I think that the direction that the Senate went made a huge amount of sense and didn’t have the intrusion on rights and the intrusion of the state actually sanctioning suicide,” Donahue said.
A possible vote is set for Tuesday. If passed, the bill would be kicked back to the Senate for a vote. This is the farthest this Oregon-style legislation has advanced in Vermont. Last year, a bill came before the full Senate, but it failed.
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Connecticut assisted suicide bill finally gets a hearing
Posted on Monday, April 1st, 2013 at 11:05 am by Life Matters Media
For the first time in Connecticut’s history, the General Assembly’s Public Health Committee allowed a legislative hearing about a physician-assisted suicide bill.
H.B. 6645 aims to allow physicians the ability to prescribe life-ending medications at the request of mentally competent, terminally ill patients. Patients would have to self-administer the drug.
Connecticut’s CBS affiliate reports that because Democratic State Sen. Ed Meyer of Guilford received so many phone calls supporting “Death with Dignity,” he chose to author the bill, which he insists is both compassionate and cautious.
“The bill that we’re hearing today, for example, requires two different physicians to certify under oath that the person is terminally ill, likely to die within six months and is mentally competent to make an informed decision about ending his or her life,” Meyer told WCBS 880.
Washington, Oregon and Montana have already approved the legislation known as “Death with Dignity.”
“If the legislators see the bill as providing a choice, an intelligent choice for people making an informed decision to end their life and end the misery and pain they’re going through at the end of life, I think the bill will go forward,” Meyer said.
However, the bill faces strong opposition from religious and social organizations, such as the Family Institute of Connecticut and Second Thoughts Connecticut. Such opposition could hold-up the bill’s passage.
“We will be killing our vulnerable parents and grandparents through public policy,” said Teresa Wells, a nursing home administrator, according to the Hartford Courant.
The Catholic Church has also been a vocal critic. The Church cites the lack of wait time between the necessary oral and written requests for drugs. Other states require a 15 day wait.
Meyer said he remains open to suggestions.
Proponents of the bill argue it would ensure individual freedoms at the end of life. “The deep yearning for increasing autonomy for patients themselves to have a voice, I think now it’s reaching a tipping point all across the world,” Compassion and Choices’ Barbara Coombs Lee told CBS. “I think the Baby Boomer generation has something to do with that.”
A similar bill was proposed in 2009, but it failed to garner a hearing. Connecticut has banned assisted suicide since the late 1960s.
Read the bill at Connecticut’s General Assembly Web site
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Vermont Statehouse votes "Death with Dignity"
Posted on Thursday, January 31st, 2013 at 8:50 am by Life Matters Media
The Vermont Senate Health and Welfare committee unanimously approved the bill known as “Death with Dignity,” which would allow some terminally ill patients to end their lives with prescription barbiturates, Vermont Public Radio reports.
More than 300 people gathered in the Vermont Statehouse Tuesday to voice opinions on the proposed “Death with Dignity.” The law would allow terminally ill patients to end their lives with prescription drugs.
Patients expected to live no longer than six months or less could be given a prescription for a lethal dose of barbiturates. Two physicians are needed to agree upon life expectancy. Patients also must declare their wish to die three times, once in writing, within a 15-day period.
The joint session of the Senate Health and Welfare and Judiciary committees heard testimony from both sides of the issue. The Judiciary committee has not yet voted.
Judy Murphy, who still mourns the loss of a friend who she said starved herself to death to end her suffering, came to support the act. ”Not everyone would make that choice to die. But many, including myself, would have great comfort in knowing that that option is possible,” Murphy said. “She should have had the choice of death with dignity,” WCAX reports.
“The bill simply offers end-of-life choice,” said another supporter, William Wilson. “Its presence alone is comforting,” USA Today reports.
Lynn Caulfield, a registered nurse, disagreed. ”It is a sad day in Vermont when our lawyers are asking health care professionals to help human beings to die rather than extending compassionate and respectful care to ease pain and suffering,” she said.
The act still needs to pass the House and Senate before being sent to Democratic Gov. Peter Shumlin for approval.
Earlier on Tuesday, Vermont Public Radio reported the Senate Health and Welfare Committee heard from Attorney General Bill Sorrell and former Gov. Madeleine Kunin, both support the bill.
Some opponents of the act say they fear suicide’s definition will change, including Guy Page from Barre. He asked his twenty-something son, who he said struggled with suicidal thoughts as a teenager, about his thoughts on the bill.
“His response shocked me. Shaking with anger and fear he said ‘What hypocrites. Everyday my teachers tell me that killing myself is never an option. But here they are saying that suicide is ‘okay’,” Page said.
In November, Massachusetts voted against allowing physicians to prescribe life-ending drugs to terminally ill patients. Question 2, known as “Death with Dignity,” faced strong opposition from prominent physicians and the Roman Catholic Church.
Physician-assisted suicide is legal in Oregon and Washington.
Last year, a bill came before the full Vermont Senate, but it failed.
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