Vermont doctors ponder physician-assisted suicide

The issue could be decided by a mail vote, with ballots sent to the entire state medical society membership.

By Andis Robeznieks, amednews staff. Oct. 6, 2003.

When the Vermont Medical Society meets Oct. 17-18, its members should be well prepared to debate whether the society should change its policy on physician-assisted suicide.

Society members have been discussing the issue in a series of seven medical society members-only forums held throughout the state in preparation for the discussion -- which is likely to capture the attention of Vermont legislators, who could soon take up their own debate on the issue.

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The debate was prompted by VMS members who have been advocating for Vermont to become the second state to allow physician-assisted suicide. To further that aim, they introduced a resolution calling for the society to rethink its position on the issue.

But because there are three related bills on the issue before the state Legislature, physicians are well aware of the weight their decision and the debate leading up to it could carry.

The three bills are now mired in committee. One specifically bans the practice, one is patterned after Oregon's law allowing physician-assisted suicide and one calls for the creation of an advisory commission on palliative care and pain management.

"It's quite common knowledge that legislators respect the opinion of physicians on a variety of issues," said Carmer Van Buren, MD, a retired internist from Shelburne, who submitted the resolution asking the society to rethink its position.

Hoping to avoid division

Dr. Van Buren is not asking the society to come out for or against assisted suicide, he's asking them to be neutral. "We want to avoid significant division within the medical society," said Dr. Van Buren, who favors passing a law patterned after Oregon's Death With Dignity Act. "We're saying we respect people's opinion on both sides of the issue, and all we ask is that the medical society take a neutral position and leave the decision up to the physician and their patient."

A neutral position likely would mean that the medical society would do no lobbying on any of the bills.

Another resolution seeks to uphold the society's current policy, adopted in 1997, which is against all assisted-suicide laws -- both for and against.

VMS Executive Vice President Paul Harrington said some members might seek to have the issue decided by the full membership through a mail-in vote, while others might submit amendments to the status quo resolution to make it match the AMA position, which is firmly against physician-assisted suicide.

The members-only forums have not provided much insight into the outcome of the final vote. Dr. Van Buren said he attended two forums and thought the membership appeared evenly divided among people who favored the status quo, those seeking a change and those on "the borderline" who felt people shouldn't try to force their beliefs on others.

Burlington family physician John Fogarty, MD, facilitated a forum in east central Vermont that about 80 physicians attended. He said there were many supporters of the neutral resolution, but he didn't think that represented the whole state.

"There seemed to be a fair amount of support, particularly among a large contingent of retired physicians, for the neutral position of the VMS and potentially in favor of physician-assisted suicide legislation," he said. "I can't speak for the other county panels, but my sense of previous council meetings was that there was not a lot of support from other counties [for the neutral position] and support for keeping the VMS policy as it is now."

The forums were closed to the public to provide some privacy and encourage a better exchange of opinions. "We're trying to educate our members, and we want to talk to each other and not the public at this time," Dr. Fogarty said.

About 100 to 120 doctors usually attend the VMS annual meeting, Dr. Fogarty said, and there are hopes that this issue will bring more of the group's 1,400 members to the meeting.

Dr. Fogarty agrees with the society's current policy and thinks that any legislation on the subject "is simply not needed."

"If my patient says 'I want to have this option,' my contract with that patient would be, 'I will be there for you,' not, 'Here's a prescription for you to end your life,' " he said. "At the present time, there are no laws to allow me to do that but, even if there were a law, that's something I wouldn't be comfortable with, but that doesn't mean that I would abandon them."

ADDITIONAL INFORMATION:

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Vermont Medical Society policy on physician-assisted suicide (www.vtmd.org/excel/PolicySuicide.htm)

Text of Vermont House bill 275, which makes it a crime to assist in a suicide and calls for the denial or revocation of a license if the violator is a doctor, nurse or pharmacist (www.leg.state.vt.us/docs/legdoc.cfm?url=/docs/2004/bills/intro/h-275.htm)

Text of Vermont House bill 318, patterned after Oregon's Death With Dignity Act, which allows physician-assisted suicide (www.leg.state.vt.us/docs/legdoc.cfm?url=/docs/2004/bills/intro/h-318.htm)

Text of Vermont House bill 419 calling for the creation of a palliative care and pain management advisory commission (www.leg.state.vt.us/docs/legdoc.cfm?url=/docs/2004/bills/intro/h-419.htm)