On January 15, 2018, the Vermont Department of Health presented its first report to the legislature and public on the implementation of the state’s physician assisted suicide law. The legislature had passed the law, Act 39, in 2013 and replaced it in 2015 with Act 27, which maintains Act 39 under “Oregon-style” regulations, including a requirement for biennial reporting.
The law has been in effect for four years, and the current report covers all of them.
There is little to say about this report, because it tells us almost nothing. The term “Oregon style”, like many of the euphemisms used in the run-up to the enactment of Act 39/27, is inaccurate, because this report contains much less information than the annual Oregon reports. Check them out here: http://www.oregon.gov/oha/PH/PROVIDERPARTNERRESOURCES/EVALUATIONRESEARCH/DEATHWITHDIGNITYACT/Pages/ar-index.aspx. It does not even tell us how many prescriptions were written and how many deaths occurred by year. True Dignity has sought, so far unsuccessfully, further information from the VT Department of Health. If this report raises questions to you, as it does to us, we urge you to call this taxpayer funded agency and ask for more information. Contact information is available online.
Here is a brief summary of the report:
52 prescriptions have been written, and 29 people (60% of those getting prescriptions) have died after taking a prescribed lethal dose of barbiturates. 83% (43) of the patients who were approved for suicide and received prescriptions had cancer and 14% (7) had ALS; the other 2 patients (3%) were approved for suicide because of unspecified “other causes”. Though the law (see Appendix C on the link to the report, given in the next paragraph) directs the Health Department to include the age, sex and date of death of the patients who received prescriptions, it does not. We expect that when and if the Health Department does call us back, it will justify this information’s not being included by a clause in Act 27 that states “as long as releasing the information complies with the Federal Health Insurance Portability and Accountability Act of 1996…”. This Act is usually called HIPAA, and it protects patient privacy. True Dignity fails to see why releasing at least the age and sex of people dying under the law would violate their privacy. No other demographic data are required to be reported.
Here is a link to the full report. It includes the name of the person at the Health Department responsible for its preparation: (https://legislature.vermont.gov/assets/Legislative-Reports/2018-Patient-Choice-Legislative-Report-12-14-17.pdf
According to the report, “100% of the death certificates listed the appropriate cause (the underlying disease) and manner of death (natural), per Act 39 requirements.” True Dignity finds this statement outrageous, and the practice it describes, falsification of the death certificates, very dangerous. Internally, the report struggles with this lie, listing the “mechanism” or “direct cause” of 29 deaths as “the patient choice prescription”; in realspeak, which must be avoided under the law’s provisions, these 29 people did not die from their disease but committed assisted suicide.
The pro-assisted suicide group Compassion and Choices says this report “proves” Act 67 is working exactly as it should, and also “applauds” the falsification of the death certificates. Why does Compassion and Choices applaud medical and state lying on official documents? We think citizens should be asking.
To True Dignity, it seems self-evident that such falsification greatly enables abuse. We are told that more than 1/3 of patients receiving prescriptions in Oregon change their minds; see https://www.deathwithdignity.org/faqs/. For whatever reason, 40% of patients who got prescriptions in VT died from their disease or mysterious “other” causes. Yet with regard to deaths that do occur, a person who suspected foul play afterwards could not get even the rudimentary information that poisoning was the true cause of death.
Add to the falsification the fact that a dead person had gone through a legal process that required him or her to announce an intention to commit suicide; such a person’s expected death would be most unlikely to arouse suspicions. Add to the falsification and the unlikelihood of suspicions the fact that the VT law (and all other US assisted suicide laws) fail to require witnesses at the time the poison is ingested. Then add the incentive to a greedy heir of life insurance companies’ being forbidden under the laws from invoking their traditional denial of benefits after a suicide. Finally give that heir the perfect weapon: a bottle of poison with instructions for using it to bring about a person’s death. The sum of these additions is a set of conditions for all kinds of abuse, including murder. Someone less malicious might delude himself that he had only “helped”; several people have admitted to “helping”, but no one has been prosecuted.
Assisted suicide laws, including the VT law, do not protect patient choice. Instead they threaten it, up to its very foundation, the right to final choice of whether to live until natural death or die by a lethal overdose previously acquired. For that reason, True Dignity finds no cause for applause or rejoicing in this report.