MONTPELIER — An end-of-life bill dismantled on the Senate floor earlier this year has been pieced back together in the House, where the Judiciary Committee approved legislation that would allow doctors to prescribe lethal doses of medication to terminally ill patients.
But prospects for “death with dignity” are as tenuous as ever. And while the legislation is almost certain to win passage on the House floor this week, its path through the Senate remains fraught.
Supporters of the bill are hoping for a better result in the Senate than they had in February. That’s when a 21-page bill, modeled after a 15-year-old law in Oregon, was scrapped on the floor in favor of a three-paragraph provision that essentially indemnifies doctors for supplying suffering patients with a lethal dose of pharmaceuticals.
Sen. Peter Galbraith, the Windham County Democrat who authored the amendment, said the language provides physicians with criminal immunity for the kinds of off-the-record arrangements now used to help patients pass in peace.
Galbraith’s amendment passed, thanks in part to votes from senators opposed to any kind of “physician-assisted suicide” legislation. But the original bill has been restored in the House, where lawmakers said the Galbraith amendment opened the door to abuse by eliminating the safeguards in the original bill.
Those safeguards, according to Rep. Ann Pugh, chairwoman of the House Committee on Human Services, “ensure people are competent and capable and actually at the end of their lives, and that they’re not under duress.”
“And it brings a practice that many say is happening already into an open and transparent process,” Pugh said.
The original Senate bill, and the one about to be adopted by the full House, establishes a lengthy process by which patients must establish not only that they suffer a terminal illness from which they’ll likely die in the next six months, but also that they’re of sound mind, and not under undue pressure from outside influences.
Rep. Bill Lippert, chairman of the House Judiciary Committee, said the Galbraith amendment lacks the checks and balances needed to prevent misuse and abuse of the criminal immunity offered in the bill — criminal immunity Lippert said his committee wouldn’t conceive of giving away without a process to guarantee against unintended consequences.
“The Senate provision has nothing in there that gives us assurances it will apply only to terminal patients, and that’s fundamental,” Lippert said.
“I think all of us on our committee felt the Senate version, in its current form, was completely inadequate,” he added. “… And with all due respect to our colleagues in the Senate, something done on the floor of a body doesn’t have a chance to get sufficient vetting of the kind that has been provided by our (Human Services and Judiciary) committees in the House, and by the Health and Welfare Committee in the Senate.”
But Galbraith said he remains uncomfortable with any legislation in which the state plays so central a role in determining when a doctor can and cannot hasten a patient’s death.
“I remain convinced that it is possible to accomplish patient choice, which in any event goes on extensively already, without necessarily having to have a state-prescribed procedure,” Galbraith said Friday.
Sen. Claire Ayer, chairwoman of the Senate Committee on Health and Welfare, and a lead champion of the Oregon model, said that she’s convinced Galbraith will again offer his amendment — or a version thereof — on the Senate floor. That amendment, she said, is the lone stumbling block for passage of a “death with dignity” bill in 2013.
That’s because the Galbraith amendment is dead on arrival in the House, where Lippert, Pugh and others would lobby for the defeat of the measure, even if it meant nothing would get passed this year. If the Galbraith amendment fails, however, then Ayer said she’s confident she has the 16 votes needed to pass the House version of the bill.
The vote on Galbraith’s amendment in February ended in a 15-15 tie. Lt. Gov. Phil Scott, an opponent of the underlying bill, cast the deciding vote in favor of Galbraith’s amendment.
The swing vote on the amendment this time will again likely fall to Sen. Robert Hartwell, a Bennington County Democrat who has declined to say where he’ll stand on either the amendment or the underlying bill.
Ayer said the Galbraith amendment offers an easy out to senators reluctant to come down one way or another on a divisive issue.
“For those who just don’t want to make a decision, it’s an easy way out,” Ayer said. “If that amendment is offered ... I think some people may feel like they had the same cover they felt like they had before, knowing that it has no chance in the House. And they can say, depending on who asks them, that they either supported (end-of-life choice) or didn’t support it.”
Galbraith said he sincerely wants to see something done in 2013.
“But it’s going to require compromise. It clearly can’t be an all-or-nothing proposition,” he said.
Asked whether that meant he was willing to entertain a version of the state-sanctioned vetting process outlined in the House bill, Galbraith said it did not.
“But I’m certainly open to examining safeguards, which seems to be a major concern of those who favor the Oregon model,” Galbraith said.
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